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BOSTON INSURANCE EMPLOYEE BENEFIT TRUST - DFE 401k Plan overview

Plan NameBOSTON INSURANCE EMPLOYEE BENEFIT TRUST - DFE
Plan identification number 501

BOSTON INSURANCE EMPLOYEE BENEFIT TRUST - DFE 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

BOSTON INSURANCE EMPLOYEE BENEFIT TRUST - DFE has sponsored the creation of one or more 401k plans.

Company Name:BOSTON INSURANCE EMPLOYEE BENEFIT TRUST - DFE
Employer identification number (EIN):042782032
NAIC Classification:525920
NAIC Description:Trusts, Estates, and Agency Accounts

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BOSTON INSURANCE EMPLOYEE BENEFIT TRUST - DFE

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01
5012021-01-01
5012020-01-01
5012019-01-01
5012018-01-01
5012017-01-01LUIS M. NUNES2018-10-11
5012016-01-01LUIS M. NUNES2017-10-12
5012015-01-01LUIS M. NUNES2016-10-14
5012014-01-01LUIS M. NUNES2015-10-15
5012013-01-01LOUIS M NUNES LUIS M. NUNES2014-10-14
5012012-01-01LOUIS M NUNES LUIS M. NUNES2013-10-15
5012011-01-01LUIS M. NUNES LUIS M. NUNES2012-10-15
5012009-01-01LUIS M. NUNES LUIS M. NUNES2010-10-15

Plan Statistics for BOSTON INSURANCE EMPLOYEE BENEFIT TRUST - DFE

401k plan membership statisitcs for BOSTON INSURANCE EMPLOYEE BENEFIT TRUST - DFE

Measure Date Value
2022: BOSTON INSURANCE EMPLOYEE BENEFIT TRUST - DFE 2022 401k membership
Total participants, beginning-of-year2022-01-0152,049
Total number of active participants reported on line 7a of the Form 55002022-01-0152,445
Number of retired or separated participants receiving benefits2022-01-01312
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-0152,757
2021: BOSTON INSURANCE EMPLOYEE BENEFIT TRUST - DFE 2021 401k membership
Total participants, beginning-of-year2021-01-0151,860
Total number of active participants reported on line 7a of the Form 55002021-01-0151,634
Number of retired or separated participants receiving benefits2021-01-01424
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-0152,058
2020: BOSTON INSURANCE EMPLOYEE BENEFIT TRUST - DFE 2020 401k membership
Total participants, beginning-of-year2020-01-0154,794
Total number of active participants reported on line 7a of the Form 55002020-01-0151,193
Number of retired or separated participants receiving benefits2020-01-01703
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-0151,896
2019: BOSTON INSURANCE EMPLOYEE BENEFIT TRUST - DFE 2019 401k membership
Total participants, beginning-of-year2019-01-0149,459
Total number of active participants reported on line 7a of the Form 55002019-01-0154,312
Number of retired or separated participants receiving benefits2019-01-01488
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-0154,800
2018: BOSTON INSURANCE EMPLOYEE BENEFIT TRUST - DFE 2018 401k membership
Total participants, beginning-of-year2018-01-0144,603
Total number of active participants reported on line 7a of the Form 55002018-01-0148,986
Number of retired or separated participants receiving benefits2018-01-01484
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-0149,470
2017: BOSTON INSURANCE EMPLOYEE BENEFIT TRUST - DFE 2017 401k membership
Total participants, beginning-of-year2017-01-0144,283
Total number of active participants reported on line 7a of the Form 55002017-01-0144,174
Number of retired or separated participants receiving benefits2017-01-01432
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-0144,606
2016: BOSTON INSURANCE EMPLOYEE BENEFIT TRUST - DFE 2016 401k membership
Total participants, beginning-of-year2016-01-0141,106
Total number of active participants reported on line 7a of the Form 55002016-01-0143,824
Number of retired or separated participants receiving benefits2016-01-01459
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-0144,283
2015: BOSTON INSURANCE EMPLOYEE BENEFIT TRUST - DFE 2015 401k membership
Total participants, beginning-of-year2015-01-0137,965
Total number of active participants reported on line 7a of the Form 55002015-01-0141,106
Number of retired or separated participants receiving benefits2015-01-01374
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-0141,480
2014: BOSTON INSURANCE EMPLOYEE BENEFIT TRUST - DFE 2014 401k membership
Total participants, beginning-of-year2014-01-0134,066
Total number of active participants reported on line 7a of the Form 55002014-01-0137,965
Number of retired or separated participants receiving benefits2014-01-01412
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-0138,377
2013: BOSTON INSURANCE EMPLOYEE BENEFIT TRUST - DFE 2013 401k membership
Total participants, beginning-of-year2013-01-0129,738
Total number of active participants reported on line 7a of the Form 55002013-01-0134,066
Number of retired or separated participants receiving benefits2013-01-01429
Total of all active and inactive participants2013-01-0134,495
2012: BOSTON INSURANCE EMPLOYEE BENEFIT TRUST - DFE 2012 401k membership
Total participants, beginning-of-year2012-01-0128,887
Total number of active participants reported on line 7a of the Form 55002012-01-0129,738
Number of retired or separated participants receiving benefits2012-01-01352
Total of all active and inactive participants2012-01-0130,090
2011: BOSTON INSURANCE EMPLOYEE BENEFIT TRUST - DFE 2011 401k membership
Total participants, beginning-of-year2011-01-0123,254
Total number of active participants reported on line 7a of the Form 55002011-01-0128,511
Number of retired or separated participants receiving benefits2011-01-01376
Total of all active and inactive participants2011-01-0128,887
2009: BOSTON INSURANCE EMPLOYEE BENEFIT TRUST - DFE 2009 401k membership
Total participants, beginning-of-year2009-01-0121,876
Total number of active participants reported on line 7a of the Form 55002009-01-0120,833
Number of retired or separated participants receiving benefits2009-01-01700
Total of all active and inactive participants2009-01-0121,533

Financial Data on BOSTON INSURANCE EMPLOYEE BENEFIT TRUST - DFE

Measure Date Value
2022 : BOSTON INSURANCE EMPLOYEE BENEFIT TRUST - DFE 2022 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$7,719,107
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$5,412,017
Total income from all sources (including contributions)2022-12-31$287,631,984
Total of all expenses incurred2022-12-31$288,076,918
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$287,405,336
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$288,040,375
Value of total assets at end of year2022-12-31$8,578,658
Value of total assets at beginning of year2022-12-31$6,716,502
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$671,582
Total interest from all sources2022-12-31$862
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$28,731
Total dividends received from registered investment company shares (eg mutual funds)2022-12-31$28,731
Administrative expenses professional fees incurred2022-12-31$66,896
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Value of other receiveables (less allowance for doubtful accounts) at end of year2022-12-31$1,779,782
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2022-12-31$630,931
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2022-12-31$7,675,715
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2022-12-31$5,306,675
Administrative expenses (other) incurred2022-12-31$31,088
Liabilities. Value of operating payables at end of year2022-12-31$43,392
Liabilities. Value of operating payables at beginning of year2022-12-31$105,342
Total non interest bearing cash at end of year2022-12-31$5,203,381
Total non interest bearing cash at beginning of year2022-12-31$3,366,159
Value of net income/loss2022-12-31$-444,934
Value of net assets at end of year (total assets less liabilities)2022-12-31$859,551
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$1,304,485
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-12-31$680,833
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-12-31$2,590,085
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2022-12-31$1,774
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2022-12-31$982
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2022-12-31$982
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2022-12-31$862
Expenses. Payments to insurance carriers foe the provision of benefits2022-12-31$287,405,336
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-12-31$-437,984
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31Yes
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$288,040,375
Employer contributions (assets) at end of year2022-12-31$912,888
Employer contributions (assets) at beginning of year2022-12-31$128,345
Contract administrator fees2022-12-31$573,598
Did the plan have assets held for investment2022-12-31Yes
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31BEERS,HAMERMAN,COHEN&BURGER,P.C.
Accountancy firm EIN2022-12-31472517893
2021 : BOSTON INSURANCE EMPLOYEE BENEFIT TRUST - DFE 2021 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$5,412,017
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$5,712,224
Total income from all sources (including contributions)2021-12-31$278,421,636
Total of all expenses incurred2021-12-31$278,809,703
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$277,627,708
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$278,335,766
Value of total assets at end of year2021-12-31$6,716,502
Value of total assets at beginning of year2021-12-31$7,404,776
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$1,181,995
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$163,799
Total dividends received from registered investment company shares (eg mutual funds)2021-12-31$163,799
Administrative expenses professional fees incurred2021-12-31$46,797
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Value of other receiveables (less allowance for doubtful accounts) at end of year2021-12-31$630,931
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2021-12-31$837,968
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2021-12-31$5,306,675
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2021-12-31$5,640,165
Administrative expenses (other) incurred2021-12-31$51,174
Liabilities. Value of operating payables at end of year2021-12-31$105,342
Liabilities. Value of operating payables at beginning of year2021-12-31$72,059
Total non interest bearing cash at end of year2021-12-31$3,366,159
Total non interest bearing cash at beginning of year2021-12-31$2,909,229
Value of net income/loss2021-12-31$-388,067
Value of net assets at end of year (total assets less liabilities)2021-12-31$1,304,485
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$1,692,552
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-12-31$2,590,085
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-12-31$2,504,214
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2021-12-31$982
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2021-12-31$992
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2021-12-31$992
Expenses. Payments to insurance carriers foe the provision of benefits2021-12-31$277,627,708
Net investment gain/loss from registered investment companies (e.g. mutual funds)2021-12-31$-77,929
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$278,335,766
Employer contributions (assets) at end of year2021-12-31$128,345
Employer contributions (assets) at beginning of year2021-12-31$1,152,373
Contract administrator fees2021-12-31$1,084,024
Did the plan have assets held for investment2021-12-31Yes
Opinion of an independent qualified public accountant for this plan2021-12-31Unqualified
Accountancy firm name2021-12-31BEERS,HAMERMAN,COHEN&BURGER,P.C.
Accountancy firm EIN2021-12-31472517893
2020 : BOSTON INSURANCE EMPLOYEE BENEFIT TRUST - DFE 2020 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2020-12-31$77,536
Total unrealized appreciation/depreciation of assets2020-12-31$77,536
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$5,712,224
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$5,767,377
Total income from all sources (including contributions)2020-12-31$286,444,276
Total of all expenses incurred2020-12-31$286,035,725
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$284,979,671
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$286,313,666
Value of total assets at end of year2020-12-31$7,404,776
Value of total assets at beginning of year2020-12-31$7,051,378
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$1,056,054
Total interest from all sources2020-12-31$3
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$53,071
Total dividends received from registered investment company shares (eg mutual funds)2020-12-31$53,071
Administrative expenses professional fees incurred2020-12-31$47,698
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Value of other receiveables (less allowance for doubtful accounts) at end of year2020-12-31$837,968
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2020-12-31$1,122,379
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2020-12-31$5,640,165
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2020-12-31$5,674,443
Administrative expenses (other) incurred2020-12-31$42,284
Liabilities. Value of operating payables at end of year2020-12-31$72,059
Liabilities. Value of operating payables at beginning of year2020-12-31$92,934
Total non interest bearing cash at end of year2020-12-31$2,909,229
Total non interest bearing cash at beginning of year2020-12-31$3,124,338
Value of net income/loss2020-12-31$408,551
Value of net assets at end of year (total assets less liabilities)2020-12-31$1,692,552
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$1,284,001
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-12-31$2,504,214
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-12-31$2,373,607
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2020-12-31$992
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2020-12-31$989
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2020-12-31$989
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2020-12-31$3
Expenses. Payments to insurance carriers foe the provision of benefits2020-12-31$284,979,671
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$286,313,666
Employer contributions (assets) at end of year2020-12-31$1,152,373
Employer contributions (assets) at beginning of year2020-12-31$430,065
Contract administrator fees2020-12-31$966,072
Did the plan have assets held for investment2020-12-31Yes
Opinion of an independent qualified public accountant for this plan2020-12-31Unqualified
Accountancy firm name2020-12-31BEER,HAMERMAN,COHEN&BURGER,P.C.
Accountancy firm EIN2020-12-31472517893
2019 : BOSTON INSURANCE EMPLOYEE BENEFIT TRUST - DFE 2019 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2019-12-31$127,880
Unrealized appreciation/depreciation of other (non real estate) assets2019-12-31$127,880
Total unrealized appreciation/depreciation of assets2019-12-31$127,880
Total unrealized appreciation/depreciation of assets2019-12-31$127,880
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$5,767,377
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$5,767,377
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$6,367,496
Total income from all sources (including contributions)2019-12-31$282,869,559
Total income from all sources (including contributions)2019-12-31$282,869,559
Total of all expenses incurred2019-12-31$282,669,202
Total of all expenses incurred2019-12-31$282,669,202
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$281,518,003
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$281,518,003
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$282,662,373
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$282,662,373
Value of total assets at end of year2019-12-31$7,051,378
Value of total assets at end of year2019-12-31$7,051,378
Value of total assets at beginning of year2019-12-31$7,451,140
Value of total assets at beginning of year2019-12-31$7,451,140
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$1,151,199
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$1,151,199
Total interest from all sources2019-12-31$19
Total interest from all sources2019-12-31$19
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$79,287
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$79,287
Total dividends received from registered investment company shares (eg mutual funds)2019-12-31$79,287
Total dividends received from registered investment company shares (eg mutual funds)2019-12-31$79,287
Administrative expenses professional fees incurred2019-12-31$46,155
Administrative expenses professional fees incurred2019-12-31$46,155
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Value of other receiveables (less allowance for doubtful accounts) at end of year2019-12-31$1,122,379
Value of other receiveables (less allowance for doubtful accounts) at end of year2019-12-31$1,122,379
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-12-31$355,292
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-12-31$355,292
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2019-12-31$5,674,443
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2019-12-31$5,674,443
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2019-12-31$6,277,764
Administrative expenses (other) incurred2019-12-31$23,462
Administrative expenses (other) incurred2019-12-31$23,462
Liabilities. Value of operating payables at end of year2019-12-31$92,934
Liabilities. Value of operating payables at beginning of year2019-12-31$89,732
Total non interest bearing cash at end of year2019-12-31$3,124,338
Total non interest bearing cash at beginning of year2019-12-31$4,505,977
Total non interest bearing cash at beginning of year2019-12-31$4,505,977
Value of net income/loss2019-12-31$200,357
Value of net income/loss2019-12-31$200,357
Value of net assets at end of year (total assets less liabilities)2019-12-31$1,284,001
Value of net assets at end of year (total assets less liabilities)2019-12-31$1,284,001
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$1,083,644
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$2,373,607
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$2,373,607
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$2,166,440
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$2,166,440
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-12-31$989
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-12-31$989
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-12-31$970
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-12-31$970
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-12-31$970
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-12-31$970
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-12-31$19
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-12-31$19
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$281,518,003
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$281,518,003
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$282,662,373
Contributions received in cash from employer2019-12-31$282,662,373
Employer contributions (assets) at end of year2019-12-31$430,065
Employer contributions (assets) at beginning of year2019-12-31$422,461
Employer contributions (assets) at beginning of year2019-12-31$422,461
Contract administrator fees2019-12-31$1,081,582
Contract administrator fees2019-12-31$1,081,582
Did the plan have assets held for investment2019-12-31Yes
Did the plan have assets held for investment2019-12-31Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31No
Opinion of an independent qualified public accountant for this plan2019-12-31Unqualified
Opinion of an independent qualified public accountant for this plan2019-12-31Unqualified
Accountancy firm name2019-12-31BEER,HAMERMAN,COHEN&BURGER,P.C.
Accountancy firm name2019-12-31BEER,HAMERMAN,COHEN&BURGER,P.C.
Accountancy firm EIN2019-12-31472517893
Accountancy firm EIN2019-12-31472517893
2018 : BOSTON INSURANCE EMPLOYEE BENEFIT TRUST - DFE 2018 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2018-12-31$-130,503
Total unrealized appreciation/depreciation of assets2018-12-31$-130,503
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$6,367,496
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$4,284,734
Total income from all sources (including contributions)2018-12-31$243,056,133
Total of all expenses incurred2018-12-31$243,463,215
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$241,968,823
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$243,115,427
Value of total assets at end of year2018-12-31$7,451,140
Value of total assets at beginning of year2018-12-31$5,775,460
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$1,494,392
Total interest from all sources2018-12-31$28
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$71,181
Total dividends received from registered investment company shares (eg mutual funds)2018-12-31$71,181
Administrative expenses professional fees incurred2018-12-31$38,473
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Value of other receiveables (less allowance for doubtful accounts) at end of year2018-12-31$355,292
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2018-12-31$1,339,132
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2018-12-31$6,277,764
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2018-12-31$4,131,245
Administrative expenses (other) incurred2018-12-31$10,716
Liabilities. Value of operating payables at end of year2018-12-31$89,732
Liabilities. Value of operating payables at beginning of year2018-12-31$153,489
Total non interest bearing cash at end of year2018-12-31$4,505,977
Total non interest bearing cash at beginning of year2018-12-31$1,761,763
Value of net income/loss2018-12-31$-407,082
Value of net assets at end of year (total assets less liabilities)2018-12-31$1,083,644
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$1,490,726
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2018-12-31$2,166,440
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-12-31$2,225,762
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2018-12-31$970
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2018-12-31$943
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2018-12-31$943
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2018-12-31$28
Expenses. Payments to insurance carriers foe the provision of benefits2018-12-31$241,968,823
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31No
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Contributions received in cash from employer2018-12-31$243,115,427
Employer contributions (assets) at end of year2018-12-31$422,461
Employer contributions (assets) at beginning of year2018-12-31$447,860
Contract administrator fees2018-12-31$1,445,203
Did the plan have assets held for investment2018-12-31Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31No
Opinion of an independent qualified public accountant for this plan2018-12-31Unqualified
Accountancy firm name2018-12-31BEER,HAMERMAN,COHEN&BURGER,P.C.
Accountancy firm EIN2018-12-31472517893
2017 : BOSTON INSURANCE EMPLOYEE BENEFIT TRUST - DFE 2017 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2017-12-31$58,412
Total unrealized appreciation/depreciation of assets2017-12-31$58,412
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$4,284,734
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$5,003,533
Total income from all sources (including contributions)2017-12-31$215,502,460
Total of all expenses incurred2017-12-31$215,614,504
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$214,208,783
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$215,360,854
Value of total assets at end of year2017-12-31$5,775,460
Value of total assets at beginning of year2017-12-31$6,606,303
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$1,405,721
Total interest from all sources2017-12-31$67
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$83,127
Total dividends received from registered investment company shares (eg mutual funds)2017-12-31$83,127
Administrative expenses professional fees incurred2017-12-31$35,201
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Value of other receiveables (less allowance for doubtful accounts) at end of year2017-12-31$1,339,132
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2017-12-31$1,411,573
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2017-12-31$4,131,245
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2017-12-31$4,852,465
Administrative expenses (other) incurred2017-12-31$77,143
Liabilities. Value of operating payables at end of year2017-12-31$153,489
Liabilities. Value of operating payables at beginning of year2017-12-31$151,068
Total non interest bearing cash at end of year2017-12-31$1,761,763
Total non interest bearing cash at beginning of year2017-12-31$2,342,211
Value of net income/loss2017-12-31$-112,044
Value of net assets at end of year (total assets less liabilities)2017-12-31$1,490,726
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$1,602,770
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2017-12-31$2,225,762
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-12-31$2,584,223
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2017-12-31$943
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2017-12-31$875
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2017-12-31$875
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2017-12-31$67
Expenses. Payments to insurance carriers foe the provision of benefits2017-12-31$214,208,783
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31Yes
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Contributions received in cash from employer2017-12-31$215,360,854
Employer contributions (assets) at end of year2017-12-31$447,860
Employer contributions (assets) at beginning of year2017-12-31$267,421
Contract administrator fees2017-12-31$1,293,377
Did the plan have assets held for investment2017-12-31Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31No
Opinion of an independent qualified public accountant for this plan2017-12-31Unqualified
Accountancy firm name2017-12-31BEER,HAMERMAN,COHEN&BURGER,P.C.
Accountancy firm EIN2017-12-31472517893
2016 : BOSTON INSURANCE EMPLOYEE BENEFIT TRUST - DFE 2016 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$5,003,533
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$4,377,877
Total income from all sources (including contributions)2016-12-31$196,235,918
Total of all expenses incurred2016-12-31$196,458,971
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$194,956,094
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$196,091,534
Value of total assets at end of year2016-12-31$6,606,303
Value of total assets at beginning of year2016-12-31$6,203,700
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$1,502,877
Total dividends received (eg from common stock, registered investment company shares)2016-12-31$123,667
Total dividends received from registered investment company shares (eg mutual funds)2016-12-31$123,667
Administrative expenses professional fees incurred2016-12-31$40,536
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Value of other receiveables (less allowance for doubtful accounts) at end of year2016-12-31$1,411,573
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2016-12-31$1,501,682
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2016-12-31$4,852,465
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2016-12-31$4,085,676
Administrative expenses (other) incurred2016-12-31$50,790
Liabilities. Value of operating payables at end of year2016-12-31$151,068
Liabilities. Value of operating payables at beginning of year2016-12-31$292,201
Total non interest bearing cash at end of year2016-12-31$2,342,211
Total non interest bearing cash at beginning of year2016-12-31$1,244,589
Value of net income/loss2016-12-31$-223,053
Value of net assets at end of year (total assets less liabilities)2016-12-31$1,602,770
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$1,825,823
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2016-12-31$2,584,223
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2016-12-31$2,939,840
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2016-12-31$875
Expenses. Payments to insurance carriers foe the provision of benefits2016-12-31$194,956,094
Net investment gain/loss from registered investment companies (e.g. mutual funds)2016-12-31$20,717
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31Yes
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Contributions received in cash from employer2016-12-31$196,091,534
Employer contributions (assets) at end of year2016-12-31$267,421
Employer contributions (assets) at beginning of year2016-12-31$517,589
Contract administrator fees2016-12-31$1,411,551
Did the plan have assets held for investment2016-12-31Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31No
Opinion of an independent qualified public accountant for this plan2016-12-31Unqualified
Accountancy firm name2016-12-31BEER,HAMERMAN,COHEN&BURGER,P.C.
Accountancy firm EIN2016-12-31472517893
2015 : BOSTON INSURANCE EMPLOYEE BENEFIT TRUST - DFE 2015 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2015-12-31$-349,892
Total unrealized appreciation/depreciation of assets2015-12-31$-349,892
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$4,377,877
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$4,863,814
Total income from all sources (including contributions)2015-12-31$167,570,718
Total of all expenses incurred2015-12-31$168,045,222
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$166,352,173
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$167,619,892
Value of total assets at end of year2015-12-31$6,203,700
Value of total assets at beginning of year2015-12-31$7,164,141
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$1,693,049
Total dividends received (eg from common stock, registered investment company shares)2015-12-31$300,718
Total dividends received from registered investment company shares (eg mutual funds)2015-12-31$300,718
Administrative expenses professional fees incurred2015-12-31$34,452
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Value of other receiveables (less allowance for doubtful accounts) at end of year2015-12-31$1,501,682
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2015-12-31$1,451,474
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2015-12-31$4,085,676
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2015-12-31$4,508,222
Administrative expenses (other) incurred2015-12-31$38,784
Liabilities. Value of operating payables at end of year2015-12-31$292,201
Liabilities. Value of operating payables at beginning of year2015-12-31$355,592
Total non interest bearing cash at end of year2015-12-31$1,244,589
Total non interest bearing cash at beginning of year2015-12-31$1,487,087
Value of net income/loss2015-12-31$-474,504
Value of net assets at end of year (total assets less liabilities)2015-12-31$1,825,823
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$2,300,327
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2015-12-31$2,939,840
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-12-31$2,989,014
Expenses. Payments to insurance carriers foe the provision of benefits2015-12-31$166,352,173
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Contributions received in cash from employer2015-12-31$167,619,892
Employer contributions (assets) at end of year2015-12-31$517,589
Employer contributions (assets) at beginning of year2015-12-31$1,236,566
Contract administrator fees2015-12-31$1,619,813
Did the plan have assets held for investment2015-12-31Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31No
Opinion of an independent qualified public accountant for this plan2015-12-31Unqualified
Accountancy firm name2015-12-31BEER,HAMERMAN,COHEN&BURGER,P.C.
Accountancy firm EIN2015-12-31472517893
2014 : BOSTON INSURANCE EMPLOYEE BENEFIT TRUST - DFE 2014 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2014-12-31$21,521
Total unrealized appreciation/depreciation of assets2014-12-31$21,521
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$4,863,814
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$4,356,129
Total income from all sources (including contributions)2014-12-31$147,370,773
Total of all expenses incurred2014-12-31$147,946,067
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$145,943,642
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$147,216,821
Value of total assets at end of year2014-12-31$7,164,141
Value of total assets at beginning of year2014-12-31$7,231,750
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$2,002,425
Total dividends received (eg from common stock, registered investment company shares)2014-12-31$132,431
Total dividends received from registered investment company shares (eg mutual funds)2014-12-31$132,431
Administrative expenses professional fees incurred2014-12-31$32,054
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Value of other receiveables (less allowance for doubtful accounts) at end of year2014-12-31$1,451,474
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2014-12-31$336,556
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2014-12-31$4,508,222
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2014-12-31$4,007,277
Administrative expenses (other) incurred2014-12-31$34,574
Liabilities. Value of operating payables at end of year2014-12-31$355,592
Liabilities. Value of operating payables at beginning of year2014-12-31$348,852
Total non interest bearing cash at end of year2014-12-31$1,487,087
Total non interest bearing cash at beginning of year2014-12-31$1,634,193
Value of net income/loss2014-12-31$-575,294
Value of net assets at end of year (total assets less liabilities)2014-12-31$2,300,327
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$2,875,621
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2014-12-31$2,989,014
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2014-12-31$3,809,988
Expenses. Payments to insurance carriers foe the provision of benefits2014-12-31$145,943,642
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31Yes
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Contributions received in cash from employer2014-12-31$147,216,821
Employer contributions (assets) at end of year2014-12-31$1,236,566
Employer contributions (assets) at beginning of year2014-12-31$1,451,013
Contract administrator fees2014-12-31$1,935,797
Did the plan have assets held for investment2014-12-31Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31No
Opinion of an independent qualified public accountant for this plan2014-12-31Unqualified
Accountancy firm name2014-12-31BEER,HAMERMAN,COHEN&BURGER,P.C.
Accountancy firm EIN2014-12-31472517893
2013 : BOSTON INSURANCE EMPLOYEE BENEFIT TRUST - DFE 2013 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2013-12-31$612,193
Total unrealized appreciation/depreciation of assets2013-12-31$612,193
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$4,356,129
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$3,430,481
Total income from all sources (including contributions)2013-12-31$128,389,723
Total of all expenses incurred2013-12-31$128,349,510
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$126,521,434
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$127,696,853
Value of total assets at end of year2013-12-31$7,231,750
Value of total assets at beginning of year2013-12-31$6,265,889
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$1,828,076
Total dividends received (eg from common stock, registered investment company shares)2013-12-31$80,677
Total dividends received from registered investment company shares (eg mutual funds)2013-12-31$61,890
Administrative expenses professional fees incurred2013-12-31$36,887
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Value of other receiveables (less allowance for doubtful accounts) at end of year2013-12-31$336,556
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2013-12-31$793,251
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2013-12-31$4,007,277
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2013-12-31$2,865,632
Administrative expenses (other) incurred2013-12-31$35,760
Liabilities. Value of operating payables at end of year2013-12-31$348,852
Liabilities. Value of operating payables at beginning of year2013-12-31$564,849
Total non interest bearing cash at end of year2013-12-31$1,634,193
Total non interest bearing cash at beginning of year2013-12-31$993,020
Value of net income/loss2013-12-31$40,213
Value of net assets at end of year (total assets less liabilities)2013-12-31$2,875,621
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$2,835,408
Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2013-12-31$3,809,988
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2013-12-31$2,668,255
Expenses. Payments to insurance carriers foe the provision of benefits2013-12-31$126,521,434
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31Yes
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Contributions received in cash from employer2013-12-31$127,696,853
Employer contributions (assets) at end of year2013-12-31$1,451,013
Employer contributions (assets) at beginning of year2013-12-31$435,876
Income. Dividends from common stock2013-12-31$18,787
Contract administrator fees2013-12-31$1,755,429
Assets. Corporate common stocks other than exployer securities at beginning of year2013-12-31$1,375,487
Did the plan have assets held for investment2013-12-31Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31No
Opinion of an independent qualified public accountant for this plan2013-12-31Unqualified
Accountancy firm name2013-12-31BEERS, HAMERMAN & CO., P.C.
Accountancy firm EIN2013-12-31060971924
2012 : BOSTON INSURANCE EMPLOYEE BENEFIT TRUST - DFE 2012 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2012-12-31$301,889
Total unrealized appreciation/depreciation of assets2012-12-31$301,889
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$3,430,481
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$2,127,015
Total income from all sources (including contributions)2012-12-31$95,172,374
Total of all expenses incurred2012-12-31$95,892,992
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$93,547,000
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$94,754,064
Value of total assets at end of year2012-12-31$6,265,889
Value of total assets at beginning of year2012-12-31$5,683,041
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$2,345,992
Total interest from all sources2012-12-31$146
Total dividends received (eg from common stock, registered investment company shares)2012-12-31$116,275
Total dividends received from registered investment company shares (eg mutual funds)2012-12-31$75,008
Administrative expenses professional fees incurred2012-12-31$33,535
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Value of other receiveables (less allowance for doubtful accounts) at end of year2012-12-31$793,251
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2012-12-31$2,865,632
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2012-12-31$1,722,964
Administrative expenses (other) incurred2012-12-31$38,747
Liabilities. Value of operating payables at end of year2012-12-31$564,849
Liabilities. Value of operating payables at beginning of year2012-12-31$404,051
Total non interest bearing cash at end of year2012-12-31$993,020
Total non interest bearing cash at beginning of year2012-12-31$518,884
Value of net income/loss2012-12-31$-720,618
Value of net assets at end of year (total assets less liabilities)2012-12-31$2,835,408
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$3,556,026
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
Were any leases to which the plan was party in default or uncollectible2012-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2012-12-31$2,668,255
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2012-12-31$3,374,149
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2012-12-31$55,184
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2012-12-31$55,184
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2012-12-31$146
Expenses. Payments to insurance carriers foe the provision of benefits2012-12-31$93,547,000
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31No
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Contributions received in cash from employer2012-12-31$94,754,064
Employer contributions (assets) at end of year2012-12-31$435,876
Employer contributions (assets) at beginning of year2012-12-31$442,129
Income. Dividends from common stock2012-12-31$41,267
Contract administrator fees2012-12-31$2,273,710
Assets. Corporate common stocks other than exployer securities at end of year2012-12-31$1,375,487
Assets. Corporate common stocks other than exployer securities at beginning of year2012-12-31$1,292,695
Did the plan have assets held for investment2012-12-31Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-12-31No
Opinion of an independent qualified public accountant for this plan2012-12-31Unqualified
Accountancy firm name2012-12-31BEERS, HAMERMAN & CO., P.C.
Accountancy firm EIN2012-12-31060971924
2011 : BOSTON INSURANCE EMPLOYEE BENEFIT TRUST - DFE 2011 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2011-12-31$-279,346
Total unrealized appreciation/depreciation of assets2011-12-31$-279,346
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$2,127,015
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$2,063,102
Total income from all sources (including contributions)2011-12-31$79,819,773
Total of all expenses incurred2011-12-31$81,594,372
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$79,078,013
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$79,982,518
Value of total assets at end of year2011-12-31$5,683,041
Value of total assets at beginning of year2011-12-31$7,393,727
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$2,516,359
Total interest from all sources2011-12-31$753
Total dividends received (eg from common stock, registered investment company shares)2011-12-31$115,848
Total dividends received from registered investment company shares (eg mutual funds)2011-12-31$78,450
Administrative expenses professional fees incurred2011-12-31$40,851
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2011-12-31$17,744
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2011-12-31$1,722,964
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2011-12-31$1,520,778
Administrative expenses (other) incurred2011-12-31$62,955
Liabilities. Value of operating payables at end of year2011-12-31$404,051
Liabilities. Value of operating payables at beginning of year2011-12-31$542,324
Total non interest bearing cash at end of year2011-12-31$518,884
Total non interest bearing cash at beginning of year2011-12-31$294,112
Value of net income/loss2011-12-31$-1,774,599
Value of net assets at end of year (total assets less liabilities)2011-12-31$3,556,026
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$5,330,625
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2011-12-31$3,374,149
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2011-12-31$4,165,471
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2011-12-31$55,184
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2011-12-31$942,432
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2011-12-31$942,432
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2011-12-31$753
Expenses. Payments to insurance carriers foe the provision of benefits2011-12-31$79,078,013
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31Yes
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Contributions received in cash from employer2011-12-31$79,982,518
Employer contributions (assets) at end of year2011-12-31$442,129
Employer contributions (assets) at beginning of year2011-12-31$298,267
Income. Dividends from common stock2011-12-31$37,398
Contract administrator fees2011-12-31$2,412,553
Assets. Corporate common stocks other than exployer securities at end of year2011-12-31$1,292,695
Assets. Corporate common stocks other than exployer securities at beginning of year2011-12-31$1,675,701
Did the plan have assets held for investment2011-12-31Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31No
Opinion of an independent qualified public accountant for this plan2011-12-31Unqualified
Accountancy firm name2011-12-31BEERS, HAMERMAN & CO., P.C.
Accountancy firm EIN2011-12-31060971924
2010 : BOSTON INSURANCE EMPLOYEE BENEFIT TRUST - DFE 2010 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2010-12-31$680,968
Total unrealized appreciation/depreciation of assets2010-12-31$680,968
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$2,063,102
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$1,897,867
Total income from all sources (including contributions)2010-12-31$57,651,658
Total of all expenses incurred2010-12-31$57,884,544
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$55,679,810
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$56,767,949
Value of total assets at end of year2010-12-31$7,393,727
Value of total assets at beginning of year2010-12-31$7,461,378
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$2,204,734
Total interest from all sources2010-12-31$1,565
Total dividends received (eg from common stock, registered investment company shares)2010-12-31$201,176
Total dividends received from registered investment company shares (eg mutual funds)2010-12-31$168,353
Administrative expenses professional fees incurred2010-12-31$40,448
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Value of other receiveables (less allowance for doubtful accounts) at end of year2010-12-31$17,744
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2010-12-31$33,764
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2010-12-31$1,520,778
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2010-12-31$1,565,949
Administrative expenses (other) incurred2010-12-31$48,868
Liabilities. Value of operating payables at end of year2010-12-31$542,324
Liabilities. Value of operating payables at beginning of year2010-12-31$331,918
Total non interest bearing cash at end of year2010-12-31$294,112
Total non interest bearing cash at beginning of year2010-12-31$632,873
Value of net income/loss2010-12-31$-232,886
Value of net assets at end of year (total assets less liabilities)2010-12-31$5,330,625
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$5,563,511
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2010-12-31$4,165,471
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2010-12-31$4,136,281
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2010-12-31$942,432
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2010-12-31$484,868
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2010-12-31$484,868
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2010-12-31$1,565
Expenses. Payments to insurance carriers foe the provision of benefits2010-12-31$55,679,810
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Contributions received in cash from employer2010-12-31$56,767,949
Employer contributions (assets) at end of year2010-12-31$298,267
Employer contributions (assets) at beginning of year2010-12-31$255,742
Income. Dividends from common stock2010-12-31$32,823
Contract administrator fees2010-12-31$2,115,418
Assets. Corporate common stocks other than exployer securities at end of year2010-12-31$1,675,701
Assets. Corporate common stocks other than exployer securities at beginning of year2010-12-31$1,917,850
Did the plan have assets held for investment2010-12-31Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31No
Opinion of an independent qualified public accountant for this plan2010-12-31Unqualified
Accountancy firm name2010-12-31BEERS, HAMERMAN & CO., P.C.
Accountancy firm EIN2010-12-31060971924

Form 5500 Responses for BOSTON INSURANCE EMPLOYEE BENEFIT TRUST - DFE

2022: BOSTON INSURANCE EMPLOYEE BENEFIT TRUST - DFE 2022 form 5500 responses
2022-01-01Type of plan entityDFE (Diect Filing Entity)
2022-01-01Submission has been amendedYes
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: BOSTON INSURANCE EMPLOYEE BENEFIT TRUST - DFE 2021 form 5500 responses
2021-01-01Type of plan entityDFE (Diect Filing Entity)
2021-01-01Submission has been amendedYes
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: BOSTON INSURANCE EMPLOYEE BENEFIT TRUST - DFE 2020 form 5500 responses
2020-01-01Type of plan entityDFE (Diect Filing Entity)
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: BOSTON INSURANCE EMPLOYEE BENEFIT TRUST - DFE 2019 form 5500 responses
2019-01-01Type of plan entityDFE (Diect Filing Entity)
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: BOSTON INSURANCE EMPLOYEE BENEFIT TRUST - DFE 2018 form 5500 responses
2018-01-01Type of plan entityDFE (Diect Filing Entity)
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: BOSTON INSURANCE EMPLOYEE BENEFIT TRUST - DFE 2017 form 5500 responses
2017-01-01Type of plan entityDFE (Diect Filing Entity)
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: BOSTON INSURANCE EMPLOYEE BENEFIT TRUST - DFE 2016 form 5500 responses
2016-01-01Type of plan entityDFE (Diect Filing Entity)
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: BOSTON INSURANCE EMPLOYEE BENEFIT TRUST - DFE 2015 form 5500 responses
2015-01-01Type of plan entityDFE (Diect Filing Entity)
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: BOSTON INSURANCE EMPLOYEE BENEFIT TRUST - DFE 2014 form 5500 responses
2014-01-01Type of plan entityDFE (Diect Filing Entity)
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: BOSTON INSURANCE EMPLOYEE BENEFIT TRUST - DFE 2013 form 5500 responses
2013-01-01Type of plan entityDFE (Diect Filing Entity)
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: BOSTON INSURANCE EMPLOYEE BENEFIT TRUST - DFE 2012 form 5500 responses
2012-01-01Type of plan entityDFE (Diect Filing Entity)
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: BOSTON INSURANCE EMPLOYEE BENEFIT TRUST - DFE 2011 form 5500 responses
2011-01-01Type of plan entityDFE (Diect Filing Entity)
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2009: BOSTON INSURANCE EMPLOYEE BENEFIT TRUST - DFE 2009 form 5500 responses
2009-01-01Type of plan entityDFE (Diect Filing Entity)
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberMULTI-CONTRACTS
Policy instance 44
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1399
Insurance policy start date2021-02-01
Insurance policy end date2022-01-31
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $1,405,555
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract numberMULTI-CONTRACTS
Policy instance 45
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered17356
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $4,868
Total amount of fees paid to insurance companyUSD $78,460
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $41,925,134
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,119
Amount paid for insurance broker fees50345
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberMULTI-CONTRACTS
Policy instance 46
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered7358
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $2,510
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $8,367,573
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,510
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 47
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered4505
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Total amount of commissions paid to insurance brokerUSD $100
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,421,257
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $100
CONNECTICARE, INC. (National Association of Insurance Commissioners NAIC id number: 95675 )
Policy contract numberMULTI-CONTRACTS
Policy instance 48
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered249
Insurance policy start date2021-04-01
Insurance policy end date2022-03-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,130,162
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONNECTICARE, INC. (National Association of Insurance Commissioners NAIC id number: 95675 )
Policy contract numberMULTI-CONTRACT
Policy instance 49
Insurance contract or identification numberMULTI-CONTRACT
Number of Individuals Covered23
Insurance policy start date2021-08-01
Insurance policy end date2022-07-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $338,018
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONNECTICARE, INC. (National Association of Insurance Commissioners NAIC id number: 95675 )
Policy contract numberMULTI-CONTRACTS
Policy instance 50
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered111
Insurance policy start date2021-12-01
Insurance policy end date2022-11-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,549,324
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONNECTICARE, INC. (National Association of Insurance Commissioners NAIC id number: 95675 )
Policy contract numberMULTI-CONTRACTS
Policy instance 51
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered250
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,835,718
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONNECTICARE, INC. (National Association of Insurance Commissioners NAIC id number: 95675 )
Policy contract numberMULTI-CONTRACTS
Policy instance 52
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered126
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,613,731
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONNECTICARE, INC. (National Association of Insurance Commissioners NAIC id number: 95675 )
Policy contract numberMULTI-CONTRACTS
Policy instance 53
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered44
Insurance policy start date2021-05-01
Insurance policy end date2022-04-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $178,045
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONNECTICARE, INC. (National Association of Insurance Commissioners NAIC id number: 95675 )
Policy contract numberMULTI-CONTRACTS
Policy instance 54
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered91
Insurance policy start date2021-11-01
Insurance policy end date2022-10-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,808,499
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONNECTICARE, INC. (National Association of Insurance Commissioners NAIC id number: 95675 )
Policy contract numberMULTI-CONTRACTS
Policy instance 55
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered741
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $12,635,384
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract numberMULTI-CONTRACTS
Policy instance 56
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered140
Insurance policy start date2021-10-01
Insurance policy end date2022-09-30
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $16,207
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract number1012272
Policy instance 57
Insurance contract or identification number1012272
Number of Individuals Covered244
Insurance policy start date2021-09-01
Insurance policy end date2022-08-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $42,014
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract numberMULTI-CONTRACTS
Policy instance 58
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered117
Insurance policy start date2021-04-01
Insurance policy end date2022-03-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $11,446
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract number1018067
Policy instance 59
Insurance contract or identification number1018067
Number of Individuals Covered69
Insurance policy start date2021-08-01
Insurance policy end date2022-07-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $9,426
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract numberMULTI-CONTRACTS
Policy instance 60
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered202
Insurance policy start date2021-12-01
Insurance policy end date2022-11-30
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $22,947
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract numberMULTI-CONTRACTS
Policy instance 61
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered972
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $107,655
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract numberMULTI-CONTRACT
Policy instance 62
Insurance contract or identification numberMULTI-CONTRACT
Number of Individuals Covered332
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $43,091
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract numberMULTI-CONTRACTS
Policy instance 63
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered430
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $21,970
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract numberMULTI-CONTRACTS
Policy instance 64
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered199
Insurance policy start date2021-05-01
Insurance policy end date2022-04-30
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $19,338
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract number1019158
Policy instance 65
Insurance contract or identification number1019158
Number of Individuals Covered6
Insurance policy start date2021-11-01
Insurance policy end date2022-10-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,959
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract numberMULTI-CONTRACTS
Policy instance 66
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered64
Insurance policy start date2021-03-01
Insurance policy end date2022-02-28
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,647
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HIP INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 60094 )
Policy contract numberMULTI-CONTRACTS
Policy instance 67
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered9
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $97,410
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HIP INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 60094 )
Policy contract numberMULTI-CONTRACTS
Policy instance 68
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2
Insurance policy start date2021-10-01
Insurance policy end date2022-09-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $180,615
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )
Policy contract number006368
Policy instance 224
Insurance contract or identification number006368
Number of Individuals Covered209
Insurance policy start date2021-12-01
Insurance policy end date2022-11-30
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $14,715
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
WELLCHOICE HMO OF NEW JERSEY (National Association of Insurance Commissioners NAIC id number: 95433 )
Policy contract number300519001M
Policy instance 69
Insurance contract or identification number300519001M
Number of Individuals Covered576
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,978,969
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
WELLCHOICE HMO OF NEW JERSEY (National Association of Insurance Commissioners NAIC id number: 95433 )
Policy contract number300453001D
Policy instance 70
Insurance contract or identification number300453001D
Number of Individuals Covered119
Insurance policy start date2021-05-01
Insurance policy end date2022-04-30
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $46,191
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 71
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered3377
Insurance policy start date2021-05-01
Insurance policy end date2022-04-30
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $364,079
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 72
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1685
Insurance policy start date2021-11-01
Insurance policy end date2022-10-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $603,957
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 73
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2148
Insurance policy start date2021-10-01
Insurance policy end date2022-09-30
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $432,369
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 74
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered6036
Insurance policy start date2021-09-01
Insurance policy end date2022-08-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,262,169
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )
Policy contract numberMULTI-CONTRACTS
Policy instance 225
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1284
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $114,801
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )
Policy contract number009980
Policy instance 226
Insurance contract or identification number009980
Number of Individuals Covered361
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Total amount of commissions paid to insurance brokerUSD $536
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $44,893
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $536
AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )
Policy contract number009889
Policy instance 227
Insurance contract or identification number009889
Number of Individuals Covered114
Insurance policy start date2021-05-01
Insurance policy end date2022-04-30
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $10,200
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )
Policy contract numberMULTI-CONTRACTS
Policy instance 228
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered296
Insurance policy start date2021-10-01
Insurance policy end date2022-09-30
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $56,614
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )
Policy contract number011007
Policy instance 229
Insurance contract or identification number011007
Number of Individuals Covered227
Insurance policy start date2021-09-01
Insurance policy end date2022-08-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $28,746
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 75
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1099
Insurance policy start date2021-04-01
Insurance policy end date2022-03-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $287,286
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 76
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1384
Insurance policy start date2021-08-01
Insurance policy end date2022-07-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $338,166
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 77
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1448
Insurance policy start date2021-12-01
Insurance policy end date2022-11-30
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $284,227
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 78
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered698
Insurance policy start date2021-02-01
Insurance policy end date2022-01-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $190,313
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 79
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered6304
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $1,963,928
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 80
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1107
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $305,782
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 81
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2270
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $575,933
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 82
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1204
Insurance policy start date2021-03-01
Insurance policy end date2022-02-28
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $281,097
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract numberMULTI-CONTRACTS
Policy instance 83
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered20
Insurance policy start date2021-05-01
Insurance policy end date2022-04-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $169,926
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract numberMULTI-CONTRACTS
Policy instance 84
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered191
Insurance policy start date2021-03-01
Insurance policy end date2022-02-28
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,099,746
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract numberMULTI-CONTRACTS
Policy instance 85
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered33
Insurance policy start date2021-12-01
Insurance policy end date2022-11-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $483,897
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract numberMULTI-CONTRACTS
Policy instance 86
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered104
Insurance policy start date2021-02-01
Insurance policy end date2022-01-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,122,452
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract numberMULTI-CONTRACTS
Policy instance 87
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered260
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,818,799
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract numberMULTI-CONTRACTS
Policy instance 88
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered167
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,046,304
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 89
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2759
Insurance policy start date2021-09-01
Insurance policy end date2022-08-31
Total amount of commissions paid to insurance brokerUSD $1,844
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $382,787
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,747
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 90
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered148
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $48,031
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 91
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered892
Insurance policy start date2021-04-01
Insurance policy end date2022-03-31
Total amount of commissions paid to insurance brokerUSD $3,633
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $236,743
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,633
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 92
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered96
Insurance policy start date2021-12-01
Insurance policy end date2022-11-30
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $13,257
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 93
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered4881
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $726,118
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 94
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered677
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $770
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $43,975
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $770
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 95
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered695
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Total amount of commissions paid to insurance brokerUSD $172
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $67,997
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $172
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 96
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered903
Insurance policy start date2021-03-01
Insurance policy end date2022-02-28
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $107,073
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 97
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered898
Insurance policy start date2021-05-01
Insurance policy end date2022-04-30
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $108,046
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULT-CONTRACTS
Policy instance 98
Insurance contract or identification numberMULT-CONTRACTS
Number of Individuals Covered3611
Insurance policy start date2021-10-01
Insurance policy end date2022-09-30
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $278,785
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number383202
Policy instance 99
Insurance contract or identification number383202
Number of Individuals Covered31
Insurance policy start date2021-10-01
Insurance policy end date2022-09-30
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,217
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberMULTI-CONTRACTS
Policy instance 100
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered108
Insurance policy start date2021-12-01
Insurance policy end date2022-11-30
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $26,256
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberMULTI-CONTRACTS
Policy instance 101
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered12775
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $24,862
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,102,708
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,479
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5725509
Policy instance 102
Insurance contract or identification number5725509
Number of Individuals Covered117
Insurance policy start date2021-03-01
Insurance policy end date2022-02-28
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $26,102
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberMULTI-CONTRACTS
Policy instance 103
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered147
Insurance policy start date2021-04-01
Insurance policy end date2022-03-31
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $16,179
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberMULTI-CONTRACTS
Policy instance 104
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered409
Insurance policy start date2021-08-01
Insurance policy end date2022-07-31
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $54,106
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberMUTI-CONTRACTS
Policy instance 105
Insurance contract or identification numberMUTI-CONTRACTS
Number of Individuals Covered323
Insurance policy start date2021-12-01
Insurance policy end date2022-11-30
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $48,794
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberMULTI-CONTRACTS
Policy instance 106
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered176
Insurance policy start date2021-02-01
Insurance policy end date2022-01-31
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $11,108
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberMULTI-CONTRACTS
Policy instance 107
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered4316
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $516,362
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberMULTI-CONTRACTS
Policy instance 108
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered108
Insurance policy start date2021-11-01
Insurance policy end date2022-10-31
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,710
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberMULTI-CONTRACTS
Policy instance 109
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered537
Insurance policy start date2021-10-01
Insurance policy end date2022-09-30
Total amount of commissions paid to insurance brokerUSD $665
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $47,972
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $665
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberMULTI-CONTRACTS
Policy instance 110
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered310
Insurance policy start date2021-09-01
Insurance policy end date2022-08-31
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $43,016
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 111
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2727
Insurance policy start date2021-04-01
Insurance policy end date2022-03-31
Total amount of commissions paid to insurance brokerUSD $25,763
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $275,373
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,372
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 112
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2099
Insurance policy start date2021-08-01
Insurance policy end date2022-07-31
Total amount of commissions paid to insurance brokerUSD $36,088
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $226,605
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $18,633
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 113
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1178
Insurance policy start date2021-12-01
Insurance policy end date2022-11-30
Total amount of commissions paid to insurance brokerUSD $13,161
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $84,325
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,802
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 114
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered840
Insurance policy start date2021-02-01
Insurance policy end date2022-01-31
Total amount of commissions paid to insurance brokerUSD $8,621
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $40,788
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,633
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 115
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered12074
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $119,246
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $1,591,104
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $61,167
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 116
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2806
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $76,342
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $329,580
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $36,894
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 117
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2349
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Total amount of commissions paid to insurance brokerUSD $51,877
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $347,529
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $24,436
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 118
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered434
Insurance policy start date2021-03-01
Insurance policy end date2022-02-28
Total amount of commissions paid to insurance brokerUSD $13,362
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $52,613
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,804
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 119
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1608
Insurance policy start date2021-05-01
Insurance policy end date2022-04-30
Total amount of commissions paid to insurance brokerUSD $37,821
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $189,027
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $18,830
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 120
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered290
Insurance policy start date2021-11-01
Insurance policy end date2022-10-31
Total amount of commissions paid to insurance brokerUSD $4,918
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $23,593
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,559
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 121
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1622
Insurance policy start date2021-10-01
Insurance policy end date2022-09-30
Total amount of commissions paid to insurance brokerUSD $39,597
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $298,546
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $20,942
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 122
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2064
Insurance policy start date2021-09-01
Insurance policy end date2022-08-31
Total amount of commissions paid to insurance brokerUSD $15,890
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $293,076
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,037
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number1368741
Policy instance 123
Insurance contract or identification number1368741
Number of Individuals Covered19
Insurance policy start date2021-04-01
Insurance policy end date2022-03-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $458,975
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 124
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered83
Insurance policy start date2021-08-01
Insurance policy end date2022-07-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $517,434
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 125
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered656
Insurance policy start date2021-11-01
Insurance policy end date2022-10-31
Total amount of commissions paid to insurance brokerUSD $140,269
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,936,090
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $66,907
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 126
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered213
Insurance policy start date2021-02-01
Insurance policy end date2022-01-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,397,916
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 127
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1225
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $1,876
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $17,690,226
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,876
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 128
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered37
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $422,848
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 129
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered195
Insurance policy start date2021-03-01
Insurance policy end date2022-02-28
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,598,116
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberMULTI-CONTRACTS
Policy instance 130
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered132
Insurance policy start date2021-09-01
Insurance policy end date2022-08-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $55,797
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1127845
Policy instance 131
Insurance contract or identification number1127845
Number of Individuals Covered36
Insurance policy start date2021-04-01
Insurance policy end date2022-03-31
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,312
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1130035
Policy instance 132
Insurance contract or identification number1130035
Number of Individuals Covered54
Insurance policy start date2021-08-01
Insurance policy end date2022-07-31
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,804
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberMULTI-CONTRACTS
Policy instance 133
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered517
Insurance policy start date2021-12-01
Insurance policy end date2022-11-30
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $100,965
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1124631
Policy instance 134
Insurance contract or identification number1124631
Number of Individuals Covered117
Insurance policy start date2021-02-01
Insurance policy end date2022-01-31
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $29,534
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberMULTI-CONTRACT
Policy instance 135
Insurance contract or identification numberMULTI-CONTRACT
Number of Individuals Covered1927
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $36,945
Total amount of fees paid to insurance companyUSD $9,401
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $584,471
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,208
Amount paid for insurance broker fees9401
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberMULTI-CONTRACTS
Policy instance 136
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered207
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $36,364
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberMULTI-CONTRACTS
Policy instance 137
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered342
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $27,465
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberMULTI-CONTRACTS
Policy instance 138
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered31
Insurance policy start date2021-03-01
Insurance policy end date2022-02-28
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $9,649
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberMULTI-CONTRACTS
Policy instance 139
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered355
Insurance policy start date2021-05-01
Insurance policy end date2022-04-30
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $110,446
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberMULTI-CONTRACTS
Policy instance 140
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered879
Insurance policy start date2021-11-01
Insurance policy end date2022-10-31
Total amount of commissions paid to insurance brokerUSD $10,062
Total amount of fees paid to insurance companyUSD $2,251
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $74,870
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,297
Amount paid for insurance broker fees2251
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberMULTI-CONTRACTS
Policy instance 141
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered188
Insurance policy start date2021-10-01
Insurance policy end date2022-09-30
Total amount of commissions paid to insurance brokerUSD $111
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $42,488
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $111
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberMULTI-CONTRACTS
Policy instance 142
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered411
Insurance policy start date2021-12-01
Insurance policy end date2022-11-30
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $36,740
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberMULTI-CONTRACTS
Policy instance 143
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered5493
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $34,950
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $499,247
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,876
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberMULTI-CONTRACTS
Policy instance 144
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered52
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $40,061
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberMULTI-CONTRACTS
Policy instance 145
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered118
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $26,078
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberMULTI-CONTRACTS
Policy instance 146
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered329
Insurance policy start date2021-03-01
Insurance policy end date2022-02-28
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $9,517
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberMULTI-CONTRACTS
Policy instance 147
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered442
Insurance policy start date2021-05-01
Insurance policy end date2022-04-30
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $45,360
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberMULTI-CONTRACTS
Policy instance 148
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered496
Insurance policy start date2021-11-01
Insurance policy end date2022-10-31
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $14,927
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberMULTI-CONTRACTS
Policy instance 149
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered101
Insurance policy start date2021-10-01
Insurance policy end date2022-09-30
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $10,933
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberMULTI-CONTRACTS
Policy instance 150
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered166
Insurance policy start date2021-09-01
Insurance policy end date2022-08-31
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,077
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberMULTI-CONTRACTS
Policy instance 151
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered408
Insurance policy start date2021-04-01
Insurance policy end date2022-03-31
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $23,403
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberMULTI-CONTRACTS
Policy instance 152
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered231
Insurance policy start date2021-02-01
Insurance policy end date2022-01-31
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $62,442
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract numberMULTI-CONTRACTS
Policy instance 153
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered197
Insurance policy start date2021-08-01
Insurance policy end date2022-07-31
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $52,458
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number759671
Policy instance 154
Insurance contract or identification number759671
Number of Individuals Covered427
Insurance policy start date2021-12-01
Insurance policy end date2022-11-30
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $63,833
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number447104
Policy instance 155
Insurance contract or identification number447104
Number of Individuals Covered104
Insurance policy start date2021-02-01
Insurance policy end date2022-01-31
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $21,734
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract numberMULTI-CONTRACTS
Policy instance 156
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2290
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $342,903
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 )
Policy contract numberMULTI-CONTRACTS
Policy instance 1
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered75
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $305
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,802
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $108
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 2
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1006
Insurance policy start date2021-04-01
Insurance policy end date2022-03-31
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,246,904
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 3
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered387
Insurance policy start date2021-10-01
Insurance policy end date2022-09-30
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,649,433
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 4
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1067
Insurance policy start date2021-09-01
Insurance policy end date2022-08-31
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,109,999
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONNECTICARE, INC. (National Association of Insurance Commissioners NAIC id number: 95675 )
Policy contract numberMULTI-CONTRACTS
Policy instance 5
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered117
Insurance policy start date2021-03-01
Insurance policy end date2022-02-28
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $617,544
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONNECTICARE, INC. (National Association of Insurance Commissioners NAIC id number: 95675 )
Policy contract numberMUTLI-CONTRACTS
Policy instance 6
Insurance contract or identification numberMUTLI-CONTRACTS
Number of Individuals Covered57
Insurance policy start date2021-09-01
Insurance policy end date2022-10-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $511,069
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number62404
Policy instance 7
Insurance contract or identification number62404
Number of Individuals Covered958
Insurance policy start date2021-12-01
Insurance policy end date2022-11-30
Total amount of commissions paid to insurance brokerUSD $17,245
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $104,270
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,714
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract numberMULTI-CONTRACTS
Policy instance 157
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1777
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $59
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $277,754
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $59
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract numberMULTI-CONTRACTS
Policy instance 158
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2220
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $132,328
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number161350
Policy instance 159
Insurance contract or identification number161350
Number of Individuals Covered131
Insurance policy start date2021-03-01
Insurance policy end date2022-02-28
Total amount of commissions paid to insurance brokerUSD $3,013
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $24,431
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,871
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract numberMULTI-CONTRACTS
Policy instance 160
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered285
Insurance policy start date2021-10-01
Insurance policy end date2022-09-30
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $20,087
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69001 )
Policy contract numberMULTI-CONTRACTS
Policy instance 161
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered285
Insurance policy start date2021-10-01
Insurance policy end date2022-09-30
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $63,240
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number753145
Policy instance 162
Insurance contract or identification number753145
Number of Individuals Covered95
Insurance policy start date2021-09-01
Insurance policy end date2022-08-31
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $21,665
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract numberMULTI-CONTRACTS
Policy instance 163
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2223
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $36,024
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $418,920
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,214
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract numberMULTI-CONTRACTS
Policy instance 8
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1012
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $18,289
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $115,544
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,084
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number89957
Policy instance 9
Insurance contract or identification number89957
Number of Individuals Covered75
Insurance policy start date2021-05-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $4,502
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $30,649
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,502
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 10
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered662
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,273,916
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 11
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered7129
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $585,778
Total amount of fees paid to insurance companyUSD $12,540
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $14,793,469
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $199,848
Amount paid for insurance broker fees7500
AETNA (National Association of Insurance Commissioners NAIC id number: 78700 )
Policy contract numberMULTI-CONTRACTS
Policy instance 12
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered205
Insurance policy start date2021-12-01
Insurance policy end date2022-11-30
Total amount of commissions paid to insurance brokerUSD $417
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $382,283
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $289
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number313803
Policy instance 13
Insurance contract or identification number313803
Number of Individuals Covered48
Insurance policy start date2021-03-01
Insurance policy end date2022-02-28
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,092
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract numberMULTI-CONTRACTS
Policy instance 164
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1640
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $59,380
Total amount of fees paid to insurance companyUSD $82
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $542,924
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $20,482
Amount paid for insurance broker fees82
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract numberMULTI-CONTRACTS
Policy instance 165
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1145
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Total amount of commissions paid to insurance brokerUSD $33,013
Total amount of fees paid to insurance companyUSD $1,837
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedCRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $222,606
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,855
Amount paid for insurance broker fees1837
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number819037
Policy instance 166
Insurance contract or identification number819037
Number of Individuals Covered428
Insurance policy start date2021-03-01
Insurance policy end date2022-02-28
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $116
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract numberMULTI-CONTRACTS
Policy instance 167
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered227
Insurance policy start date2021-11-01
Insurance policy end date2022-10-31
Total amount of commissions paid to insurance brokerUSD $1,208
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $10,474
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $839
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number942021
Policy instance 168
Insurance contract or identification number942021
Number of Individuals Covered683
Insurance policy start date2021-10-01
Insurance policy end date2022-09-30
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $77,526
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number931478
Policy instance 169
Insurance contract or identification number931478
Number of Individuals Covered47
Insurance policy start date2021-09-01
Insurance policy end date2022-08-31
Total amount of commissions paid to insurance brokerUSD $25,332
Total amount of fees paid to insurance companyUSD $229
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $30,648
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,626
Amount paid for insurance broker fees229
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract numberMULTI-CONTRACTS
Policy instance 170
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1947
Insurance policy start date2021-04-01
Insurance policy end date2022-03-31
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedEAP
Welfare Benefit Premiums Paid to CarrierUSD $215,833
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract numberMULTI-CONTRACTS
Policy instance 171
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered246
Insurance policy start date2021-08-01
Insurance policy end date2022-07-31
Total amount of commissions paid to insurance brokerUSD $4,174
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $30,691
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,245
SUNLIFE FINANCIAL ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract numberMULTI-CONTRACTS
Policy instance 172
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1090
Insurance policy start date2021-12-01
Insurance policy end date2022-11-30
Total amount of commissions paid to insurance brokerUSD $12,646
Total amount of fees paid to insurance companyUSD $1,433
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedCRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $130,249
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,177
Amount paid for insurance broker fees1433
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 173
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered364
Insurance policy start date2021-02-01
Insurance policy end date2022-01-31
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $51,566
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 174
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered5795
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $487,189
Total amount of fees paid to insurance companyUSD $2,454
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $16,192,972
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $29,601
Amount paid for insurance broker fees2454
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 175
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1201
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $126,008
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,761,302
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $104,114
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 176
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1826
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Total amount of commissions paid to insurance brokerUSD $121,297
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,502,847
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $82,882
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 177
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2035
Insurance policy start date2021-03-01
Insurance policy end date2022-02-28
Total amount of commissions paid to insurance brokerUSD $6,486
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,348,448
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,486
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 178
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered596
Insurance policy start date2021-05-01
Insurance policy end date2022-04-30
Total amount of commissions paid to insurance brokerUSD $21
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,071,688
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $21
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 179
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered408
Insurance policy start date2021-11-01
Insurance policy end date2022-10-31
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $28,250
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 180
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered290
Insurance policy start date2021-10-01
Insurance policy end date2022-09-30
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,233,340
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 181
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered750
Insurance policy start date2021-09-01
Insurance policy end date2022-08-31
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,406,321
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 182
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered491
Insurance policy start date2021-04-01
Insurance policy end date2022-03-31
Total amount of commissions paid to insurance brokerUSD $1,526
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,328,747
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,526
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 183
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered791
Insurance policy start date2021-08-01
Insurance policy end date2022-07-31
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,225,914
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 184
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2046
Insurance policy start date2021-12-01
Insurance policy end date2022-11-30
Total amount of commissions paid to insurance brokerUSD $255,577
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,189,769
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $73,045
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract numberMULTI-CONTRACTS
Policy instance 185
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered232
Insurance policy start date2021-12-01
Insurance policy end date2022-11-30
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $30,218
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract numberMULTI-CONTRACTS
Policy instance 186
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered168
Insurance policy start date2021-02-01
Insurance policy end date2022-01-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $25,184
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 14
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1249
Insurance policy start date2021-05-01
Insurance policy end date2022-04-30
Total amount of commissions paid to insurance brokerUSD $4,152
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $380,206
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,488
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 15
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered77
Insurance policy start date2021-11-01
Insurance policy end date2022-10-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,574
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 16
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1393
Insurance policy start date2021-10-01
Insurance policy end date2022-09-30
Total amount of commissions paid to insurance brokerUSD $74,451
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $600,883
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $28,682
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 17
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1624
Insurance policy start date2021-09-01
Insurance policy end date2022-08-31
Total amount of commissions paid to insurance brokerUSD $240,915
Total amount of fees paid to insurance companyUSD $45,243
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,415,395
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $187,914
Amount paid for insurance broker fees45243
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberMULTI-CONTRACTS
Policy instance 18
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered124
Insurance policy start date2021-04-01
Insurance policy end date2022-03-31
Total amount of commissions paid to insurance brokerUSD $2,642
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $30,105
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,629
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberMULTI-CONTRACTS
Policy instance 19
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered75
Insurance policy start date2021-09-01
Insurance policy end date2022-08-31
Total amount of commissions paid to insurance brokerUSD $4,111
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $70,216
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,605
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number26-202565
Policy instance 20
Insurance contract or identification number26-202565
Number of Individuals Covered43
Insurance policy start date2021-05-01
Insurance policy end date2022-04-30
Total amount of commissions paid to insurance brokerUSD $435
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,354
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $435
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberMULTI-CONTRACTS
Policy instance 21
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered14
Insurance policy start date2021-10-01
Insurance policy end date2022-09-30
Total amount of commissions paid to insurance brokerUSD $183
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,832
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $183
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberMULTI-CONTRACTS
Policy instance 22
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered68
Insurance policy start date2021-08-01
Insurance policy end date2022-07-31
Total amount of commissions paid to insurance brokerUSD $3,220
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $35,958
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,379
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberMULTI-CONTRACTS
Policy instance 23
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered203
Insurance policy start date2021-12-01
Insurance policy end date2022-11-30
Total amount of commissions paid to insurance brokerUSD $7,148
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $79,791
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,450
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberMULTI-CONTRACTS
Policy instance 24
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered127
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $2,974
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $49,570
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,698
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberMULTI-CONTRACTS
Policy instance 25
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered82
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $2,590
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $40,749
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,033
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberMULTI-CONTRACTS
Policy instance 26
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered125
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Total amount of commissions paid to insurance brokerUSD $1,716
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $17,161
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,356
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberMULTI-CONTRACTS
Policy instance 27
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered40
Insurance policy start date2021-03-01
Insurance policy end date2022-02-28
Total amount of commissions paid to insurance brokerUSD $806
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $8,063
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $615
ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 )
Policy contract numberMULTI-CONTRACTS
Policy instance 28
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1160
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $456,725
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 )
Policy contract numberMULTI-CONTRACTS
Policy instance 29
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered231
Insurance policy start date2021-11-01
Insurance policy end date2022-10-31
Health Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $74,908
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 )
Policy contract numberMULTI-CONTRACTS
Policy instance 30
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered387
Insurance policy start date2021-10-01
Insurance policy end date2022-09-30
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $41,608
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 )
Policy contract numberMULTI-CONTRACTS
Policy instance 31
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered103
Insurance policy start date2021-03-01
Insurance policy end date2022-02-28
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $565,325
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 )
Policy contract number801254V001
Policy instance 32
Insurance contract or identification number801254V001
Number of Individuals Covered166
Insurance policy start date2021-08-01
Insurance policy end date2022-07-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,047
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 )
Policy contract numberMULTI-CONTRACTS
Policy instance 33
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered185
Insurance policy start date2021-12-01
Insurance policy end date2022-11-30
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,057,078
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 )
Policy contract numberMULTI-CONTRACTS
Policy instance 34
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered6863
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $13,941,365
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 )
Policy contract numberMULTI-CONTRACTS
Policy instance 35
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered260
Insurance policy start date2021-05-01
Insurance policy end date2022-04-30
Health Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $512,112
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 )
Policy contract numberMULTI-CONTRACTS
Policy instance 36
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2131
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,395,590
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ARKANSAS BLUE CROSS BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 83470 )
Policy contract number111812912
Policy instance 37
Insurance contract or identification number111812912
Number of Individuals Covered247
Insurance policy start date2021-03-01
Insurance policy end date2022-02-28
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,929,272
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract numberMULTI-CONTRACTS
Policy instance 187
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1131
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $167,212
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract numberMULTI-CONTRACTS
Policy instance 188
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered420
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $49,253
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30067528
Policy instance 189
Insurance contract or identification number30067528
Number of Individuals Covered60
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,928
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract numberMULTI-CONTRACTS
Policy instance 190
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered208
Insurance policy start date2021-03-01
Insurance policy end date2022-02-28
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $26,676
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract numberMULTI-CONTRACTS
Policy instance 191
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered99
Insurance policy start date2021-05-01
Insurance policy end date2022-04-30
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $18,240
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract numberMULTI-CONTRACTS
Policy instance 192
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered140
Insurance policy start date2021-11-01
Insurance policy end date2022-10-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $16,514
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract numberMULTI-CONTRACTS
Policy instance 193
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered62
Insurance policy start date2021-10-01
Insurance policy end date2022-09-30
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,848
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONNECTICARE, INC. (National Association of Insurance Commissioners NAIC id number: 95675 )
Policy contract numberMULTI-CONTRACTS
Policy instance 38
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered24
Insurance policy start date2021-02-01
Insurance policy end date2022-01-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $185,224
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 39
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2431
Insurance policy start date2021-03-01
Insurance policy end date2022-02-28
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,539,858
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract numberMULTI-CONTRACTS
Policy instance 40
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1155
Insurance policy start date2021-05-01
Insurance policy end date2022-04-30
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,569,929
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 41
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered990
Insurance policy start date2021-11-01
Insurance policy end date2022-10-31
Total amount of commissions paid to insurance brokerUSD $14
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $2,913,415
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberMULTI-CONTRACTS
Policy instance 42
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered4065
Insurance policy start date2021-08-01
Insurance policy end date2022-07-31
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,529,298
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberMULTI-CONTRACTS
Policy instance 43
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered965
Insurance policy start date2021-12-01
Insurance policy end date2022-11-30
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,183,203
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract numberMULTI-CONTRACTS
Policy instance 194
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered60
Insurance policy start date2021-09-01
Insurance policy end date2022-08-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $10,303
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 195
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered4918
Insurance policy start date2021-10-01
Insurance policy end date2022-09-30
Total amount of commissions paid to insurance brokerUSD $28,190
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $161,403
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,295
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 196
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered634
Insurance policy start date2021-04-01
Insurance policy end date2022-03-31
Total amount of commissions paid to insurance brokerUSD $23,818
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $92,732
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,584
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 197
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered267
Insurance policy start date2021-08-01
Insurance policy end date2022-07-31
Total amount of commissions paid to insurance brokerUSD $3,759
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $17,048
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,012
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 198
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1006
Insurance policy start date2021-12-01
Insurance policy end date2022-11-30
Total amount of commissions paid to insurance brokerUSD $90,904
Total amount of fees paid to insurance companyUSD $1,726
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $183,908
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $60,323
Amount paid for insurance broker fees1726
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 199
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1305
Insurance policy start date2021-02-01
Insurance policy end date2022-01-31
Total amount of commissions paid to insurance brokerUSD $24,672
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $125,754
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,365
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 200
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1645
Insurance policy start date2021-09-01
Insurance policy end date2022-08-31
Total amount of commissions paid to insurance brokerUSD $373,262
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $1,577,276
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $214,568
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 201
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered13301
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $413,104
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $2,705,233
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $207,851
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 202
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1491
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $39,334
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $127,804
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,727
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 203
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1037
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Total amount of commissions paid to insurance brokerUSD $34,695
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $189,396
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $18,245
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 204
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered512
Insurance policy start date2021-03-01
Insurance policy end date2022-02-28
Total amount of commissions paid to insurance brokerUSD $29,200
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $115,238
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,227
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 205
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1068
Insurance policy start date2021-05-01
Insurance policy end date2022-04-30
Total amount of commissions paid to insurance brokerUSD $44,148
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $174,520
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $23,117
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI_CONTRACTS
Policy instance 206
Insurance contract or identification numberMULTI_CONTRACTS
Number of Individuals Covered1094
Insurance policy start date2021-11-01
Insurance policy end date2022-10-31
Total amount of commissions paid to insurance brokerUSD $31,682
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $157,176
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17,579
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 207
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered195
Insurance policy start date2021-03-01
Insurance policy end date2022-02-28
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,955,780
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 208
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered161
Insurance policy start date2021-05-01
Insurance policy end date2022-04-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,745,641
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 209
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered366
Insurance policy start date2021-10-01
Insurance policy end date2022-09-30
Total amount of commissions paid to insurance brokerUSD $185,310
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,142,158
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $148,673
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 210
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered21
Insurance policy start date2021-11-01
Insurance policy end date2022-10-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $342,465
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 211
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered199
Insurance policy start date2021-09-01
Insurance policy end date2022-08-31
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,923,201
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberMULTI-CONTRACTS
Policy instance 212
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered163
Insurance policy start date2021-03-01
Insurance policy end date2022-02-28
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $23,697
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberMULTI-CONTRACTS
Policy instance 213
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered42
Insurance policy start date2021-03-01
Insurance policy end date2022-02-28
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $8,078
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract numberMULTI-CONTRACTS
Policy instance 214
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered112
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $952,425
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract numberMULTI-CONTRACT
Policy instance 215
Insurance contract or identification numberMULTI-CONTRACT
Number of Individuals Covered60
Insurance policy start date2021-10-01
Insurance policy end date2022-09-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $502,108
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract numberMULTI-CONTRACTS
Policy instance 216
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered24
Insurance policy start date2021-09-01
Insurance policy end date2022-08-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $251,907
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberMULTI-CONTRACTS
Policy instance 217
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered230
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $23,786
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number707201
Policy instance 218
Insurance contract or identification number707201
Number of Individuals Covered158
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $6,162
Life Insurance Welfare BenefitYes
Other welfare benefits providedCRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $26,505
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,500
VISION BENEFITS OF AMERICA (National Association of Insurance Commissioners NAIC id number: 53953 )
Policy contract number6316
Policy instance 219
Insurance contract or identification number6316
Number of Individuals Covered12
Insurance policy start date2021-04-01
Insurance policy end date2022-03-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,437
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION BENEFITS OF AMERICA (National Association of Insurance Commissioners NAIC id number: 53953 )
Policy contract number6309
Policy instance 220
Insurance contract or identification number6309
Number of Individuals Covered25
Insurance policy start date2021-12-01
Insurance policy end date2022-11-30
Total amount of commissions paid to insurance brokerUSD $63
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,979
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $63
VISION BENEFITS OF AMERICA (National Association of Insurance Commissioners NAIC id number: 53953 )
Policy contract numberMULTI-CONTRACTS
Policy instance 221
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered759
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $197
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $64,395
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $197
VISION BENEFITS OF AMERICA (National Association of Insurance Commissioners NAIC id number: 53953 )
Policy contract numberMULTI-CONTRACTS
Policy instance 222
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered226
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $258
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $20,449
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $258
VISION BENEFITS OF AMERICA (National Association of Insurance Commissioners NAIC id number: 53953 )
Policy contract number6304
Policy instance 223
Insurance contract or identification number6304
Number of Individuals Covered32
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,696
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number0155417
Policy instance 149
Insurance contract or identification number0155417
Number of Individuals Covered197
Insurance policy start date2020-08-01
Insurance policy end date2021-07-31
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $55,799
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number759671
Policy instance 150
Insurance contract or identification number759671
Number of Individuals Covered185
Insurance policy start date2020-12-01
Insurance policy end date2021-11-30
Total amount of commissions paid to insurance brokerUSD $11,269
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $48,047
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,867
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number447104
Policy instance 151
Insurance contract or identification number447104
Number of Individuals Covered104
Insurance policy start date2020-02-01
Insurance policy end date2021-01-31
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $21,915
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract numberMULTI-CONTRACTS
Policy instance 152
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered944
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $27,447
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $172,728
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,894
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract numberMULTI-CONTRACTS
Policy instance 153
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1115
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $37,972
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $289,833
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $20,103
THE STANDARD LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 89009 )
Policy contract numberMULTI-CONTRACTS
Policy instance 154
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1941
Insurance policy start date2020-06-01
Insurance policy end date2021-05-31
Total amount of commissions paid to insurance brokerUSD $13,991
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $183,894
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,640
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number161350
Policy instance 155
Insurance contract or identification number161350
Number of Individuals Covered282
Insurance policy start date2020-03-01
Insurance policy end date2021-02-28
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $21,525
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract numberMULTI-CONTRACTS
Policy instance 156
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered4204
Insurance policy start date2020-11-01
Insurance policy end date2021-10-31
Total amount of commissions paid to insurance brokerUSD $4,460
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $107,213
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,436
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract numberMULTI-CONTRACTS
Policy instance 157
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered285
Insurance policy start date2020-10-01
Insurance policy end date2021-09-30
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $60,904
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number753145
Policy instance 158
Insurance contract or identification number753145
Number of Individuals Covered94
Insurance policy start date2020-09-01
Insurance policy end date2021-08-31
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $50,760
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract numberMULTI-CONTRACTS
Policy instance 159
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2620
Insurance policy start date2020-04-01
Insurance policy end date2021-03-31
Total amount of commissions paid to insurance brokerUSD $40,407
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedEAP
Welfare Benefit Premiums Paid to CarrierUSD $266,642
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,904
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract numberMULTI-CONTRACTS
Policy instance 160
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered219
Insurance policy start date2020-08-01
Insurance policy end date2021-07-31
Total amount of commissions paid to insurance brokerUSD $4,072
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $28,011
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,131
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract numberMULTI-CONTRACTS
Policy instance 161
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered703
Insurance policy start date2020-12-01
Insurance policy end date2021-11-30
Total amount of commissions paid to insurance brokerUSD $10,451
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $64,639
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,159
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract numberMULTI-CONTRACTS
Policy instance 162
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered819
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $20,111
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $163,206
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,877
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract numberMULTI-CONTRACTS
Policy instance 163
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1432
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $61,625
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $492,071
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $20,924
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract numberMULTI-CONTRACTS
Policy instance 164
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1080
Insurance policy start date2020-06-01
Insurance policy end date2021-05-31
Total amount of commissions paid to insurance brokerUSD $33,522
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $208,709
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,358
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number819037
Policy instance 165
Insurance contract or identification number819037
Number of Individuals Covered413
Insurance policy start date2020-03-01
Insurance policy end date2021-02-28
Total amount of commissions paid to insurance brokerUSD $11,338
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $88,946
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,534
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract numberMULTI-CONTRACTS
Policy instance 166
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered175
Insurance policy start date2020-11-01
Insurance policy end date2021-10-31
Total amount of commissions paid to insurance brokerUSD $3,938
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $40,507
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,801
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract numberMULTI-CONTRACTS
Policy instance 167
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered700
Insurance policy start date2020-10-01
Insurance policy end date2021-09-30
Total amount of commissions paid to insurance brokerUSD $8,372
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $143,544
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,434
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number931478
Policy instance 168
Insurance contract or identification number931478
Number of Individuals Covered36
Insurance policy start date2020-09-01
Insurance policy end date2021-08-31
Total amount of commissions paid to insurance brokerUSD $2,046
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $21,167
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,346
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 169
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered502
Insurance policy start date2020-04-01
Insurance policy end date2021-05-31
Total amount of commissions paid to insurance brokerUSD $572
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $971,728
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $572
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 170
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered824
Insurance policy start date2020-08-01
Insurance policy end date2021-07-31
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $434,558
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 171
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1219
Insurance policy start date2020-12-01
Insurance policy end date2021-11-30
Total amount of commissions paid to insurance brokerUSD $106,754
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,824,885
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $44,430
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 172
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered345
Insurance policy start date2020-02-01
Insurance policy end date2021-01-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $56,325
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 173
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered3364
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $31,402
Total amount of fees paid to insurance companyUSD $111,489
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,630,095
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,430
Amount paid for insurance broker fees86607
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 174
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1469
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $280
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,439,248
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $280
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 175
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered813
Insurance policy start date2020-06-01
Insurance policy end date2021-05-31
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $994,891
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 176
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1926
Insurance policy start date2020-03-01
Insurance policy end date2021-02-28
Total amount of commissions paid to insurance brokerUSD $2,716
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,083,855
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,716
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 177
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered581
Insurance policy start date2020-05-01
Insurance policy end date2021-04-30
Total amount of commissions paid to insurance brokerUSD $833
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,973,712
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $833
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 178
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered657
Insurance policy start date2020-11-01
Insurance policy end date2021-10-31
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $37,135
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 )
Policy contract numberMULTI-CONTRACTS
Policy instance 1
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered72
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $290
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,493
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $106
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 2
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1069
Insurance policy start date2020-04-01
Insurance policy end date2021-03-31
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,282,035
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 3
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered308
Insurance policy start date2020-10-01
Insurance policy end date2021-09-30
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $702,532
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract numberMULTI-CONTRACTS
Policy instance 4
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1174
Insurance policy start date2020-09-01
Insurance policy end date2021-08-31
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,013,403
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONNECTICARE, INC. (National Association of Insurance Commissioners NAIC id number: 95675 )
Policy contract number1103811
Policy instance 5
Insurance contract or identification number1103811
Number of Individuals Covered67
Insurance policy start date2020-10-01
Insurance policy end date2021-09-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $470,699
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONNECTICARE, INC. (National Association of Insurance Commissioners NAIC id number: 95675 )
Policy contract numberMUTLI-CONTRACTS
Policy instance 6
Insurance contract or identification numberMUTLI-CONTRACTS
Number of Individuals Covered24
Insurance policy start date2020-09-01
Insurance policy end date2021-08-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $335,532
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number62404
Policy instance 7
Insurance contract or identification number62404
Number of Individuals Covered692
Insurance policy start date2020-12-01
Insurance policy end date2021-11-30
Dental Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $78,278
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract numberMULTI-CONTRACTS
Policy instance 8
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered659
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $87,770
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number8957
Policy instance 9
Insurance contract or identification number8957
Number of Individuals Covered130
Insurance policy start date2020-05-01
Insurance policy end date2021-04-30
Total amount of commissions paid to insurance brokerUSD $6,724
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $50,923
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,724
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 10
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered985
Insurance policy start date2020-06-01
Insurance policy end date2021-05-31
Total amount of commissions paid to insurance brokerUSD $150,937
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,697,827
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $79,575
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 11
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered8494
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $729,139
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $13,884,855
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,146
AETNA (National Association of Insurance Commissioners NAIC id number: 78700 )
Policy contract numberMULTI-CONTRACTS
Policy instance 12
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered216
Insurance policy start date2020-12-01
Insurance policy end date2021-11-30
Total amount of commissions paid to insurance brokerUSD $498
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $382,474
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $310
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number313803
Policy instance 13
Insurance contract or identification number313803
Number of Individuals Covered53
Insurance policy start date2020-03-01
Insurance policy end date2021-02-28
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,645
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 14
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1075
Insurance policy start date2020-05-01
Insurance policy end date2021-04-30
Total amount of commissions paid to insurance brokerUSD $17,466
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $909,490
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,115
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 15
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered417
Insurance policy start date2020-11-01
Insurance policy end date2021-10-31
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $790,777
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 16
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1692
Insurance policy start date2020-10-01
Insurance policy end date2021-09-30
Total amount of commissions paid to insurance brokerUSD $83,720
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $632,211
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $28,244
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number141277
Policy instance 17
Insurance contract or identification number141277
Number of Individuals Covered41
Insurance policy start date2020-09-01
Insurance policy end date2021-08-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,367
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA (National Association of Insurance Commissioners NAIC id number: 78700 )
Policy contract number223476
Policy instance 18
Insurance contract or identification number223476
Number of Individuals Covered65
Insurance policy start date2020-04-01
Insurance policy end date2021-03-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,602
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberMULTI-CONTRACTS
Policy instance 19
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered11
Insurance policy start date2020-10-01
Insurance policy end date2021-09-30
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $18,852
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberMULTI-CONTRACTS
Policy instance 20
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered87
Insurance policy start date2020-04-01
Insurance policy end date2021-03-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $11,639
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberMULTI-CONTRACTS
Policy instance 21
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered87
Insurance policy start date2020-04-01
Insurance policy end date2021-03-31
Total amount of commissions paid to insurance brokerUSD $1,165
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $11,639
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $724
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberMULTI-CONTRACTS
Policy instance 22
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered57
Insurance policy start date2020-08-01
Insurance policy end date2021-07-31
Total amount of commissions paid to insurance brokerUSD $2,608
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $31,369
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,507
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberMULTI-CONTRACTS
Policy instance 23
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered75
Insurance policy start date2020-12-01
Insurance policy end date2021-11-30
Total amount of commissions paid to insurance brokerUSD $3,220
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $35,234
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,527
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberMULTI-CONTRACTS
Policy instance 24
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered139
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $3,028
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $49,666
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,688
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number10-51084-1
Policy instance 25
Insurance contract or identification number10-51084-1
Number of Individuals Covered67
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $2,084
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $36,103
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,084
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberMULTI-CONTRACTS
Policy instance 26
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered139
Insurance policy start date2020-06-01
Insurance policy end date2021-05-31
Total amount of commissions paid to insurance brokerUSD $1,734
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $17,345
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,368
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number10-53204-1
Policy instance 27
Insurance contract or identification number10-53204-1
Number of Individuals Covered36
Insurance policy start date2020-03-01
Insurance policy end date2021-02-28
Total amount of commissions paid to insurance brokerUSD $699
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,157
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $616
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberMULTI-CONTRACTS
Policy instance 28
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered11
Insurance policy start date2020-10-01
Insurance policy end date2021-09-30
Total amount of commissions paid to insurance brokerUSD $196
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,957
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $196
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 179
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered557
Insurance policy start date2020-10-01
Insurance policy end date2021-09-30
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $527,581
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 180
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered469
Insurance policy start date2020-09-01
Insurance policy end date2021-08-31
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,215,411
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 181
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered699
Insurance policy start date2020-04-01
Insurance policy end date2021-03-31
Total amount of commissions paid to insurance brokerUSD $25,887
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $102,121
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,503
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 182
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered298
Insurance policy start date2020-08-01
Insurance policy end date2021-07-31
Total amount of commissions paid to insurance brokerUSD $6,757
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $27,405
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,196
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 183
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered827
Insurance policy start date2020-12-01
Insurance policy end date2021-11-30
Total amount of commissions paid to insurance brokerUSD $56,500
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $169,009
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $28,166
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 184
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1055
Insurance policy start date2020-02-01
Insurance policy end date2021-01-31
Total amount of commissions paid to insurance brokerUSD $24,829
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $103,432
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,170
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract numberMULTI-CONTRACTS
Policy instance 185
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered52
Insurance policy start date2020-08-01
Insurance policy end date2021-07-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,348
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract numberMULTI-CONTRACTS
Policy instance 186
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered215
Insurance policy start date2020-12-01
Insurance policy end date2021-11-30
Total amount of commissions paid to insurance brokerUSD $756
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $28,706
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $756
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30002139
Policy instance 187
Insurance contract or identification number30002139
Number of Individuals Covered113
Insurance policy start date2020-02-01
Insurance policy end date2021-01-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $18,218
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract numberMULTI-CONTRACTS
Policy instance 188
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1340
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $187,297
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract numberMULTI-CONTRACTS
Policy instance 189
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered477
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $59,085
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30067528
Policy instance 190
Insurance contract or identification number30067528
Number of Individuals Covered64
Insurance policy start date2020-06-01
Insurance policy end date2021-05-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $8,876
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract numberMULTI-CONTRACTS
Policy instance 191
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered190
Insurance policy start date2020-03-01
Insurance policy end date2021-02-28
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $25,307
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract numberMULTI-CONTRACTS
Policy instance 192
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered101
Insurance policy start date2020-05-01
Insurance policy end date2021-04-30
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $17,736
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract numberMULTI-CONTRACTS
Policy instance 193
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered77
Insurance policy start date2020-11-01
Insurance policy end date2021-10-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $8,911
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30051603
Policy instance 194
Insurance contract or identification number30051603
Number of Individuals Covered57
Insurance policy start date2020-10-01
Insurance policy end date2021-09-30
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,907
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract numberMULTI-CONTRACTS
Policy instance 195
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered85
Insurance policy start date2020-09-01
Insurance policy end date2021-08-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $11,974
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
Policy contract numberMULTI-CONTRACTS
Policy instance 196
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered232
Insurance policy start date2020-08-01
Insurance policy end date2021-07-31
Total amount of commissions paid to insurance brokerUSD $6,076
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $792,579
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,076
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
Policy contract numberMULTI-CONTRACTS
Policy instance 197
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered541
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $9,555
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $570,100
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,818
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
Policy contract numberMULTI-CONTRACTS
Policy instance 198
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered336
Insurance policy start date2020-06-01
Insurance policy end date2021-05-31
Total amount of commissions paid to insurance brokerUSD $10,247
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $134,626
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,604
ARKANSAS BLUE CROSS BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 83470 )
Policy contract number11181291
Policy instance 199
Insurance contract or identification number11181291
Number of Individuals Covered213
Insurance policy start date2020-03-01
Insurance policy end date2021-02-28
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,989,750
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 200
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered6452
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $194,853
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $977,715
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $102,553
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 201
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1382
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $36,280
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $143,008
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $19,192
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 202
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1005
Insurance policy start date2020-06-01
Insurance policy end date2021-05-31
Total amount of commissions paid to insurance brokerUSD $33,687
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $196,077
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $434
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 203
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered227
Insurance policy start date2020-03-01
Insurance policy end date2021-02-28
Total amount of commissions paid to insurance brokerUSD $25,758
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $110,405
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,641
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 204
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered796
Insurance policy start date2020-05-01
Insurance policy end date2021-04-30
Total amount of commissions paid to insurance brokerUSD $38,501
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $165,658
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $18,551
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 205
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1566
Insurance policy start date2020-11-01
Insurance policy end date2021-10-31
Total amount of commissions paid to insurance brokerUSD $18,473
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $93,613
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,773
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI_CONTRACTS
Policy instance 206
Insurance contract or identification numberMULTI_CONTRACTS
Number of Individuals Covered4325
Insurance policy start date2020-10-01
Insurance policy end date2021-09-30
Total amount of commissions paid to insurance brokerUSD $30,342
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $169,508
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,280
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 207
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1823
Insurance policy start date2020-09-01
Insurance policy end date2021-08-31
Total amount of commissions paid to insurance brokerUSD $357,289
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $1,588,674
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $194,935
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 208
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered22
Insurance policy start date2020-11-01
Insurance policy end date2021-10-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $371,780
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 )
Policy contract numberMULTI-CONTRACTS
Policy instance 29
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered621
Insurance policy start date2020-10-01
Insurance policy end date2021-09-30
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,228,807
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 )
Policy contract numberMULTI-CONTRACTS
Policy instance 30
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered911
Insurance policy start date2020-09-01
Insurance policy end date2021-08-31
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $461,646
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 )
Policy contract numberAL00006464
Policy instance 31
Insurance contract or identification numberAL00006464
Number of Individuals Covered230
Insurance policy start date2020-04-01
Insurance policy end date2021-03-31
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,706
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 )
Policy contract number801254V0
Policy instance 32
Insurance contract or identification number801254V0
Number of Individuals Covered183
Insurance policy start date2020-08-01
Insurance policy end date2021-07-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,928
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 )
Policy contract numberMULTI-CONTRACTS
Policy instance 33
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered159
Insurance policy start date2020-12-01
Insurance policy end date2021-11-30
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $182,062
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 )
Policy contract numberMULTI-CONTRACTS
Policy instance 34
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2791
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $5,295
Total amount of fees paid to insurance companyUSD $6,750
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,866,986
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,295
Amount paid for insurance broker fees1455
ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 )
Policy contract number300453
Policy instance 35
Insurance contract or identification number300453
Number of Individuals Covered242
Insurance policy start date2020-05-01
Insurance policy end date2021-04-30
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $22,738
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 )
Policy contract numberMULTI-CONTRACTS
Policy instance 36
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered637
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $184,055
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 )
Policy contract numberMULTI-CONTRACTS
Policy instance 37
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1045
Insurance policy start date2020-06-01
Insurance policy end date2021-05-31
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,059,423
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 )
Policy contract numberMULTI-CONTRACTS
Policy instance 38
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered194
Insurance policy start date2020-03-01
Insurance policy end date2021-02-28
Total amount of commissions paid to insurance brokerUSD $4,686
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $694,343
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,686
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 39
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2350
Insurance policy start date2020-03-01
Insurance policy end date2021-02-28
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,157,657
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract numberMULTI-CONTRACTS
Policy instance 40
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1673
Insurance policy start date2020-05-01
Insurance policy end date2021-04-30
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $8,232,283
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 41
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered791
Insurance policy start date2020-11-01
Insurance policy end date2021-10-31
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $3,436,197
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberMULTI-CONTRACTS
Policy instance 42
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1826
Insurance policy start date2020-08-01
Insurance policy end date2021-07-31
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,405,527
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberMULTI-CONTRACTS
Policy instance 43
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered944
Insurance policy start date2020-12-01
Insurance policy end date2021-11-30
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,013,269
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberMULTI-CONTRACTS
Policy instance 44
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1208
Insurance policy start date2020-02-01
Insurance policy end date2021-01-31
Total amount of commissions paid to insurance brokerUSD $9,710
Total amount of fees paid to insurance companyUSD $249
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $1,523,391
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,528
Amount paid for insurance broker fees249
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberMULTI-CONTRACTS
Policy instance 45
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered14095
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $4,312
Total amount of fees paid to insurance companyUSD $72,112
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $38,649,787
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees66952
Commission paid to Insurance BrokerUSD $4,312
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberMULTI-CONTRACTS
Policy instance 46
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered6576
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,924,205
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 47
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered3455
Insurance policy start date2020-06-01
Insurance policy end date2021-05-31
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,962,829
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONNECTICARE, INC. (National Association of Insurance Commissioners NAIC id number: 95675 )
Policy contract number006569
Policy instance 48
Insurance contract or identification number006569
Number of Individuals Covered59
Insurance policy start date2020-04-01
Insurance policy end date2021-03-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $524,967
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONNECTICARE, INC. (National Association of Insurance Commissioners NAIC id number: 95675 )
Policy contract number008117
Policy instance 49
Insurance contract or identification number008117
Number of Individuals Covered31
Insurance policy start date2020-08-01
Insurance policy end date2021-07-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $100,203
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONNECTICARE, INC. (National Association of Insurance Commissioners NAIC id number: 95675 )
Policy contract numberMULTI-CONTRACTS
Policy instance 50
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered166
Insurance policy start date2020-12-01
Insurance policy end date2021-11-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,747,507
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONNECTICARE, INC. (National Association of Insurance Commissioners NAIC id number: 95675 )
Policy contract numberMULTI-CONTRACTS
Policy instance 51
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered335
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,293,399
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONNECTICARE, INC. (National Association of Insurance Commissioners NAIC id number: 95675 )
Policy contract numberMULTI-CONTRACTS
Policy instance 52
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered215
Insurance policy start date2020-06-01
Insurance policy end date2021-05-31
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,186,972
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONNECTICARE, INC. (National Association of Insurance Commissioners NAIC id number: 95675 )
Policy contract numberMULTI-CONTRACTS
Policy instance 53
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered124
Insurance policy start date2020-05-01
Insurance policy end date2021-04-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $967,820
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONNECTICARE, INC. (National Association of Insurance Commissioners NAIC id number: 95675 )
Policy contract numberMULTI-CONTRACTS
Policy instance 54
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered133
Insurance policy start date2020-11-01
Insurance policy end date2021-10-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,185,152
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract number1019158
Policy instance 55
Insurance contract or identification number1019158
Number of Individuals Covered35
Insurance policy start date2020-11-01
Insurance policy end date2021-10-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,252
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract numberMULTI-CONTRACTS
Policy instance 56
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered117
Insurance policy start date2020-10-01
Insurance policy end date2021-09-30
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $15,184
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract number1012272
Policy instance 57
Insurance contract or identification number1012272
Number of Individuals Covered150
Insurance policy start date2020-09-01
Insurance policy end date2021-08-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $28,248
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract numberMULTI-CONTRACTS
Policy instance 58
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered118
Insurance policy start date2020-04-01
Insurance policy end date2021-03-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $11,998
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract number1018067
Policy instance 59
Insurance contract or identification number1018067
Number of Individuals Covered22
Insurance policy start date2020-08-01
Insurance policy end date2021-07-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,460
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract numberMULTI-CONTRACTS
Policy instance 60
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered215
Insurance policy start date2020-12-01
Insurance policy end date2021-11-30
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $22,349
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract numberMULTI-CONTRACTS
Policy instance 61
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered862
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $100,788
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract numberMULTI-CONTRACT
Policy instance 62
Insurance contract or identification numberMULTI-CONTRACT
Number of Individuals Covered356
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $736
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $47,095
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $736
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract numberMULTI-CONTRACTS
Policy instance 63
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered476
Insurance policy start date2020-06-01
Insurance policy end date2021-05-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $37,133
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract numberMULTI-CONTRACTS
Policy instance 64
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered211
Insurance policy start date2020-05-01
Insurance policy end date2021-04-30
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $20,630
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
FALLON COMMUNITY HEALTH PLAN -MEDICARE (National Association of Insurance Commissioners NAIC id number: 95541 )
Policy contract numberMULTI-CONTRACTS
Policy instance 65
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered45
Insurance policy start date2020-02-01
Insurance policy end date2021-01-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $127,273
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 )
Policy contract numberMULTI-CONTRACTS
Policy instance 66
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered50
Insurance policy start date2020-06-01
Insurance policy end date2021-05-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $275,822
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 )
Policy contract numberMULTI-CONTRACTS
Policy instance 67
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered49
Insurance policy start date2020-10-01
Insurance policy end date2021-09-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $175,856
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
WELLCHOICE HMO OF NEW JERSEY (National Association of Insurance Commissioners NAIC id number: 95433 )
Policy contract number300133
Policy instance 68
Insurance contract or identification number300133
Number of Individuals Covered54
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $499
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
WELLCHOICE HMO OF NEW JERSEY (National Association of Insurance Commissioners NAIC id number: 95433 )
Policy contract number300453
Policy instance 69
Insurance contract or identification number300453
Number of Individuals Covered67
Insurance policy start date2020-05-01
Insurance policy end date2021-04-30
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,299
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
WELLCHOICE HMO OF NEW JERSEY (National Association of Insurance Commissioners NAIC id number: 95433 )
Policy contract number300083
Policy instance 70
Insurance contract or identification number300083
Number of Individuals Covered221
Insurance policy start date2020-11-01
Insurance policy end date2021-10-31
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $14,279
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 71
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2592
Insurance policy start date2020-11-01
Insurance policy end date2021-10-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $715,309
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 72
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2204
Insurance policy start date2020-10-01
Insurance policy end date2021-09-30
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $462,952
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number1276219
Policy instance 209
Insurance contract or identification number1276219
Number of Individuals Covered161
Insurance policy start date2020-10-01
Insurance policy end date2021-09-30
Total amount of commissions paid to insurance brokerUSD $12,964
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,078,875
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,964
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 210
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered156
Insurance policy start date2020-08-01
Insurance policy end date2021-07-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,318,917
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
Policy contract numberMULTI-CONTRACTS
Policy instance 211
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered250
Insurance policy start date2020-05-01
Insurance policy end date2021-04-30
Total amount of commissions paid to insurance brokerUSD $4,463
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $52,797
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,463
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
Policy contract number04416-00001
Policy instance 212
Insurance contract or identification number04416-00001
Number of Individuals Covered65
Insurance policy start date2020-11-01
Insurance policy end date2021-10-31
Total amount of commissions paid to insurance brokerUSD $3,099
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $37,845
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,099
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
Policy contract number09631-00001
Policy instance 213
Insurance contract or identification number09631-00001
Number of Individuals Covered168
Insurance policy start date2020-10-01
Insurance policy end date2021-09-30
Total amount of commissions paid to insurance brokerUSD $11,904
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $209,665
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,904
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract numberMULTI-CONTRACTS
Policy instance 214
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered192
Insurance policy start date2020-03-01
Insurance policy end date2021-02-28
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,012,677
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract numberMULTI-CONTRACT
Policy instance 215
Insurance contract or identification numberMULTI-CONTRACT
Number of Individuals Covered282
Insurance policy start date2020-05-01
Insurance policy end date2021-04-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,786,486
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract numberMULTI-CONTRACTS
Policy instance 216
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered29
Insurance policy start date2020-09-01
Insurance policy end date2021-08-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $212,879
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number707201
Policy instance 217
Insurance contract or identification number707201
Number of Individuals Covered102
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Vision Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $13,887
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberMULTI-CONTRACTS
Policy instance 218
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered302
Insurance policy start date2020-10-01
Insurance policy end date2021-09-30
Total amount of commissions paid to insurance brokerUSD $104
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $47,160
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $104
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberMULTI-CONTRACTS
Policy instance 219
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered148
Insurance policy start date2020-09-01
Insurance policy end date2021-08-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $51,182
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION BENEFITS OF AMERICA (National Association of Insurance Commissioners NAIC id number: 53953 )
Policy contract number6309
Policy instance 220
Insurance contract or identification number6309
Number of Individuals Covered25
Insurance policy start date2020-12-01
Insurance policy end date2021-11-30
Total amount of commissions paid to insurance brokerUSD $65
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,107
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $65
VISION BENEFITS OF AMERICA (National Association of Insurance Commissioners NAIC id number: 53953 )
Policy contract numberMULTI-CONTRACTS
Policy instance 221
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered689
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $33
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $57,283
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $33
VISION BENEFITS OF AMERICA (National Association of Insurance Commissioners NAIC id number: 53953 )
Policy contract numberMULTI-CONTRACTS
Policy instance 222
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered179
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $396
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $19,140
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $331
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 73
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered4757
Insurance policy start date2020-09-01
Insurance policy end date2021-08-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,151,698
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 74
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1033
Insurance policy start date2020-04-01
Insurance policy end date2021-03-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $330,446
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 75
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered3089
Insurance policy start date2020-08-01
Insurance policy end date2021-07-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $550,360
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 76
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1578
Insurance policy start date2020-12-01
Insurance policy end date2021-11-30
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $444,072
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 77
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2660
Insurance policy start date2020-02-01
Insurance policy end date2021-01-31
Total amount of commissions paid to insurance brokerUSD $11,974
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $642,578
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,737
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 78
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered6486
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $1,758,662
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 79
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered3298
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $508,828
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 80
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered3696
Insurance policy start date2020-06-01
Insurance policy end date2021-05-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $682,081
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 81
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered888
Insurance policy start date2020-03-01
Insurance policy end date2021-02-28
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $265,162
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 82
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered4229
Insurance policy start date2020-05-01
Insurance policy end date2021-04-30
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $619,732
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract numberMULTI-CONTRACTS
Policy instance 83
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered63
Insurance policy start date2020-08-01
Insurance policy end date2021-07-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $538,509
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract numberMULTI-CONTRACTS
Policy instance 84
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered412
Insurance policy start date2020-12-01
Insurance policy end date2021-11-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,386,616
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract numberMULTI-CONTRACTS
Policy instance 85
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered88
Insurance policy start date2020-02-01
Insurance policy end date2021-01-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $683,969
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract numberMULTI-CONTRACTS
Policy instance 86
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered135
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $608,778
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract numberMULTI-CONTRACTS
Policy instance 87
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered41
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $384,461
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract numberMULTI-CONTRACTS
Policy instance 88
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered381
Insurance policy start date2020-06-01
Insurance policy end date2021-05-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,650,094
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 89
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered844
Insurance policy start date2020-04-01
Insurance policy end date2021-03-31
Total amount of commissions paid to insurance brokerUSD $3,419
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $218,838
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,419
VISION BENEFITS OF AMERICA (National Association of Insurance Commissioners NAIC id number: 53953 )
Policy contract number6304
Policy instance 223
Insurance contract or identification number6304
Number of Individuals Covered25
Insurance policy start date2020-06-01
Insurance policy end date2021-05-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,235
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 90
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered632
Insurance policy start date2020-08-01
Insurance policy end date2021-07-31
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $24,593
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 91
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered100
Insurance policy start date2020-12-01
Insurance policy end date2021-11-30
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $14,234
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 92
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered3343
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $441,038
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 93
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1458
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $991
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $177,879
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $991
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 94
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered620
Insurance policy start date2020-06-01
Insurance policy end date2021-05-31
Total amount of commissions paid to insurance brokerUSD $245
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $73,842
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $245
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 95
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered568
Insurance policy start date2020-03-01
Insurance policy end date2021-02-28
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $69,448
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 96
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered934
Insurance policy start date2020-05-01
Insurance policy end date2021-04-30
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $98,454
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 97
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered720
Insurance policy start date2020-10-01
Insurance policy end date2021-09-30
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $57,231
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULT-CONTRACTS
Policy instance 98
Insurance contract or identification numberMULT-CONTRACTS
Number of Individuals Covered1102
Insurance policy start date2020-09-01
Insurance policy end date2021-08-31
Total amount of commissions paid to insurance brokerUSD $2,445
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $172,644
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,324
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5949826
Policy instance 99
Insurance contract or identification number5949826
Number of Individuals Covered78
Insurance policy start date2020-02-01
Insurance policy end date2021-01-31
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $80,421
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberMULTI-CONTRACTS
Policy instance 100
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered8559
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $7,296
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,365,458
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,379
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberMULTI-CONTRACTS
Policy instance 101
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered121
Insurance policy start date2020-03-01
Insurance policy end date2021-02-28
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $28,997
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number383202
Policy instance 102
Insurance contract or identification number383202
Number of Individuals Covered25
Insurance policy start date2020-10-01
Insurance policy end date2021-09-30
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,525
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberMULTI-CONTRACTS
Policy instance 103
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered80
Insurance policy start date2020-08-01
Insurance policy end date2021-07-31
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,297
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberMULTI-CONTRACTS
Policy instance 104
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered97
Insurance policy start date2020-12-01
Insurance policy end date2021-11-30
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $12,149
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberMUTI-CONTRACTS
Policy instance 105
Insurance contract or identification numberMUTI-CONTRACTS
Number of Individuals Covered177
Insurance policy start date2020-02-01
Insurance policy end date2021-01-31
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $11,334
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberMULTI-CONTRACTS
Policy instance 106
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered864
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $87,582
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberMULTI-CONTRACTS
Policy instance 107
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered66
Insurance policy start date2020-11-01
Insurance policy end date2021-10-31
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,796
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberMULTI-CONTRACTS
Policy instance 108
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered498
Insurance policy start date2020-10-01
Insurance policy end date2021-09-30
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $43,542
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGL-805267
Policy instance 109
Insurance contract or identification numberGL-805267
Number of Individuals Covered88
Insurance policy start date2020-09-01
Insurance policy end date2021-08-31
Total amount of commissions paid to insurance brokerUSD $1
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $344
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 110
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2434
Insurance policy start date2020-04-01
Insurance policy end date2021-03-31
Total amount of commissions paid to insurance brokerUSD $27,069
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $286,886
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,012
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 111
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2132
Insurance policy start date2020-08-01
Insurance policy end date2021-07-31
Total amount of commissions paid to insurance brokerUSD $35,521
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $229,359
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17,389
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 112
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered151
Insurance policy start date2020-12-01
Insurance policy end date2021-11-30
Total amount of commissions paid to insurance brokerUSD $1,953
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $24,616
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,010
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 113
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered228
Insurance policy start date2020-02-01
Insurance policy end date2021-01-31
Total amount of commissions paid to insurance brokerUSD $4,099
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $8,638
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,076
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 114
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered9896
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $110,995
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $1,433,389
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $61,959
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 115
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1715
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $57,807
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $217,908
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $26,114
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 116
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1530
Insurance policy start date2020-06-01
Insurance policy end date2021-05-31
Total amount of commissions paid to insurance brokerUSD $46,448
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $228,503
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $23,177
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 117
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered559
Insurance policy start date2020-03-01
Insurance policy end date2021-02-28
Total amount of commissions paid to insurance brokerUSD $14,571
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $64,207
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,919
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 118
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2128
Insurance policy start date2020-05-01
Insurance policy end date2021-04-30
Total amount of commissions paid to insurance brokerUSD $44,597
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $241,693
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $22,735
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberG000BSBS
Policy instance 119
Insurance contract or identification numberG000BSBS
Number of Individuals Covered276
Insurance policy start date2020-11-01
Insurance policy end date2021-10-31
Total amount of commissions paid to insurance brokerUSD $4,723
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $21,250
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,598
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 120
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1033
Insurance policy start date2020-10-01
Insurance policy end date2021-09-30
Total amount of commissions paid to insurance brokerUSD $51,956
Total amount of fees paid to insurance companyUSD $20,774
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $229,682
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $32,085
Amount paid for insurance broker fees18464
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 121
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered894
Insurance policy start date2020-09-01
Insurance policy end date2021-08-31
Total amount of commissions paid to insurance brokerUSD $12,782
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $194,638
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,239
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 122
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered188
Insurance policy start date2020-04-01
Insurance policy end date2021-03-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,034,139
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 123
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered322
Insurance policy start date2020-08-01
Insurance policy end date2021-07-31
Total amount of commissions paid to insurance brokerUSD $2,340
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $155,499
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,340
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 124
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered414
Insurance policy start date2020-12-01
Insurance policy end date2021-11-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,914,049
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 125
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered285
Insurance policy start date2020-02-01
Insurance policy end date2021-01-31
Total amount of commissions paid to insurance brokerUSD $117
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,783,219
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $117
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 126
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered583
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,086,672
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 127
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered324
Insurance policy start date2020-06-01
Insurance policy end date2021-05-31
Total amount of commissions paid to insurance brokerUSD $189
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,898,423
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $189
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 128
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered201
Insurance policy start date2020-03-01
Insurance policy end date2021-02-28
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,773,416
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 129
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered309
Insurance policy start date2020-05-01
Insurance policy end date2021-04-30
Total amount of commissions paid to insurance brokerUSD $306
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,079,665
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $306
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1127845
Policy instance 130
Insurance contract or identification number1127845
Number of Individuals Covered36
Insurance policy start date2020-04-01
Insurance policy end date2021-03-31
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $18,639
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberMULTI-CONTRACTS
Policy instance 131
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered173
Insurance policy start date2020-08-01
Insurance policy end date2021-07-31
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $31,169
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberMULTI-CONTRACTS
Policy instance 132
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered272
Insurance policy start date2020-12-01
Insurance policy end date2021-11-30
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $74,765
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberMULTI-CONTRACTS
Policy instance 133
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered134
Insurance policy start date2020-02-01
Insurance policy end date2021-01-31
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $26,857
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberMULTI-CONTRACTS
Policy instance 134
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered722
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $23,989
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $109,275
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,322
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberMULTI-CONTRACT
Policy instance 135
Insurance contract or identification numberMULTI-CONTRACT
Number of Individuals Covered255
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $42,213
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberMULTI-CONTRACTS
Policy instance 136
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1578
Insurance policy start date2020-06-01
Insurance policy end date2021-05-31
Total amount of commissions paid to insurance brokerUSD $5,013
Total amount of fees paid to insurance companyUSD $453
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $96,303
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,974
Amount paid for insurance broker fees453
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberMULTI-CONTRACTS
Policy instance 137
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered323
Insurance policy start date2020-03-01
Insurance policy end date2021-02-28
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $72,304
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberMULTI-CONTRACTS
Policy instance 138
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered324
Insurance policy start date2020-05-01
Insurance policy end date2021-04-30
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $107,972
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberMULTI-CONTRACTS
Policy instance 139
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered336
Insurance policy start date2020-11-01
Insurance policy end date2021-10-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $77,339
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberMULTI-CONTRACTS
Policy instance 140
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered144
Insurance policy start date2020-04-01
Insurance policy end date2021-03-31
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $20,287
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberMULTI-CONTRACTS
Policy instance 141
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered411
Insurance policy start date2020-12-01
Insurance policy end date2021-11-30
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $47,281
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberMULTI-CONTRACTS
Policy instance 142
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered3295
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $331,026
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberMULTI-CONTRACTS
Policy instance 143
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered617
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $120,138
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberMULTI-CONTRACTS
Policy instance 144
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered133
Insurance policy start date2020-06-01
Insurance policy end date2021-05-31
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $28,131
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberMULTI-CONTRACTS
Policy instance 145
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered323
Insurance policy start date2020-03-01
Insurance policy end date2021-02-28
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $27,069
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberMULTI-CONTRACTS
Policy instance 146
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered448
Insurance policy start date2020-05-01
Insurance policy end date2021-04-30
Health Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $47,042
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberMULTI-CONTRACTS
Policy instance 147
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered112
Insurance policy start date2020-10-01
Insurance policy end date2021-09-30
Total amount of commissions paid to insurance brokerUSD $82
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $11,740
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $82
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberMULTI-CONTRACTS
Policy instance 148
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered117
Insurance policy start date2020-09-01
Insurance policy end date2021-08-31
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,050
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 )
Policy contract numberMULTI-CONTRACTS
Policy instance 1
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered137
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $463
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $8,762
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $107
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 2
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1199
Insurance policy start date2019-04-01
Insurance policy end date2020-03-31
Total amount of commissions paid to insurance brokerUSD $3,093
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,688,295
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,093
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 3
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered368
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,107,480
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract numberMULTI-CONTRACTS
Policy instance 4
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1295
Insurance policy start date2019-09-01
Insurance policy end date2020-08-31
Total amount of commissions paid to insurance brokerUSD $6,829
Total amount of fees paid to insurance companyUSD $79,580
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,057,590
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,814
Amount paid for insurance broker fees50833
CONNECTICARE, INC. (National Association of Insurance Commissioners NAIC id number: 95675 )
Policy contract number008090
Policy instance 5
Insurance contract or identification number008090
Number of Individuals Covered19
Insurance policy start date2019-05-01
Insurance policy end date2020-04-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $157,703
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONNECTICARE, INC. (National Association of Insurance Commissioners NAIC id number: 95675 )
Policy contract numberMUTLI-CONTRACTS
Policy instance 6
Insurance contract or identification numberMUTLI-CONTRACTS
Number of Individuals Covered166
Insurance policy start date2019-11-01
Insurance policy end date2020-10-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,774,986
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 7
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered10877
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $727,549
Total amount of fees paid to insurance companyUSD $9,284
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $16,404,024
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $187,655
Amount paid for insurance broker fees9284
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number617383
Policy instance 8
Insurance contract or identification number617383
Number of Individuals Covered2394
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $20,813
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $122,985
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,713
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 9
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered175
Insurance policy start date2019-04-01
Insurance policy end date2020-03-31
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $470,035
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 10
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1188
Insurance policy start date2019-06-01
Insurance policy end date2020-05-31
Total amount of commissions paid to insurance brokerUSD $64,161
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,956,358
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $64,161
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 11
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered138
Insurance policy start date2019-08-01
Insurance policy end date2020-07-31
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $596,426
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA (National Association of Insurance Commissioners NAIC id number: 78700 )
Policy contract numberMULTI-CONTRACTS
Policy instance 12
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered200
Insurance policy start date2019-12-01
Insurance policy end date2020-11-30
Total amount of commissions paid to insurance brokerUSD $294
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $333,916
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $294
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number313803
Policy instance 13
Insurance contract or identification number313803
Number of Individuals Covered52
Insurance policy start date2019-03-01
Insurance policy end date2020-04-30
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $8,355
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 14
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered372
Insurance policy start date2019-05-01
Insurance policy end date2020-04-30
Total amount of commissions paid to insurance brokerUSD $21,350
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $844,232
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,012
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 15
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered427
Insurance policy start date2019-11-01
Insurance policy end date2020-10-31
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,729,318
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 16
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2129
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Total amount of commissions paid to insurance brokerUSD $100,331
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $737,269
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $35,219
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 17
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered835
Insurance policy start date2019-09-01
Insurance policy end date2020-08-31
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,928,825
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberMULTI-CONTRACTS
Policy instance 18
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered45
Insurance policy start date2019-04-01
Insurance policy end date2020-03-31
Total amount of commissions paid to insurance brokerUSD $584
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $9,059
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $334
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number10-48556-01
Policy instance 19
Insurance contract or identification number10-48556-01
Number of Individuals Covered14
Insurance policy start date2019-08-01
Insurance policy end date2020-07-31
Total amount of commissions paid to insurance brokerUSD $888
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $9,459
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $888
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberMULTI-CONTRACTS
Policy instance 20
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered118
Insurance policy start date2019-12-01
Insurance policy end date2020-11-30
Total amount of commissions paid to insurance brokerUSD $3,318
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $37,026
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,438
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberMULTI-CONTRACTS
Policy instance 21
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered265
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $4,285
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $63,263
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,639
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number10-51084-1
Policy instance 22
Insurance contract or identification number10-51084-1
Number of Individuals Covered63
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $2,034
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $34,586
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,031
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number10-36239-39
Policy instance 23
Insurance contract or identification number10-36239-39
Number of Individuals Covered10
Insurance policy start date2019-06-01
Insurance policy end date2020-05-31
Total amount of commissions paid to insurance brokerUSD $64
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $542
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $61
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number10-35124
Policy instance 24
Insurance contract or identification number10-35124
Number of Individuals Covered27
Insurance policy start date2019-03-01
Insurance policy end date2020-02-28
Total amount of commissions paid to insurance brokerUSD $2,236
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $40,458
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,236
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberMULTI-CONTRACTS
Policy instance 25
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered7
Insurance policy start date2019-05-01
Insurance policy end date2020-04-30
Total amount of commissions paid to insurance brokerUSD $61
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $613
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $61
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number010-052024
Policy instance 26
Insurance contract or identification number010-052024
Number of Individuals Covered70
Insurance policy start date2019-11-01
Insurance policy end date2020-10-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,411
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number10-051625
Policy instance 27
Insurance contract or identification number10-051625
Number of Individuals Covered34
Insurance policy start date2019-09-01
Insurance policy end date2020-08-31
Total amount of commissions paid to insurance brokerUSD $1,229
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $15,154
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $775
ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 )
Policy contract numberAL00006464
Policy instance 28
Insurance contract or identification numberAL00006464
Number of Individuals Covered236
Insurance policy start date2019-04-01
Insurance policy end date2020-03-31
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,386
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 )
Policy contract numberMULTI-CONTRACTS
Policy instance 29
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered218
Insurance policy start date2019-08-01
Insurance policy end date2020-07-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,056
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 )
Policy contract numberMULTI-CONTRACTS
Policy instance 30
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered518
Insurance policy start date2019-12-01
Insurance policy end date2020-11-30
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $588,386
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 )
Policy contract numberMULTI-CONTRACTS
Policy instance 31
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered227
Insurance policy start date2019-02-01
Insurance policy end date2020-01-31
Total amount of commissions paid to insurance brokerUSD $374
Health Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $103,123
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $374
ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 )
Policy contract numberMULTI-CONTRACTS
Policy instance 32
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered4600
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $9,401
Total amount of fees paid to insurance companyUSD $6,814
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $3,005,690
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,242
Amount paid for insurance broker fees5986
ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 )
Policy contract numberMULTI-CONTRACTS
Policy instance 33
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered686
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $291,571
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 )
Policy contract numberMULTI-CONTRACTS
Policy instance 34
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2074
Insurance policy start date2019-06-01
Insurance policy end date2020-05-31
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,189,210
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 )
Policy contract numberMULTI-CONTRACTS
Policy instance 35
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered134
Insurance policy start date2019-03-01
Insurance policy end date2020-02-28
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $55,878
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 )
Policy contract number800563
Policy instance 36
Insurance contract or identification number800563
Number of Individuals Covered32
Insurance policy start date2019-11-01
Insurance policy end date2020-10-31
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $29,927
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 )
Policy contract numberMULTI-CONTRACTS
Policy instance 37
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered979
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $347,746
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 )
Policy contract numberMULTI-CONTRACTS
Policy instance 38
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered821
Insurance policy start date2019-09-01
Insurance policy end date2020-08-31
Total amount of commissions paid to insurance brokerUSD $2,774
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $851,544
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,387
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberMULTI-CONTRACTS
Policy instance 39
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1435
Insurance policy start date2019-08-01
Insurance policy end date2020-07-31
Total amount of commissions paid to insurance brokerUSD $1,888
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,745,394
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,888
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract numberMULTI-CONTRACTS
Policy instance 40
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1498
Insurance policy start date2019-12-01
Insurance policy end date2020-11-30
Total amount of commissions paid to insurance brokerUSD $1,600
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,218,817
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,600
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberMULTI-CONTRACTS
Policy instance 41
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered941
Insurance policy start date2019-02-01
Insurance policy end date2020-01-31
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,443,780
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberMULTI-CONTRACTS
Policy instance 42
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered19004
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $14,516
Total amount of fees paid to insurance companyUSD $8,288
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $44,657,289
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,601
Amount paid for insurance broker fees7356
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract numberMULTI-CONTRACTS
Policy instance 43
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered4671
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $6,285
Total amount of fees paid to insurance companyUSD $3,591
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $10,442,582
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,285
Amount paid for insurance broker fees3591
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 44
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered3040
Insurance policy start date2019-06-01
Insurance policy end date2020-05-31
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $5,158,842
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 45
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2624
Insurance policy start date2019-03-01
Insurance policy end date2020-02-28
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,108,612
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract numberMULTI-CONTRACTS
Policy instance 46
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2937
Insurance policy start date2019-05-01
Insurance policy end date2020-04-30
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $8,022,933
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 47
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered424
Insurance policy start date2019-11-01
Insurance policy end date2020-10-31
Total amount of commissions paid to insurance brokerUSD $76
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $652,960
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $76
CONNECTICARE, INC. (National Association of Insurance Commissioners NAIC id number: 95675 )
Policy contract numberMULTI-CONTRACTS
Policy instance 48
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered115
Insurance policy start date2019-04-01
Insurance policy end date2020-03-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $904,776
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONNECTICARE, INC. (National Association of Insurance Commissioners NAIC id number: 95675 )
Policy contract number008117
Policy instance 49
Insurance contract or identification number008117
Number of Individuals Covered26
Insurance policy start date2019-08-01
Insurance policy end date2020-07-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $228,590
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONNECTICARE, INC. (National Association of Insurance Commissioners NAIC id number: 95675 )
Policy contract numberMULTI-CONTRACTS
Policy instance 50
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered303
Insurance policy start date2019-12-01
Insurance policy end date2020-11-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,947,207
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONNECTICARE, INC. (National Association of Insurance Commissioners NAIC id number: 95675 )
Policy contract numberMULTI-CONTRACTS
Policy instance 51
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1379
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $28,296
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $16,782,805
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $28,132
CONNECTICARE, INC. (National Association of Insurance Commissioners NAIC id number: 95675 )
Policy contract numberMULTI-CONTRACTS
Policy instance 52
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered385
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,022,021
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONNECTICARE, INC. (National Association of Insurance Commissioners NAIC id number: 95675 )
Policy contract numberMULTI-CONTRACTS
Policy instance 53
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered407
Insurance policy start date2019-06-01
Insurance policy end date2020-05-31
Total amount of commissions paid to insurance brokerUSD $4,282
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,293,864
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,279
CONNECTICARE, INC. (National Association of Insurance Commissioners NAIC id number: 95675 )
Policy contract numberMULTI-CONTRACTS
Policy instance 54
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered58
Insurance policy start date2019-03-01
Insurance policy end date2020-02-28
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $651,873
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract numberMULTI-CONTRACTS
Policy instance 55
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered103
Insurance policy start date2019-04-01
Insurance policy end date2020-03-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $10,356
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract numberMULTI-CONTRACTS
Policy instance 56
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered151
Insurance policy start date2019-08-01
Insurance policy end date2020-07-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $18,149
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract numberMULTI-CONTRACTS
Policy instance 57
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered207
Insurance policy start date2019-12-01
Insurance policy end date2020-11-30
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $22,007
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract numberMULTI-CONTRACTS
Policy instance 58
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2472
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $83
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $295,017
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $83
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract numberMULTI-CONTRACTS
Policy instance 59
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered732
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $937
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $50,494
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $937
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract numberMULTI-CONTRACTS
Policy instance 60
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered472
Insurance policy start date2019-06-01
Insurance policy end date2020-05-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $36,405
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract numberMULTI-CONTRACTS
Policy instance 61
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered236
Insurance policy start date2019-05-01
Insurance policy end date2020-04-30
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $20,230
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract number1019158
Policy instance 62
Insurance contract or identification number1019158
Number of Individuals Covered10
Insurance policy start date2019-11-01
Insurance policy end date2020-10-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,859
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract numberMULTI-CONTRACTS
Policy instance 63
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered109
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $14,205
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract number1012272
Policy instance 64
Insurance contract or identification number1012272
Number of Individuals Covered117
Insurance policy start date2019-09-01
Insurance policy end date2020-08-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $22,416
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HIP INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 60094 )
Policy contract numberMULTI-CONTRACTS
Policy instance 65
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered328
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,020,081
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
FALLON COMMUNITY HEALTH PLAN -MEDICARE (National Association of Insurance Commissioners NAIC id number: 95541 )
Policy contract numberMULTI-CONTRACTS
Policy instance 66
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered45
Insurance policy start date2019-02-01
Insurance policy end date2020-01-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $436,130
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 )
Policy contract numberMULTI-CONTRACTS
Policy instance 67
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered51
Insurance policy start date2019-06-01
Insurance policy end date2020-05-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $597,379
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 )
Policy contract numberMULTI-CONTRACTS
Policy instance 68
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered49
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $690,053
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 )
Policy contract numberMULTI-CONTRACTS
Policy instance 69
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered490
Insurance policy start date2019-09-01
Insurance policy end date2020-08-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,685,941
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
WELLCHOICE HMO OF NEW JERSEY (National Association of Insurance Commissioners NAIC id number: 95433 )
Policy contract number300133
Policy instance 70
Insurance contract or identification number300133
Number of Individuals Covered56
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,411
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
WELLCHOICE HMO OF NEW JERSEY (National Association of Insurance Commissioners NAIC id number: 95433 )
Policy contract number300083
Policy instance 71
Insurance contract or identification number300083
Number of Individuals Covered218
Insurance policy start date2019-11-01
Insurance policy end date2020-10-31
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $144,299
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 72
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1842
Insurance policy start date2019-04-01
Insurance policy end date2020-03-31
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $496,703
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 73
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered3445
Insurance policy start date2019-08-01
Insurance policy end date2020-07-31
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedHOSPITAL INDEMNITY
Welfare Benefit Premiums Paid to CarrierUSD $1,003,250
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 74
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1235
Insurance policy start date2019-12-01
Insurance policy end date2020-11-30
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $473,818
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 75
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered849
Insurance policy start date2019-02-01
Insurance policy end date2020-01-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $166,783
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 76
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered10707
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $13,303
Total amount of fees paid to insurance companyUSD $5,111
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $3,758,320
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,921
Amount paid for insurance broker fees5111
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 77
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2848
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Vision Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $399,803
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 78
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered4419
Insurance policy start date2019-06-01
Insurance policy end date2020-05-31
Vision Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,120,978
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 79
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1628
Insurance policy start date2019-03-01
Insurance policy end date2020-02-28
Vision Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $330,176
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 80
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered3912
Insurance policy start date2019-05-01
Insurance policy end date2020-04-30
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedHOSPITAL INDEMNITY
Welfare Benefit Premiums Paid to CarrierUSD $850,856
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 81
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2777
Insurance policy start date2019-11-01
Insurance policy end date2020-10-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $821,950
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 82
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2424
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $575,856
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 83
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered4555
Insurance policy start date2019-09-01
Insurance policy end date2020-08-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,183,383
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract numberMULTI-CONTRACTS
Policy instance 84
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered19
Insurance policy start date2019-08-01
Insurance policy end date2020-07-31
Total amount of commissions paid to insurance brokerUSD $209
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $159,300
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $209
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract numberMULTI-CONTRACTS
Policy instance 85
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered147
Insurance policy start date2019-12-01
Insurance policy end date2020-11-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,302,419
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract numberMULTI-CONTRACTS
Policy instance 86
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered81
Insurance policy start date2019-02-01
Insurance policy end date2020-01-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $675,125
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract numberMULTI-CONTRACTS
Policy instance 87
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered424
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,321,933
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract numberMULTI-CONTRACTS
Policy instance 88
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered45
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $530,190
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract numberMULTI-CONTRACTS
Policy instance 89
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered377
Insurance policy start date2019-06-01
Insurance policy end date2020-05-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,502,001
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 90
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered749
Insurance policy start date2019-04-01
Insurance policy end date2020-03-31
Total amount of commissions paid to insurance brokerUSD $2,443
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $158,160
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,443
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 91
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered112
Insurance policy start date2019-12-01
Insurance policy end date2020-11-30
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $13,322
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 92
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered27
Insurance policy start date2019-02-01
Insurance policy end date2020-01-31
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $14,428
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 93
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered11790
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $2,111,531
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 94
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1484
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $988
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $199,993
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $988
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 95
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered655
Insurance policy start date2019-06-01
Insurance policy end date2020-05-31
Total amount of commissions paid to insurance brokerUSD $181
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $72,420
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $181
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 96
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1809
Insurance policy start date2019-03-01
Insurance policy end date2020-02-28
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $60,996
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 97
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered890
Insurance policy start date2019-05-01
Insurance policy end date2020-04-30
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $101,810
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 98
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1143
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $96,154
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULT-CONTRACTS
Policy instance 99
Insurance contract or identification numberMULT-CONTRACTS
Number of Individuals Covered2139
Insurance policy start date2019-09-01
Insurance policy end date2020-08-31
Total amount of commissions paid to insurance brokerUSD $2,109
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $224,549
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,737
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberMULTI-CONTRACTS
Policy instance 100
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered5841
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $3,390
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,069,103
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,035
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number05936766
Policy instance 101
Insurance contract or identification number05936766
Number of Individuals Covered317
Insurance policy start date2019-06-01
Insurance policy end date2020-05-31
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $11,001
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5725509
Policy instance 102
Insurance contract or identification number5725509
Number of Individuals Covered153
Insurance policy start date2019-03-01
Insurance policy end date2020-02-28
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $36,687
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number383202
Policy instance 103
Insurance contract or identification number383202
Number of Individuals Covered44
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,398
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberMULTI-CONTRACTS
Policy instance 104
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered82
Insurance policy start date2019-08-01
Insurance policy end date2020-07-31
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $174
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGLT-803138
Policy instance 105
Insurance contract or identification numberGLT-803138
Number of Individuals Covered7
Insurance policy start date2019-08-01
Insurance policy end date2020-07-31
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $106
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberMUTI-CONTRACTS
Policy instance 106
Insurance contract or identification numberMUTI-CONTRACTS
Number of Individuals Covered106
Insurance policy start date2019-12-01
Insurance policy end date2020-11-30
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $14,446
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberMULTI-CONTRACTS
Policy instance 107
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1451
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $3,847
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $103,704
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,847
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberMULTI-CONTRACTS
Policy instance 108
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered175
Insurance policy start date2019-11-01
Insurance policy end date2020-10-31
Total amount of commissions paid to insurance brokerUSD $35
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $8,255
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $35
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberMULTI-CONTRACTS
Policy instance 109
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered349
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $31,342
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGL-805267
Policy instance 110
Insurance contract or identification numberGL-805267
Number of Individuals Covered74
Insurance policy start date2019-09-01
Insurance policy end date2020-08-31
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $297
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 111
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1945
Insurance policy start date2019-04-01
Insurance policy end date2020-03-31
Total amount of commissions paid to insurance brokerUSD $47,485
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $224,006
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $24,794
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 112
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2093
Insurance policy start date2019-08-01
Insurance policy end date2020-07-31
Total amount of commissions paid to insurance brokerUSD $42,131
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $226,608
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $21,277
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 113
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered194
Insurance policy start date2019-12-01
Insurance policy end date2020-11-30
Total amount of commissions paid to insurance brokerUSD $4,131
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $32,620
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,154
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 114
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered706
Insurance policy start date2019-02-01
Insurance policy end date2020-01-31
Total amount of commissions paid to insurance brokerUSD $22,822
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $73,463
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,722
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 115
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered10125
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $120,312
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $1,198,336
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $52,982
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 116
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1696
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $35,621
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $195,313
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17,111
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 117
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1405
Insurance policy start date2019-06-01
Insurance policy end date2020-05-31
Total amount of commissions paid to insurance brokerUSD $42,093
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $202,064
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $20,494
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 118
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered881
Insurance policy start date2019-03-01
Insurance policy end date2020-02-28
Total amount of commissions paid to insurance brokerUSD $18,178
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $71,042
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,862
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 119
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1272
Insurance policy start date2019-05-01
Insurance policy end date2020-04-30
Total amount of commissions paid to insurance brokerUSD $42,216
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $207,647
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $20,834
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberG000ATLW
Policy instance 120
Insurance contract or identification numberG000ATLW
Number of Individuals Covered162
Insurance policy start date2019-11-01
Insurance policy end date2020-10-31
Total amount of commissions paid to insurance brokerUSD $2,414
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $11,415
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
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 121
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1029
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Total amount of commissions paid to insurance brokerUSD $29,185
Total amount of fees paid to insurance companyUSD $22,083
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $211,026
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,095
Amount paid for insurance broker fees19845
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 122
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered759
Insurance policy start date2019-09-01
Insurance policy end date2020-08-31
Total amount of commissions paid to insurance brokerUSD $10,899
Total amount of fees paid to insurance companyUSD $2,238
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $164,684
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,645
Amount paid for insurance broker fees2238
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 123
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered188
Insurance policy start date2019-04-01
Insurance policy end date2020-03-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,624,868
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 124
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered56
Insurance policy start date2019-08-01
Insurance policy end date2020-07-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $905,031
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 125
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered427
Insurance policy start date2019-12-01
Insurance policy end date2020-11-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,191,815
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 126
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered212
Insurance policy start date2019-02-01
Insurance policy end date2020-01-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,770,383
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 127
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered982
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $574
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $10,141,088
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $574
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberSU2349
Policy instance 128
Insurance contract or identification numberSU2349
Number of Individuals Covered193
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $740,953
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 129
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered192
Insurance policy start date2019-06-01
Insurance policy end date2020-05-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,387,929
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 130
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered469
Insurance policy start date2019-03-01
Insurance policy end date2020-02-28
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,729,388
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1095841
Policy instance 131
Insurance contract or identification number1095841
Number of Individuals Covered152
Insurance policy start date2019-08-01
Insurance policy end date2020-07-31
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $32,039
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberMULTI-CONTRACTS
Policy instance 132
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered302
Insurance policy start date2019-12-01
Insurance policy end date2020-11-30
Vision Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $85,837
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberMULTI-CONTRACTS
Policy instance 133
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1737
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $309
Vision Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $181,723
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $309
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberMULTI-CONTRACTS
Policy instance 134
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered316
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $40,607
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberMULTI-CONTRACTS
Policy instance 135
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1916
Insurance policy start date2019-06-01
Insurance policy end date2020-05-31
Total amount of commissions paid to insurance brokerUSD $16,972
Total amount of fees paid to insurance companyUSD $3,094
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $156,831
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,634
Amount paid for insurance broker fees1870
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1107741
Policy instance 136
Insurance contract or identification number1107741
Number of Individuals Covered50
Insurance policy start date2019-03-01
Insurance policy end date2020-02-28
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $16,885
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberMULTI-CONTRACTS
Policy instance 137
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered183
Insurance policy start date2019-05-01
Insurance policy end date2020-04-30
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $39,495
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number62404
Policy instance 138
Insurance contract or identification number62404
Number of Individuals Covered830
Insurance policy start date2019-12-01
Insurance policy end date2020-11-30
Total amount of commissions paid to insurance brokerUSD $7,749
Total amount of fees paid to insurance companyUSD $28
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $95,019
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,749
Amount paid for insurance broker fees24
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number60406
Policy instance 139
Insurance contract or identification number60406
Number of Individuals Covered655
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $14,299
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $87,770
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,321
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number89957
Policy instance 140
Insurance contract or identification number89957
Number of Individuals Covered105
Insurance policy start date2019-05-01
Insurance policy end date2020-04-30
Total amount of commissions paid to insurance brokerUSD $8,261
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $55,716
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,261
FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71005 )
Policy contract numberMULTI-CONTRACTS
Policy instance 141
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered144
Insurance policy start date2019-04-01
Insurance policy end date2020-03-31
Total amount of commissions paid to insurance brokerUSD $28
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $21,502
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $28
FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71005 )
Policy contract numberMULTI-CONTRACTS
Policy instance 142
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered407
Insurance policy start date2019-12-01
Insurance policy end date2020-11-30
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $49,575
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71005 )
Policy contract numberMULTI-CONTRACTS
Policy instance 143
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered37
Insurance policy start date2019-02-01
Insurance policy end date2020-01-31
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,927
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberMULTI-CONTRACTS
Policy instance 144
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered15630
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $15,244
Total amount of fees paid to insurance companyUSD $199
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $437,787
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,558
Amount paid for insurance broker fees199
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberMULTI-CONTRACTS
Policy instance 145
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered56
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $8,125
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberMULTI-CONTRACTS
Policy instance 146
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered123
Insurance policy start date2019-06-01
Insurance policy end date2020-05-31
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $30,180
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberMULTI-CONTRACTS
Policy instance 147
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered311
Insurance policy start date2019-03-01
Insurance policy end date2020-02-28
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $27,311
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberMULTI-CONTRACTS
Policy instance 148
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered765
Insurance policy start date2019-05-01
Insurance policy end date2020-04-30
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $56,884
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberMULTI-CONTRACTS
Policy instance 149
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered33
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,272
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberMULTI-CONTRACTS
Policy instance 150
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered125
Insurance policy start date2019-09-01
Insurance policy end date2020-08-31
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,020
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number0155417
Policy instance 151
Insurance contract or identification number0155417
Number of Individuals Covered210
Insurance policy start date2019-08-01
Insurance policy end date2020-07-31
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $56,114
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number447104
Policy instance 152
Insurance contract or identification number447104
Number of Individuals Covered96
Insurance policy start date2019-02-01
Insurance policy end date2020-01-31
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $20,144
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract numberMULTI-CONTRACTS
Policy instance 153
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered972
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $196,356
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number755497
Policy instance 154
Insurance contract or identification number755497
Number of Individuals Covered38
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,627
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE STANDARD LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 89009 )
Policy contract number754033
Policy instance 155
Insurance contract or identification number754033
Number of Individuals Covered2238
Insurance policy start date2019-06-01
Insurance policy end date2020-05-31
Total amount of commissions paid to insurance brokerUSD $5,725
Total amount of fees paid to insurance companyUSD $199
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $123,416
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,604
Amount paid for insurance broker fees199
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number161350
Policy instance 156
Insurance contract or identification number161350
Number of Individuals Covered246
Insurance policy start date2019-03-01
Insurance policy end date2020-02-28
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $21,004
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number159866
Policy instance 157
Insurance contract or identification number159866
Number of Individuals Covered145
Insurance policy start date2019-05-01
Insurance policy end date2020-04-30
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $9,235
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract numberMULTI-CONTRACTS
Policy instance 158
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered4421
Insurance policy start date2019-11-01
Insurance policy end date2020-10-31
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $512,059
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract numberMULTI-CONTRACTS
Policy instance 159
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered132
Insurance policy start date2019-09-01
Insurance policy end date2020-08-31
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $48,060
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract numberMULTI-CONTRACTS
Policy instance 160
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1812
Insurance policy start date2019-04-01
Insurance policy end date2020-03-31
Total amount of commissions paid to insurance brokerUSD $15,479
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $235,298
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,653
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract numberMULTI-CONTRACTS
Policy instance 161
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered142
Insurance policy start date2019-08-01
Insurance policy end date2020-07-31
Total amount of commissions paid to insurance brokerUSD $4,297
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $41,195
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,887
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract numberMULTI-CONTRACTS
Policy instance 162
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered592
Insurance policy start date2019-12-01
Insurance policy end date2020-11-30
Total amount of commissions paid to insurance brokerUSD $10,019
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $73,249
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,798
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract numberMULTI-CONTRACTS
Policy instance 163
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered860
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $1,303
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $153,445
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $670
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract numberMULTI-CONTRACTS
Policy instance 164
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1429
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $32,683
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $425,770
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,252
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract numberMULTI-CONTRACTS
Policy instance 165
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1030
Insurance policy start date2019-06-01
Insurance policy end date2020-05-31
Total amount of commissions paid to insurance brokerUSD $22,325
Vision Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $186,757
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,013
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract number819037
Policy instance 166
Insurance contract or identification number819037
Number of Individuals Covered436
Insurance policy start date2019-03-01
Insurance policy end date2020-02-28
Total amount of commissions paid to insurance brokerUSD $12,124
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $88,946
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,566
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract numberMULTI-CONTRACTS
Policy instance 167
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered175
Insurance policy start date2019-11-01
Insurance policy end date2020-10-31
Total amount of commissions paid to insurance brokerUSD $5,894
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $41,937
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,919
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract numberMULTI-CONTRACTS
Policy instance 168
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered216
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Total amount of commissions paid to insurance brokerUSD $8,501
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $40,833
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,113
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number931478
Policy instance 169
Insurance contract or identification number931478
Number of Individuals Covered80
Insurance policy start date2019-09-01
Insurance policy end date2020-08-31
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $22,804
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 170
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered224
Insurance policy start date2019-04-01
Insurance policy end date2020-03-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $58,558
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 171
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered271
Insurance policy start date2019-08-01
Insurance policy end date2020-07-31
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $638,067
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 172
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered907
Insurance policy start date2019-12-01
Insurance policy end date2020-11-30
Total amount of commissions paid to insurance brokerUSD $9,815
Total amount of fees paid to insurance companyUSD $1,092
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,990,121
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,908
Amount paid for insurance broker fees1092
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 173
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered218
Insurance policy start date2019-02-01
Insurance policy end date2020-01-31
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $960,108
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 174
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered20275
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $12,195
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $11,966,185
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,195
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 175
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered307
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $47,166
Total amount of fees paid to insurance companyUSD $580
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,254,396
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $28,296
Amount paid for insurance broker fees580
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 176
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered483
Insurance policy start date2019-06-01
Insurance policy end date2020-05-31
Total amount of commissions paid to insurance brokerUSD $5,970
Total amount of fees paid to insurance companyUSD $2,225
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $618,040
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,467
Amount paid for insurance broker fees1904
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 177
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1983
Insurance policy start date2019-03-01
Insurance policy end date2020-02-28
Total amount of commissions paid to insurance brokerUSD $5,590
Total amount of fees paid to insurance companyUSD $2,936
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,422,488
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,310
Amount paid for insurance broker fees2936
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 178
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1375
Insurance policy start date2019-05-01
Insurance policy end date2020-04-30
Total amount of commissions paid to insurance brokerUSD $214
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,016,258
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $214
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 179
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered920
Insurance policy start date2019-11-01
Insurance policy end date2020-10-31
Total amount of commissions paid to insurance brokerUSD $303
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,220,643
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $303
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number09Y1191
Policy instance 180
Insurance contract or identification number09Y1191
Number of Individuals Covered1
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $53,378
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 181
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered736
Insurance policy start date2019-09-01
Insurance policy end date2020-08-31
Total amount of commissions paid to insurance brokerUSD $11,076
Total amount of fees paid to insurance companyUSD $60,721
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,627,833
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,613
Amount paid for insurance broker fees60721
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 182
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1159
Insurance policy start date2019-04-01
Insurance policy end date2020-03-31
Total amount of commissions paid to insurance brokerUSD $36,987
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $147,132
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $18,176
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 183
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered236
Insurance policy start date2019-08-01
Insurance policy end date2020-07-31
Total amount of commissions paid to insurance brokerUSD $3,517
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $15,042
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,706
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 184
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered771
Insurance policy start date2019-12-01
Insurance policy end date2020-11-30
Total amount of commissions paid to insurance brokerUSD $64,205
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $189,121
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $33,950
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 185
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered592
Insurance policy start date2019-02-01
Insurance policy end date2020-01-31
Total amount of commissions paid to insurance brokerUSD $12,659
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $48,168
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,036
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract numberMULTI-CONTRACTS
Policy instance 186
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered57
Insurance policy start date2019-08-01
Insurance policy end date2020-07-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,198
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract numberMULTI-CONTRACTS
Policy instance 187
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered230
Insurance policy start date2019-12-01
Insurance policy end date2020-11-30
Total amount of commissions paid to insurance brokerUSD $742
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $27,580
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $742
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30002139
Policy instance 188
Insurance contract or identification number30002139
Number of Individuals Covered81
Insurance policy start date2019-02-01
Insurance policy end date2020-01-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $13,001
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract numberMULTI-CONTRACTS
Policy instance 189
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1205
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $323
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $176,681
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $323
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract numberMULTI-CONTRACTS
Policy instance 190
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered442
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $58,012
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30067528
Policy instance 191
Insurance contract or identification number30067528
Number of Individuals Covered63
Insurance policy start date2019-06-01
Insurance policy end date2020-05-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,536
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract numberMULTI-CONTRACTS
Policy instance 192
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered213
Insurance policy start date2019-03-01
Insurance policy end date2020-02-28
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $28,547
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract numberMULTI-CONTRACTS
Policy instance 193
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered90
Insurance policy start date2019-05-01
Insurance policy end date2020-04-30
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $17,570
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract numberMULTI-CONTRACTS
Policy instance 194
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered86
Insurance policy start date2019-11-01
Insurance policy end date2020-10-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $16,187
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30051603
Policy instance 195
Insurance contract or identification number30051603
Number of Individuals Covered54
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,957
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract numberMULTI-CONTRACTS
Policy instance 196
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered95
Insurance policy start date2019-09-01
Insurance policy end date2020-08-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $13,219
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
Policy contract numberMULTI-CONTRACTS
Policy instance 197
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered40
Insurance policy start date2019-12-01
Insurance policy end date2020-11-30
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,145
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
Policy contract numberMULTI-CONTRACTS
Policy instance 198
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered520
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $5,252
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $478,136
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,068
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
Policy contract numberMULTI-CONTRACTS
Policy instance 199
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered259
Insurance policy start date2019-05-01
Insurance policy end date2020-04-30
Total amount of commissions paid to insurance brokerUSD $4,749
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $65,305
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,749
ARKANSAS BLUE CROSS BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 83470 )
Policy contract number111812912
Policy instance 200
Insurance contract or identification number111812912
Number of Individuals Covered208
Insurance policy start date2019-03-01
Insurance policy end date2020-02-28
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,858,878
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 201
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered7355
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $231,142
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $1,171,452
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $115,817
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 202
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2460
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $31,644
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $144,734
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,437
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract numberMULTI-CONTRACTS
Policy instance 203
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered940
Insurance policy start date2019-06-01
Insurance policy end date2020-05-31
Total amount of commissions paid to insurance brokerUSD $19,696
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $160,179
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,357
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 204
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered283
Insurance policy start date2019-03-01
Insurance policy end date2020-02-28
Total amount of commissions paid to insurance brokerUSD $31,168
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $121,982
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $18,082
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 205
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered786
Insurance policy start date2019-05-01
Insurance policy end date2020-04-30
Total amount of commissions paid to insurance brokerUSD $19,262
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $72,257
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,644
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 206
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1542
Insurance policy start date2019-11-01
Insurance policy end date2020-10-31
Total amount of commissions paid to insurance brokerUSD $38,603
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $211,578
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $22,600
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI_CONTRACTS
Policy instance 207
Insurance contract or identification numberMULTI_CONTRACTS
Number of Individuals Covered3003
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Total amount of commissions paid to insurance brokerUSD $36,776
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $212,402
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $18,284
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 208
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1919
Insurance policy start date2019-09-01
Insurance policy end date2020-08-31
Total amount of commissions paid to insurance brokerUSD $354,671
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $1,638,719
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $185,001
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 209
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered106
Insurance policy start date2019-09-01
Insurance policy end date2020-08-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,113,482
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 210
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered217
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Total amount of commissions paid to insurance brokerUSD $10,972
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,680,894
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,972
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 211
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered224
Insurance policy start date2019-11-01
Insurance policy end date2020-10-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,890,928
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMUTLI-CONTRACTS
Policy instance 212
Insurance contract or identification numberMUTLI-CONTRACTS
Number of Individuals Covered610
Insurance policy start date2019-05-01
Insurance policy end date2020-04-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,790,244
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number707201
Policy instance 213
Insurance contract or identification number707201
Number of Individuals Covered65
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $1,694
Life Insurance Welfare BenefitYes
Other welfare benefits providedCRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $10,998
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,287
CONNECTICARE, INC. (National Association of Insurance Commissioners NAIC id number: 95675 )
Policy contract numberMULTI-CONTRACTS
Policy instance 214
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered67
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $753,888
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONNECTICARE, INC. (National Association of Insurance Commissioners NAIC id number: 95675 )
Policy contract numberMULTI-CONTRACTS
Policy instance 215
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered56
Insurance policy start date2019-09-01
Insurance policy end date2020-08-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $499,905
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract numberMULTI-CONTRACTS
Policy instance 216
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered127
Insurance policy start date2019-03-01
Insurance policy end date2020-02-28
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,133,185
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract numberMULTI-CONTRACT
Policy instance 217
Insurance contract or identification numberMULTI-CONTRACT
Number of Individuals Covered337
Insurance policy start date2019-05-01
Insurance policy end date2020-04-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,921,606
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract numberMULTI-CONTRACTS
Policy instance 218
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered58
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $665,395
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract numberMULTI-CONTRACTS
Policy instance 219
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered33
Insurance policy start date2019-09-01
Insurance policy end date2020-08-31
Total amount of commissions paid to insurance brokerUSD $789
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $620,097
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $789
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberMULTI-CONTRACTS
Policy instance 220
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered260
Insurance policy start date2019-11-01
Insurance policy end date2020-10-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $63,601
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberMULTI-CONTRACTS
Policy instance 221
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered171
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Total amount of commissions paid to insurance brokerUSD $320
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $43,704
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $320
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberMULTI-CONTRACTS
Policy instance 222
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered256
Insurance policy start date2019-09-01
Insurance policy end date2020-08-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $69,474
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION BENEFITS OF AMERICA (National Association of Insurance Commissioners NAIC id number: 53953 )
Policy contract number6309
Policy instance 223
Insurance contract or identification number6309
Number of Individuals Covered26
Insurance policy start date2019-12-01
Insurance policy end date2020-11-30
Total amount of commissions paid to insurance brokerUSD $71
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,372
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $71
VISION BENEFITS OF AMERICA (National Association of Insurance Commissioners NAIC id number: 53953 )
Policy contract numberMULTI-CONTRACTS
Policy instance 224
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered727
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $33
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $60,212
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $33
VISION BENEFITS OF AMERICA (National Association of Insurance Commissioners NAIC id number: 53953 )
Policy contract number6307
Policy instance 225
Insurance contract or identification number6307
Number of Individuals Covered143
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $324
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $15,425
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $324
VISION BENEFITS OF AMERICA (National Association of Insurance Commissioners NAIC id number: 53953 )
Policy contract number6304
Policy instance 226
Insurance contract or identification number6304
Number of Individuals Covered27
Insurance policy start date2019-06-01
Insurance policy end date2020-05-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,074
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 )
Policy contract numberMULTI-CONTRACTS
Policy instance 1
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered223
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $404
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $17,065
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $404
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 2
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1199
Insurance policy start date2019-04-01
Insurance policy end date2019-03-31
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,642,262
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONNECTICARE, INC. (National Association of Insurance Commissioners NAIC id number: 95675 )
Policy contract numberMULTI-CONTRACTS
Policy instance 3
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered392
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $41,330
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $307,368
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $28,319
CONNECTICARE, INC. (National Association of Insurance Commissioners NAIC id number: 95675 )
Policy contract number006569
Policy instance 4
Insurance contract or identification number006569
Number of Individuals Covered58
Insurance policy start date2018-04-01
Insurance policy end date2019-03-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $446,257
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberMULTI-CONTRACTS
Policy instance 5
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered370
Insurance policy start date2018-12-01
Insurance policy end date2019-11-30
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $54,431
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMUTLI-CONTRACTS
Policy instance 6
Insurance contract or identification numberMUTLI-CONTRACTS
Number of Individuals Covered125
Insurance policy start date2018-04-01
Insurance policy end date2019-03-31
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $522,009
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 7
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered8492
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $744,699
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,209,314
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $369,957
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number772654
Policy instance 8
Insurance contract or identification number772654
Number of Individuals Covered1856
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
Total amount of commissions paid to insurance brokerUSD $61,208
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $487,440
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $25,421
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number772973
Policy instance 9
Insurance contract or identification number772973
Number of Individuals Covered59
Insurance policy start date2018-04-01
Insurance policy end date2019-03-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,206
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 10
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered111
Insurance policy start date2018-12-01
Insurance policy end date2019-11-30
Total amount of commissions paid to insurance brokerUSD $497
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $16,742
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $255
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 11
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered50
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,734
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number617383
Policy instance 12
Insurance contract or identification number617383
Number of Individuals Covered3047
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $401,138
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number109322
Policy instance 13
Insurance contract or identification number109322
Number of Individuals Covered38
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,114
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number313803
Policy instance 14
Insurance contract or identification number313803
Number of Individuals Covered59
Insurance policy start date2018-03-01
Insurance policy end date2019-02-28
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $8,474
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number773080
Policy instance 15
Insurance contract or identification number773080
Number of Individuals Covered200
Insurance policy start date2018-05-01
Insurance policy end date2019-04-30
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $25,172
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number119304
Policy instance 16
Insurance contract or identification number119304
Number of Individuals Covered10
Insurance policy start date2018-11-01
Insurance policy end date2019-10-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $838
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number228728
Policy instance 17
Insurance contract or identification number228728
Number of Individuals Covered41
Insurance policy start date2018-09-01
Insurance policy end date2019-08-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $9,413
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 18
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered77
Insurance policy start date2018-04-01
Insurance policy end date2019-03-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $544,092
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number477384
Policy instance 19
Insurance contract or identification number477384
Number of Individuals Covered48
Insurance policy start date2018-08-01
Insurance policy end date2019-07-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $428,629
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA (National Association of Insurance Commissioners NAIC id number: 78700 )
Policy contract numberMULTI-CONTRACTS
Policy instance 20
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered91
Insurance policy start date2018-12-01
Insurance policy end date2019-11-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,080,234
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberMULTI-CONTRACTS
Policy instance 21
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered94
Insurance policy start date2018-04-01
Insurance policy end date2019-03-31
Total amount of commissions paid to insurance brokerUSD $4,939
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $75,440
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,069
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberMULTI-CONTRACTS
Policy instance 22
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered28
Insurance policy start date2018-08-01
Insurance policy end date2019-07-31
Total amount of commissions paid to insurance brokerUSD $1,283
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $19,173
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $861
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberMULTI-CONTRACTS
Policy instance 23
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered105
Insurance policy start date2018-12-01
Insurance policy end date2019-11-30
Total amount of commissions paid to insurance brokerUSD $3,836
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $42,253
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,505
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberMULTI-CONTRACTS
Policy instance 24
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered80
Insurance policy start date2018-02-01
Insurance policy end date2019-01-31
Total amount of commissions paid to insurance brokerUSD $889
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $12,459
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $889
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberMULTI-CONTRACTS
Policy instance 25
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered556
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $9,572
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $147,468
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,805
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberMULTI-CONTRACTS
Policy instance 26
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered78
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $2,155
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $47,554
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,155
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberMULTI-CONTRACTS
Policy instance 27
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered160
Insurance policy start date2018-06-01
Insurance policy end date2019-05-01
Total amount of commissions paid to insurance brokerUSD $2,328
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $23,753
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $768
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberMULTI-CONTRACT
Policy instance 28
Insurance contract or identification numberMULTI-CONTRACT
Number of Individuals Covered32
Insurance policy start date2018-03-01
Insurance policy end date2019-02-28
Total amount of commissions paid to insurance brokerUSD $2,328
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $44,219
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,328
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberMULTI-CONTRACTS
Policy instance 29
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered8
Insurance policy start date2018-05-01
Insurance policy end date2019-04-30
Total amount of commissions paid to insurance brokerUSD $368
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,680
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $368
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberMULTI-CONTRACTS
Policy instance 30
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered23
Insurance policy start date2018-09-01
Insurance policy end date2019-08-31
Total amount of commissions paid to insurance brokerUSD $1,542
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $15,950
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,542
ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 )
Policy contract numberMULTI-CONTRACTS
Policy instance 31
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered116
Insurance policy start date2018-04-01
Insurance policy end date2019-03-31
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,527
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 )
Policy contract numberMULTI-CONTRACTS
Policy instance 32
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered247
Insurance policy start date2018-08-01
Insurance policy end date2019-07-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $12,211
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 )
Policy contract numberMULTI-CONTRACTS
Policy instance 33
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered44
Insurance policy start date2018-12-01
Insurance policy end date2019-11-30
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,164
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 )
Policy contract numberMULTI-CONTRACTS
Policy instance 34
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered58
Insurance policy start date2018-02-01
Insurance policy end date2019-01-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $718,540
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 )
Policy contract numberMULTI-CONTRACTS
Policy instance 35
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2367
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $11,217
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $1,429,065
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,328
ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 )
Policy contract numberMULTI-CONTRACTS
Policy instance 36
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered191
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $6,086
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $125,074
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,834
ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 )
Policy contract numberMULTI-CONTRACTS
Policy instance 37
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered193
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $103,435
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 )
Policy contract numberMULTI-CONTRACTS
Policy instance 38
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered237
Insurance policy start date2018-03-01
Insurance policy end date2019-02-28
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $98,804
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 )
Policy contract numberAL0006267
Policy instance 39
Insurance contract or identification numberAL0006267
Number of Individuals Covered159
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $724,781
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 40
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1162
Insurance policy start date2018-12-01
Insurance policy end date2019-11-30
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,006,834
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberMULTI-CONTRACTS
Policy instance 41
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered721
Insurance policy start date2018-08-01
Insurance policy end date2019-07-31
Total amount of commissions paid to insurance brokerUSD $1,246
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $253,778
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,246
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberMULTI-CONTRACTS
Policy instance 42
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered765
Insurance policy start date2018-02-01
Insurance policy end date2019-01-31
Total amount of commissions paid to insurance brokerUSD $27
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $858,381
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $27
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberMULTI-CONTRACTS
Policy instance 43
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered14251
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $11,283
Total amount of fees paid to insurance companyUSD $212,528
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $36,639,941
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,271
Amount paid for insurance broker fees118939
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract numberMULTI-CONTRACTS
Policy instance 44
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered4831
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $25,355
Total amount of fees paid to insurance companyUSD $110,382
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $9,955,557
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,156
Amount paid for insurance broker fees68219
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 45
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered3066
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,675,461
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 46
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1675
Insurance policy start date2018-03-01
Insurance policy end date2019-02-28
Total amount of commissions paid to insurance brokerUSD $1,742
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,893,899
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,337
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract numberMULTI-CONTRACTS
Policy instance 47
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2747
Insurance policy start date2018-05-01
Insurance policy end date2019-04-30
Total amount of commissions paid to insurance brokerUSD $9,573
Total amount of fees paid to insurance companyUSD $264,545
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,094,780
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,573
Amount paid for insurance broker fees182122
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 48
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1022
Insurance policy start date2018-11-01
Insurance policy end date2019-10-31
Total amount of commissions paid to insurance brokerUSD $2,142
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $819,681
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,142
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 49
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered161
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $46,771
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract numberMULTI-CONTRACTS
Policy instance 50
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1163
Insurance policy start date2018-09-01
Insurance policy end date2019-08-30
Total amount of commissions paid to insurance brokerUSD $7,443
Total amount of fees paid to insurance companyUSD $84,746
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,913,625
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,840
Amount paid for insurance broker fees53318
CONNECTICARE, INC. (National Association of Insurance Commissioners NAIC id number: 95675 )
Policy contract number008006
Policy instance 51
Insurance contract or identification number008006
Number of Individuals Covered16
Insurance policy start date2018-08-01
Insurance policy end date2019-07-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $154,202
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONNECTICARE, INC. (National Association of Insurance Commissioners NAIC id number: 95675 )
Policy contract numberMULTI-CONTRACTS
Policy instance 52
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered333
Insurance policy start date2018-12-01
Insurance policy end date2019-11-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,556,557
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONNECTICARE, INC. (National Association of Insurance Commissioners NAIC id number: 95675 )
Policy contract number007949
Policy instance 53
Insurance contract or identification number007949
Number of Individuals Covered22
Insurance policy start date2018-02-01
Insurance policy end date2019-01-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $148,959
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONNECTICARE, INC. (National Association of Insurance Commissioners NAIC id number: 95675 )
Policy contract numberMULTI-CONTRACTS
Policy instance 54
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1224
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $16,995,856
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONNECTICARE, INC. (National Association of Insurance Commissioners NAIC id number: 95675 )
Policy contract numberMULTI-CONTRACTS
Policy instance 55
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered382
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,753,283
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONNECTICARE, INC. (National Association of Insurance Commissioners NAIC id number: 95675 )
Policy contract numberMULTI-CONTRACTS
Policy instance 56
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered157
Insurance policy start date2018-06-30
Insurance policy end date2019-05-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,930,261
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONNECTICARE, INC. (National Association of Insurance Commissioners NAIC id number: 95675 )
Policy contract numberMULTI-CONTRACTS
Policy instance 57
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered125
Insurance policy start date2018-11-01
Insurance policy end date2019-10-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,249,631
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract numberMULTI-CONTRACTS
Policy instance 58
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered72
Insurance policy start date2018-04-01
Insurance policy end date2019-03-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,901
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract numberMULTI-CONTRACTS
Policy instance 59
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered132
Insurance policy start date2018-08-01
Insurance policy end date2019-07-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $16,384
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract numberMULTI-CONTRACTS
Policy instance 60
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered216
Insurance policy start date2018-12-01
Insurance policy end date2019-11-30
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $20,816
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract numberMULTI-CONTRACTS
Policy instance 61
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2353
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $427
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $271,998
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $427
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract number1001246
Policy instance 62
Insurance contract or identification number1001246
Number of Individuals Covered331
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $46,528
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract numberMULTI-CONTRACTS
Policy instance 63
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered450
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $35,142
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract number9813544
Policy instance 64
Insurance contract or identification number9813544
Number of Individuals Covered95
Insurance policy start date2018-03-01
Insurance policy end date2019-02-28
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $10,431
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract numberMULT-CONTRACTS
Policy instance 65
Insurance contract or identification numberMULT-CONTRACTS
Number of Individuals Covered208
Insurance policy start date2018-05-01
Insurance policy end date2019-04-30
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $19,956
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract number1019158
Policy instance 66
Insurance contract or identification number1019158
Number of Individuals Covered38
Insurance policy start date2018-11-01
Insurance policy end date2019-10-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,251
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract numberMULTI-CONTRACTS
Policy instance 67
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered111
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $13,764
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract number1012272
Policy instance 68
Insurance contract or identification number1012272
Number of Individuals Covered95
Insurance policy start date2018-09-01
Insurance policy end date2019-08-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $16,302
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 )
Policy contract numberMULTI-CONTRACTS
Policy instance 69
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered35
Insurance policy start date2018-12-01
Insurance policy end date2019-11-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $57,985
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 )
Policy contract numberMULTI-CONTRACTS
Policy instance 70
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered49
Insurance policy start date2018-06-30
Insurance policy end date2019-05-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $428,587
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 )
Policy contract numberMULTI-CONTRACTS
Policy instance 71
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered58
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $742,362
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 )
Policy contract numberMULTI-CONTRACTS
Policy instance 72
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered794
Insurance policy start date2018-09-01
Insurance policy end date2019-08-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,124,646
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
WELLCHOICE HMO OF NEW JERSEY (National Association of Insurance Commissioners NAIC id number: 95433 )
Policy contract number300083
Policy instance 73
Insurance contract or identification number300083
Number of Individuals Covered274
Insurance policy start date2018-11-01
Insurance policy end date2019-10-31
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $131,268
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
WELLCHOICE HMO OF NEW JERSEY (National Association of Insurance Commissioners NAIC id number: 95433 )
Policy contract number300133
Policy instance 74
Insurance contract or identification number300133
Number of Individuals Covered61
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $88
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,051
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $88
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 75
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1256
Insurance policy start date2018-04-01
Insurance policy end date2019-03-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $488,332
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 76
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2474
Insurance policy start date2018-08-01
Insurance policy end date2019-07-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $927,124
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 77
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered866
Insurance policy start date2018-12-01
Insurance policy end date2019-11-30
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $366,476
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 78
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered659
Insurance policy start date2018-02-01
Insurance policy end date2019-01-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $205,902
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 79
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered7427
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $24,812
Total amount of fees paid to insurance companyUSD $3,188
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,097,998
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,352
Amount paid for insurance broker fees1081
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 80
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1944
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $244,260
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 81
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2807
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $914,606
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 82
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2807
Insurance policy start date2018-03-01
Insurance policy end date2019-02-28
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $275,153
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 83
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2542
Insurance policy start date2018-05-01
Insurance policy end date2019-04-30
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $655,285
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 84
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1643
Insurance policy start date2018-11-01
Insurance policy end date2019-10-31
Total amount of commissions paid to insurance brokerUSD $2,489
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $514,337
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,489
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 85
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1708
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
Total amount of commissions paid to insurance brokerUSD $665
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $592,586
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $665
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 86
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered3576
Insurance policy start date2018-09-01
Insurance policy end date2019-08-31
Total amount of commissions paid to insurance brokerUSD $3,544
Total amount of fees paid to insurance companyUSD $1,444
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,198,722
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,519
Amount paid for insurance broker fees1444
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract numberMULTI-CONTRACTS
Policy instance 87
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered86
Insurance policy start date2018-08-01
Insurance policy end date2019-07-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,250,559
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract numberMULTI-CONTRACTS
Policy instance 88
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered51
Insurance policy start date2018-12-01
Insurance policy end date2019-11-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $334,575
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract numberMULTI-CONTRACTS
Policy instance 89
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered32
Insurance policy start date2018-02-01
Insurance policy end date2019-01-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $313,605
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract numberMULTI-CONTRACTS
Policy instance 90
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered298
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,907,628
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract numberMULTI-CONTRACTS
Policy instance 91
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered50
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $516,434
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract numberMULTI-CONTRACTS
Policy instance 92
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered240
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,893,694
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 93
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered130
Insurance policy start date2018-04-01
Insurance policy end date2019-03-31
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $12,893
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 94
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered209
Insurance policy start date2018-12-01
Insurance policy end date2019-11-30
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $64,351
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 95
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered9100
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $304
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,171,087
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $304
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 96
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered992
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $207,307
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 97
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered501
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Total amount of commissions paid to insurance brokerUSD $223
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $125,885
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $223
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 98
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1269
Insurance policy start date2018-03-01
Insurance policy end date2019-02-28
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $180,771
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 99
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered667
Insurance policy start date2018-05-31
Insurance policy end date2019-04-30
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $94,748
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 100
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered289
Insurance policy start date2018-11-01
Insurance policy end date2019-10-31
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $80,620
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 101
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered741
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $102,218
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULT-CONTRACTS
Policy instance 102
Insurance contract or identification numberMULT-CONTRACTS
Number of Individuals Covered1121
Insurance policy start date2018-09-01
Insurance policy end date2019-08-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $249,643
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5567099
Policy instance 103
Insurance contract or identification number5567099
Number of Individuals Covered50
Insurance policy start date2018-04-01
Insurance policy end date2019-03-31
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,881
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberMULTI-CONTRACTS
Policy instance 104
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered5220
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $6,054
Total amount of fees paid to insurance companyUSD $4,676
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,681,519
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,086
Amount paid for insurance broker fees4676
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberMULTI-CONTRACTS
Policy instance 105
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered220
Insurance policy start date2018-03-01
Insurance policy end date2019-02-28
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $49,639
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberMUTLI-CONTRACTS
Policy instance 106
Insurance contract or identification numberMUTLI-CONTRACTS
Number of Individuals Covered650
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $522,795
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
FALLON COMMUNITY HEALTH PLAN -MEDICARE (National Association of Insurance Commissioners NAIC id number: 95541 )
Policy contract numberMULTI-CONTRACTS
Policy instance 107
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered45
Insurance policy start date2018-02-01
Insurance policy end date2019-01-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $22,939
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberMULTI-CONTRACTS
Policy instance 108
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2109
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $596,854
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberMUTI-CONTRACTS
Policy instance 109
Insurance contract or identification numberMUTI-CONTRACTS
Number of Individuals Covered302
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $10,538
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberMULTI-CONTRACTS
Policy instance 110
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered142
Insurance policy start date2018-11-01
Insurance policy end date2019-10-31
Total amount of commissions paid to insurance brokerUSD $51
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,945
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $51
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 111
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1250
Insurance policy start date2018-04-01
Insurance policy end date2019-03-31
Total amount of commissions paid to insurance brokerUSD $40,903
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $192,755
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $20,046
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 112
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1259
Insurance policy start date2018-08-01
Insurance policy end date2019-07-31
Total amount of commissions paid to insurance brokerUSD $47,391
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $222,882
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $24,905
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 113
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered388
Insurance policy start date2018-12-01
Insurance policy end date2019-11-30
Total amount of commissions paid to insurance brokerUSD $8,839
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $35,884
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,876
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 114
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered904
Insurance policy start date2018-02-01
Insurance policy end date2019-01-31
Total amount of commissions paid to insurance brokerUSD $27,366
Total amount of fees paid to insurance companyUSD $1,493
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $142,767
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,519
Amount paid for insurance broker fees1371
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 115
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1273
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $114,591
Total amount of fees paid to insurance companyUSD $6,061
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $215,637
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $58,643
Amount paid for insurance broker fees5606
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 116
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered846
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $21,643
Total amount of fees paid to insurance companyUSD $428
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $114,019
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,415
Amount paid for insurance broker fees396
UNITED OF OMAHA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberMULTI-CONTRACTS
Policy instance 117
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered468
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Total amount of commissions paid to insurance brokerUSD $41,032
Total amount of fees paid to insurance companyUSD $396
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $57,541
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $21,128
Amount paid for insurance broker fees396
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberMULTI-CONTRACTS
Policy instance 118
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered728
Insurance policy start date2018-03-01
Insurance policy end date2019-02-28
Total amount of commissions paid to insurance brokerUSD $25,137
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $131,231
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,961
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberMULTI-CONTRACTS
Policy instance 119
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1548
Insurance policy start date2018-05-01
Insurance policy end date2019-04-30
Total amount of commissions paid to insurance brokerUSD $5,256
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $296,595
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,256
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberMULTI-CONTRACTS
Policy instance 120
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2386
Insurance policy start date2018-11-01
Insurance policy end date2019-10-31
Total amount of commissions paid to insurance brokerUSD $2,185
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $396,921
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,110
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberMULTI-CONTRACTS
Policy instance 121
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered4493
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
Total amount of commissions paid to insurance brokerUSD $34,638
Total amount of fees paid to insurance companyUSD $20,264
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,417,271
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $18,010
Amount paid for insurance broker fees19091
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberMULTI-CONTRACTS
Policy instance 122
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered577
Insurance policy start date2018-09-01
Insurance policy end date2019-08-31
Total amount of commissions paid to insurance brokerUSD $29,039
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $140,823
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,718
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 123
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered11
Insurance policy start date2018-08-01
Insurance policy end date2019-07-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $172,474
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 124
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered627
Insurance policy start date2018-12-01
Insurance policy end date2019-11-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $8,165,903
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 125
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered124
Insurance policy start date2018-02-01
Insurance policy end date2019-01-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,108,086
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 126
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered770
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $8,656,029
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 127
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered332
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,348,450
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 128
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered375
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Total amount of commissions paid to insurance brokerUSD $848
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,435,453
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $848
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 129
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered608
Insurance policy start date2018-03-01
Insurance policy end date2019-02-28
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,027,448
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 130
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered590
Insurance policy start date2018-05-01
Insurance policy end date2019-04-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,317,089
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 131
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered139
Insurance policy start date2018-11-01
Insurance policy end date2019-10-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,254,084
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 132
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered194
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
Total amount of commissions paid to insurance brokerUSD $6,657
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,967,348
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,657
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 133
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered88
Insurance policy start date2018-09-01
Insurance policy end date2019-08-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $686,077
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1095841
Policy instance 134
Insurance contract or identification number1095841
Number of Individuals Covered95
Insurance policy start date2018-08-01
Insurance policy end date2019-07-31
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $32,929
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberMULTI-CONTRACTS
Policy instance 135
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered440
Insurance policy start date2018-12-01
Insurance policy end date2019-11-30
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $130,518
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberMULTI-CONTRACTS
Policy instance 136
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered255
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $166,499
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberH44693-1
Policy instance 137
Insurance contract or identification numberH44693-1
Number of Individuals Covered167
Insurance policy start date2018-02-01
Insurance policy end date2019-01-31
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $88,838
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberMULTI-CONTRACTS
Policy instance 138
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered155
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $37,815
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberMULTI-CONTRACTS
Policy instance 139
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered96
Insurance policy start date2018-05-01
Insurance policy end date2019-04-30
Total amount of commissions paid to insurance brokerUSD $138
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $35,418
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $138
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberMULTI-CONTRACTS
Policy instance 140
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered164
Insurance policy start date2018-11-01
Insurance policy end date2019-10-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $73,455
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract numberMULTI-CONTRACTS
Policy instance 141
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered400
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $14,069
Total amount of fees paid to insurance companyUSD $52
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $75,930
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,945
Amount paid for insurance broker fees52
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number89957
Policy instance 142
Insurance contract or identification number89957
Number of Individuals Covered124
Insurance policy start date2018-05-01
Insurance policy end date2019-04-30
Total amount of commissions paid to insurance brokerUSD $8,068
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $64,623
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,068
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 143
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered177
Insurance policy start date2018-04-01
Insurance policy end date2019-03-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,480,272
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberMULTI-CONTRACTS
Policy instance 144
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered245
Insurance policy start date2018-12-01
Insurance policy end date2019-11-30
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $50,166
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberMULTI-CONTRACTS
Policy instance 145
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered36
Insurance policy start date2018-02-01
Insurance policy end date2019-01-31
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,859
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71005 )
Policy contract numberMULTI-CONTRACTS
Policy instance 146
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered4777
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $37,059
Total amount of fees paid to insurance companyUSD $3,198
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $373,904
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,579
Amount paid for insurance broker fees3198
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberMULTI-CONTRACTS
Policy instance 147
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered194
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $17,847
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberMULTI-CONTRACTS
Policy instance 148
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered153
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $32,652
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberMULTI-CONTRACTS
Policy instance 149
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered333
Insurance policy start date2018-05-01
Insurance policy end date2019-04-30
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $43,224
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberMULTI-CONTRACTS
Policy instance 150
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered24
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,719
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberMULTI-CONTRACTS
Policy instance 151
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered64
Insurance policy start date2018-09-01
Insurance policy end date2019-08-30
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,182
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number0155417
Policy instance 152
Insurance contract or identification number0155417
Number of Individuals Covered262
Insurance policy start date2018-08-01
Insurance policy end date2019-07-31
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $56,940
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number162441
Policy instance 153
Insurance contract or identification number162441
Number of Individuals Covered351
Insurance policy start date2018-12-01
Insurance policy end date2019-11-30
Total amount of commissions paid to insurance brokerUSD $2,010
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $73,393
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,025
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number447104
Policy instance 154
Insurance contract or identification number447104
Number of Individuals Covered69
Insurance policy start date2018-02-01
Insurance policy end date2019-01-31
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $19,733
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract numberMULTI-CONTRACTS
Policy instance 155
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1047
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $14,223
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $253,475
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,747
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number160153
Policy instance 156
Insurance contract or identification number160153
Number of Individuals Covered118
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $30,344
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract numberMULTI-CONTRACTS
Policy instance 157
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered870
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Total amount of commissions paid to insurance brokerUSD $248
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $70,992
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $248
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract numberMULTI-CONTRACTS
Policy instance 158
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered192
Insurance policy start date2018-05-01
Insurance policy end date2019-04-30
Total amount of commissions paid to insurance brokerUSD $2,287
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $28,217
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,473
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract numberMULTI-CONTRACTS
Policy instance 159
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2952
Insurance policy start date2018-11-01
Insurance policy end date2019-10-31
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $449,852
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number753145
Policy instance 160
Insurance contract or identification number753145
Number of Individuals Covered104
Insurance policy start date2018-09-01
Insurance policy end date2019-08-31
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $49,479
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract number240697
Policy instance 161
Insurance contract or identification number240697
Number of Individuals Covered561
Insurance policy start date2018-04-01
Insurance policy end date2019-03-31
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $462,580
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract numberMULTI-CONTRACTS
Policy instance 162
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered887
Insurance policy start date2018-04-01
Insurance policy end date2019-03-31
Total amount of commissions paid to insurance brokerUSD $10,771
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $166,667
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,754
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract numberMULTI-CONTRACTS
Policy instance 163
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered135
Insurance policy start date2018-08-01
Insurance policy end date2019-07-31
Total amount of commissions paid to insurance brokerUSD $6,149
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $58,475
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,512
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract numberMULTI-CONTRACTS
Policy instance 164
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered938
Insurance policy start date2018-12-01
Insurance policy end date2019-11-30
Total amount of commissions paid to insurance brokerUSD $9,519
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $141,486
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,415
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract numberMULTI-CONTRACTS
Policy instance 165
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1452
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $12,359
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $217,717
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,758
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract numberMULTI-CONTRACTS
Policy instance 166
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1518
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $37,929
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $393,882
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,256
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract numberMULTI-CONTRACTS
Policy instance 167
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered726
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Total amount of commissions paid to insurance brokerUSD $35,506
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $183,197
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,400
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract number819037
Policy instance 168
Insurance contract or identification number819037
Number of Individuals Covered399
Insurance policy start date2018-03-01
Insurance policy end date2019-02-28
Total amount of commissions paid to insurance brokerUSD $11,506
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $102,185
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,377
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract numberMULTI-CONTRACTS
Policy instance 169
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered234
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
Total amount of commissions paid to insurance brokerUSD $4,943
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $45,274
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,482
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number5486587
Policy instance 170
Insurance contract or identification number5486587
Number of Individuals Covered21
Insurance policy start date2018-09-01
Insurance policy end date2019-08-31
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $13,749
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 171
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered54
Insurance policy start date2018-08-01
Insurance policy end date2019-07-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $26,991
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 172
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered276
Insurance policy start date2018-12-01
Insurance policy end date2019-11-30
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $756,293
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 173
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered171
Insurance policy start date2018-02-01
Insurance policy end date2019-01-31
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $739,123
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 174
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered4172
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $79,302
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $11,066,162
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $53,616
UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 175
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered335
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $3,759
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,242,371
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,759
UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 176
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered348
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Total amount of commissions paid to insurance brokerUSD $82,381
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,918,941
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $58,653
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract numberMULTI-CONTRACTS
Policy instance 177
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered318
Insurance policy start date2018-04-01
Insurance policy end date2019-03-31
Total amount of commissions paid to insurance brokerUSD $13,307
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $58,261
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,622
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract numberMULTI-CONTRACTS
Policy instance 178
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered109
Insurance policy start date2018-08-01
Insurance policy end date2019-07-31
Total amount of commissions paid to insurance brokerUSD $7,667
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $19,911
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,984
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract numberMULTI-CONTRACTS
Policy instance 179
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered458
Insurance policy start date2018-12-01
Insurance policy end date2019-11-30
Total amount of commissions paid to insurance brokerUSD $60,622
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $185,543
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $30,110
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract numberMULTI-CONTRACTS
Policy instance 180
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered264
Insurance policy start date2018-02-01
Insurance policy end date2019-01-31
Total amount of commissions paid to insurance brokerUSD $12,817
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $46,272
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,516
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract numberMULTI-CONTRACTS
Policy instance 181
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered4365
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $199,514
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $969,965
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $98,425
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract numberMULTI-CONTRACTS
Policy instance 182
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered639
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $25,013
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $123,795
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,137
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract numberMULTI-CONTRACTS
Policy instance 183
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered618
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Total amount of commissions paid to insurance brokerUSD $30,577
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $173,097
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,807
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract numberMULTI-CONTRACTS
Policy instance 184
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered172
Insurance policy start date2018-03-01
Insurance policy end date2019-02-28
Total amount of commissions paid to insurance brokerUSD $14,647
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $66,197
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,080
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract numberMULTI-CONTRACTS
Policy instance 185
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered505
Insurance policy start date2018-05-01
Insurance policy end date2019-04-30
Total amount of commissions paid to insurance brokerUSD $19,271
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $83,003
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,553
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract numberMULTI-CONTRACTS
Policy instance 186
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1373
Insurance policy start date2018-11-01
Insurance policy end date2019-10-31
Total amount of commissions paid to insurance brokerUSD $28,298
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $159,223
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,421
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract numberMULTI-CONTRACTS
Policy instance 187
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2312
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
Total amount of commissions paid to insurance brokerUSD $32,930
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $214,083
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,626
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract numberMULTI-CONTRACTS
Policy instance 188
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1556
Insurance policy start date2018-09-01
Insurance policy end date2019-08-31
Total amount of commissions paid to insurance brokerUSD $323,417
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,600,404
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $163,611
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract numberMULTI-CONTRACTS
Policy instance 189
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered42
Insurance policy start date2018-08-01
Insurance policy end date2019-07-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,115
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract numberMULTI-CONTRACTS
Policy instance 190
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered277
Insurance policy start date2018-12-01
Insurance policy end date2019-11-30
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $37,665
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract numberMULTI-CONTRACTS
Policy instance 191
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered59
Insurance policy start date2018-02-01
Insurance policy end date2019-01-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $11,684
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract numberMULTI-CONTRACTS
Policy instance 192
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1069
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $154,802
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract numberMULTI-CONTRACTS
Policy instance 193
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered438
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $57,551
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract numberMULTI-CONTRACTS
Policy instance 194
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered213
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $23,076
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract numberMULTI-CONTRACTS
Policy instance 195
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered260
Insurance policy start date2018-03-01
Insurance policy end date2019-02-28
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $26,321
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract numberMULTI-CONTRACTS
Policy instance 196
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered99
Insurance policy start date2018-05-01
Insurance policy end date2019-04-30
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $17,214
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract number30029779
Policy instance 197
Insurance contract or identification number30029779
Number of Individuals Covered136
Insurance policy start date2018-11-01
Insurance policy end date1209-01-10
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $27,431
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract number30060743
Policy instance 198
Insurance contract or identification number30060743
Number of Individuals Covered995
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $147,209
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract number300083
Policy instance 199
Insurance contract or identification number300083
Number of Individuals Covered54
Insurance policy start date2018-09-01
Insurance policy end date2019-08-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $8,060
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
Policy contract numberMULTI-CONTRACTS
Policy instance 200
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered445
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $2,909
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $485,518
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,909
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
Policy contract number4544
Policy instance 201
Insurance contract or identification number4544
Number of Individuals Covered46
Insurance policy start date2018-12-01
Insurance policy end date2019-11-30
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,833
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
Policy contract numberMULTI-CONTRACTS
Policy instance 202
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered188
Insurance policy start date2018-05-01
Insurance policy end date2019-04-30
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $9,040
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ARKANSAS BLUE CROSS BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 83470 )
Policy contract numberMULTI-CONTRACTS
Policy instance 203
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered290
Insurance policy start date2018-03-01
Insurance policy end date2019-02-28
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,938,875
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 204
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1622
Insurance policy start date2018-03-01
Insurance policy end date2019-02-28
Total amount of commissions paid to insurance brokerUSD $6,983
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $430,549
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,983
UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 205
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1752
Insurance policy start date2018-05-01
Insurance policy end date2019-04-30
Total amount of commissions paid to insurance brokerUSD $163,594
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,741,223
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $60,325
UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 206
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered846
Insurance policy start date2018-11-01
Insurance policy end date2019-10-31
Total amount of commissions paid to insurance brokerUSD $101,545
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,762,175
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $51,910
UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number09Y1191
Policy instance 207
Insurance contract or identification number09Y1191
Number of Individuals Covered41
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $497,776
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 208
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered306
Insurance policy start date2018-09-01
Insurance policy end date2019-08-31
Total amount of commissions paid to insurance brokerUSD $18,377
Total amount of fees paid to insurance companyUSD $47,642
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,189,003
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,309
Amount paid for insurance broker fees47642
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 209
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1277
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $127,264
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $13,388,657
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $80,542
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI_CONTRACTS
Policy instance 210
Insurance contract or identification numberMULTI_CONTRACTS
Number of Individuals Covered555
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,899,660
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 211
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered134
Insurance policy start date2018-03-01
Insurance policy end date2019-02-28
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,535,671
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number777096
Policy instance 212
Insurance contract or identification number777096
Number of Individuals Covered26
Insurance policy start date2018-05-01
Insurance policy end date2019-06-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $168,376
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 213
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered410
Insurance policy start date2018-11-01
Insurance policy end date2019-10-31
Total amount of commissions paid to insurance brokerUSD $2,364
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,764,298
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,364
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 214
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1077
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $14,490,416
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMUTLI-CONTRACTS
Policy instance 215
Insurance contract or identification numberMUTLI-CONTRACTS
Number of Individuals Covered59
Insurance policy start date2018-09-01
Insurance policy end date2019-08-31
Total amount of commissions paid to insurance brokerUSD $6,543
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,078,385
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,543
ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 )
Policy contract numberMULTI-CONTRACTS
Policy instance 216
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered550
Insurance policy start date2018-09-01
Insurance policy end date2019-08-31
Total amount of commissions paid to insurance brokerUSD $3,414
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $724,781
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,707
CONNECTICARE, INC. (National Association of Insurance Commissioners NAIC id number: 95675 )
Policy contract numberMULTI-CONTRACTS
Policy instance 217
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered175
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,417,329
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONNECTICARE, INC. (National Association of Insurance Commissioners NAIC id number: 95675 )
Policy contract number008011
Policy instance 218
Insurance contract or identification number008011
Number of Individuals Covered24
Insurance policy start date2018-09-01
Insurance policy end date2019-08-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $187,305
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract numberMULTI-CONTRACTS
Policy instance 219
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered243
Insurance policy start date2018-03-01
Insurance policy end date2019-02-28
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,375,174
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract numberMULTI-CONTRACT
Policy instance 220
Insurance contract or identification numberMULTI-CONTRACT
Number of Individuals Covered104
Insurance policy start date2018-05-01
Insurance policy end date2019-04-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,148,609
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract numberMULTI-CONTRACTS
Policy instance 221
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered110
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,086,836
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract numberMULTI-CONTRACTS
Policy instance 222
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered81
Insurance policy start date2018-09-01
Insurance policy end date2019-08-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $844,848
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1067967
Policy instance 223
Insurance contract or identification number1067967
Number of Individuals Covered48
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
Total amount of commissions paid to insurance brokerUSD $568
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $13,082
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $568
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1047823
Policy instance 224
Insurance contract or identification number1047823
Number of Individuals Covered69
Insurance policy start date2018-09-01
Insurance policy end date2019-08-30
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $41,853
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION BENEFITS OF AMERICA (National Association of Insurance Commissioners NAIC id number: 53953 )
Policy contract number6300
Policy instance 225
Insurance contract or identification number6300
Number of Individuals Covered52
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,342
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 )
Policy contract numberMULTI-CONTRACTS
Policy instance 1
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered185
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $299
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $13,136
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $299
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 2
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1061
Insurance policy start date2017-09-01
Insurance policy end date2018-08-31
Total amount of commissions paid to insurance brokerUSD $1,006
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $152,807
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,006
CONNECTICARE, INC. (National Association of Insurance Commissioners NAIC id number: 95675 )
Policy contract number007889
Policy instance 4
Insurance contract or identification number007889
Number of Individuals Covered28
Insurance policy start date2017-09-01
Insurance policy end date2018-08-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $345,450
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONNECTICARE, INC. (National Association of Insurance Commissioners NAIC id number: 95675 )
Policy contract numberMULTI-CONTRACTS
Policy instance 3
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered140
Insurance policy start date2017-10-01
Insurance policy end date2018-09-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,552,342
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberMULTI-CONTRACTS
Policy instance 5
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered101
Insurance policy start date2017-05-01
Insurance policy end date2018-04-30
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $11,014
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMUTLI-CONTRACTS
Policy instance 6
Insurance contract or identification numberMUTLI-CONTRACTS
Number of Individuals Covered1535
Insurance policy start date2017-05-01
Insurance policy end date2018-04-30
Total amount of commissions paid to insurance brokerUSD $107,627
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,951,420
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $75,578
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 7
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered8660
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $518,112
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,273,347
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $157,535
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number772654
Policy instance 8
Insurance contract or identification number772654
Number of Individuals Covered842
Insurance policy start date2017-10-01
Insurance policy end date2018-09-30
Total amount of commissions paid to insurance brokerUSD $39,501
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $385,010
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17,177
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number696715
Policy instance 9
Insurance contract or identification number696715
Number of Individuals Covered1611
Insurance policy start date2017-08-01
Insurance policy end date2018-09-30
Total amount of commissions paid to insurance brokerUSD $156,528
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $995,259
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $100,649
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 10
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered8036
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $72,297
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $549,220
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,516
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 11
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered95
Insurance policy start date2017-04-01
Insurance policy end date2018-03-31
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $226,919
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number477384
Policy instance 12
Insurance contract or identification number477384
Number of Individuals Covered47
Insurance policy start date2017-08-01
Insurance policy end date2018-07-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $433,368
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA (National Association of Insurance Commissioners NAIC id number: 78700 )
Policy contract numberMULTI-CONTRACTS
Policy instance 13
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered236
Insurance policy start date2017-12-01
Insurance policy end date2018-11-30
Total amount of commissions paid to insurance brokerUSD $227
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,369,962
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $227
AETNA LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 14
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2883
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $463,092
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $16,886,475
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $158,210
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 15
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered364
Insurance policy start date2017-06-01
Insurance policy end date2018-05-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,289,183
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 16
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered616
Insurance policy start date2017-03-01
Insurance policy end date2018-02-28
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,285,351
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number773080
Policy instance 17
Insurance contract or identification number773080
Number of Individuals Covered205
Insurance policy start date2017-05-01
Insurance policy end date2018-04-30
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $23,440
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 18
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered343
Insurance policy start date2017-11-01
Insurance policy end date2018-10-31
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,560,055
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 19
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered429
Insurance policy start date2017-10-01
Insurance policy end date2018-09-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,187,116
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 20
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered311
Insurance policy start date2017-09-01
Insurance policy end date2018-08-31
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,054,504
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberMULTI-CONTRACTS
Policy instance 21
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered101
Insurance policy start date2017-04-01
Insurance policy end date2018-03-31
Total amount of commissions paid to insurance brokerUSD $5,454
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $81,373
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,458
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number10-36239-15
Policy instance 22
Insurance contract or identification number10-36239-15
Number of Individuals Covered15
Insurance policy start date2017-08-01
Insurance policy end date2018-07-31
Total amount of commissions paid to insurance brokerUSD $396
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $9,908
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $293
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberMULTI-CONTRACTS
Policy instance 23
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered35
Insurance policy start date2017-12-01
Insurance policy end date2018-11-30
Total amount of commissions paid to insurance brokerUSD $2,619
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $27,834
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,595
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number10-41703
Policy instance 24
Insurance contract or identification number10-41703
Number of Individuals Covered53
Insurance policy start date2017-02-01
Insurance policy end date2018-01-31
Total amount of commissions paid to insurance brokerUSD $977
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $11,113
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $977
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberMULTI-CONTRACTS
Policy instance 25
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered562
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $11,423
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $180,856
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,973
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberMULTI-CONTRACTS
Policy instance 26
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered89
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $2,157
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $37,252
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,079
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberMULTI-CONTRACTS
Policy instance 27
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered79
Insurance policy start date2017-06-01
Insurance policy end date2018-05-31
Total amount of commissions paid to insurance brokerUSD $1,216
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $12,155
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $529
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number10-035124
Policy instance 28
Insurance contract or identification number10-035124
Number of Individuals Covered53
Insurance policy start date2017-03-01
Insurance policy end date2018-02-28
Total amount of commissions paid to insurance brokerUSD $2,093
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $36,385
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,093
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number10-36239-29
Policy instance 29
Insurance contract or identification number10-36239-29
Number of Individuals Covered3
Insurance policy start date2017-05-01
Insurance policy end date2018-04-30
Total amount of commissions paid to insurance brokerUSD $138
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,380
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $78
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberMULTI-CONTRACTS
Policy instance 30
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2
Insurance policy start date2017-11-01
Insurance policy end date2018-10-31
Total amount of commissions paid to insurance brokerUSD $28
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $295
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $28
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberMULTI-CONTRACTS
Policy instance 31
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered21
Insurance policy start date2017-09-01
Insurance policy end date2018-08-31
Total amount of commissions paid to insurance brokerUSD $1,663
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $17,389
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,376
ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 )
Policy contract numberMULTI-CONTRACTS
Policy instance 33
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered83
Insurance policy start date2017-08-01
Insurance policy end date2018-07-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $34,417
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 )
Policy contract number068946009
Policy instance 32
Insurance contract or identification number068946009
Number of Individuals Covered55
Insurance policy start date2017-04-01
Insurance policy end date2018-03-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $492,784
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 )
Policy contract numberMULTI-CONTRACTS
Policy instance 34
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered388
Insurance policy start date2017-12-01
Insurance policy end date2018-11-30
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $135,527
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 )
Policy contract number610052
Policy instance 35
Insurance contract or identification number610052
Number of Individuals Covered61
Insurance policy start date2017-02-01
Insurance policy end date2018-01-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,175
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 )
Policy contract numberMULTI-CONTRACTS
Policy instance 36
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1721
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $9,565
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $550,509
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,668
ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 )
Policy contract numberMULTI-CONTRACTS
Policy instance 37
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered209
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $3,629
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $122,535
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,164
ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 )
Policy contract numberMULTI-CONTRACTS
Policy instance 38
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered231
Insurance policy start date2017-06-01
Insurance policy end date2018-05-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $105,635
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ARKANSAS BLUE CROSS BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 83470 )
Policy contract number111812912
Policy instance 39
Insurance contract or identification number111812912
Number of Individuals Covered283
Insurance policy start date2017-03-01
Insurance policy end date2018-02-28
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,831,961
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 40
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered820
Insurance policy start date2017-04-01
Insurance policy end date2018-03-31
Total amount of commissions paid to insurance brokerUSD $1,139
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,325,042
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,139
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberMULTI-CONTRACTS
Policy instance 41
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered986
Insurance policy start date2017-08-01
Insurance policy end date2018-07-31
Total amount of commissions paid to insurance brokerUSD $47
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $287,008
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $47
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 42
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered420
Insurance policy start date2017-12-01
Insurance policy end date2018-11-30
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,140,608
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberMULTI-CONTRACTS
Policy instance 43
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered817
Insurance policy start date2017-02-01
Insurance policy end date2018-01-31
Total amount of commissions paid to insurance brokerUSD $447
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $738,750
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $447
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 44
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered10633
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $27,634,199
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract numberMULTI-CONTRACTS
Policy instance 45
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered5545
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $15,264
Total amount of fees paid to insurance companyUSD $7,632
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $9,200,237
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,264
Amount paid for insurance broker fees7632
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 46
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2441
Insurance policy start date2017-06-01
Insurance policy end date2018-05-31
Total amount of commissions paid to insurance brokerUSD $161
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $1,563,567
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $161
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 47
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1214
Insurance policy start date2017-03-01
Insurance policy end date2018-02-28
Total amount of commissions paid to insurance brokerUSD $1,977
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,624,585
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $990
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 48
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered3531
Insurance policy start date2017-05-01
Insurance policy end date2018-04-30
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $8,362,482
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 49
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1503
Insurance policy start date2017-11-01
Insurance policy end date2018-10-31
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $873,127
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 50
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered135
Insurance policy start date2017-10-01
Insurance policy end date2018-09-30
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $30,146
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONNECTICARE, INC. (National Association of Insurance Commissioners NAIC id number: 95675 )
Policy contract number006569
Policy instance 51
Insurance contract or identification number006569
Number of Individuals Covered53
Insurance policy start date2017-04-01
Insurance policy end date2018-03-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $343,527
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONNECTICARE, INC. (National Association of Insurance Commissioners NAIC id number: 95675 )
Policy contract number007720
Policy instance 52
Insurance contract or identification number007720
Number of Individuals Covered86
Insurance policy start date2017-08-01
Insurance policy end date2018-07-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $645,716
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONNECTICARE, INC. (National Association of Insurance Commissioners NAIC id number: 95675 )
Policy contract numberMULTI-CONTRACTS
Policy instance 53
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered299
Insurance policy start date2017-12-01
Insurance policy end date2018-11-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,171,337
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONNECTICARE, INC. (National Association of Insurance Commissioners NAIC id number: 95675 )
Policy contract numberMULTI-CONTRACTS
Policy instance 54
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered856
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $12,681,921
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONNECTICARE, INC. (National Association of Insurance Commissioners NAIC id number: 95675 )
Policy contract numberMULTI-CONTRACTS
Policy instance 55
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered161
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,874,771
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONNECTICARE, INC. (National Association of Insurance Commissioners NAIC id number: 95675 )
Policy contract numberMULTI-CONTRACTS
Policy instance 56
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered84
Insurance policy start date2017-06-01
Insurance policy end date2018-05-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $987,387
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONNECTICARE, INC. (National Association of Insurance Commissioners NAIC id number: 95675 )
Policy contract numberMULTI-CONTRACTS
Policy instance 57
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered89
Insurance policy start date2017-11-01
Insurance policy end date2018-10-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,449,864
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract number9877325
Policy instance 58
Insurance contract or identification number9877325
Number of Individuals Covered28
Insurance policy start date2017-04-01
Insurance policy end date2018-03-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,401
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract number9882929
Policy instance 59
Insurance contract or identification number9882929
Number of Individuals Covered109
Insurance policy start date2017-08-01
Insurance policy end date2018-07-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $11,298
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract numberMULTI-CONTRACTS
Policy instance 60
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered189
Insurance policy start date2017-12-01
Insurance policy end date2018-11-30
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $18,981
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract numberMULTI-CONTRACTS
Policy instance 61
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1992
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $513
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $237,129
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $513
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract number1001246
Policy instance 62
Insurance contract or identification number1001246
Number of Individuals Covered335
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $45,709
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract number9813544
Policy instance 64
Insurance contract or identification number9813544
Number of Individuals Covered109
Insurance policy start date2017-03-01
Insurance policy end date2018-02-28
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $13,156
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract numberMULTI-CONTRACTS
Policy instance 63
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered395
Insurance policy start date2017-06-01
Insurance policy end date2018-05-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $31,451
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract number9816570
Policy instance 65
Insurance contract or identification number9816570
Number of Individuals Covered146
Insurance policy start date2017-05-01
Insurance policy end date2018-04-30
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $14,026
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 numberF018610
Policy instance 66
Insurance contract or identification numberF018610
Number of Individuals Covered93
Insurance policy start date2017-09-01
Insurance policy end date2018-08-31
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,660
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
WELLCHOICE HMO OF NEW JERSEY (National Association of Insurance Commissioners NAIC id number: 95433 )
Policy contract number300133
Policy instance 67
Insurance contract or identification number300133
Number of Individuals Covered67
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,000
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
FALLON COMMUNITY HEALTH PLAN -MEDICARE (National Association of Insurance Commissioners NAIC id number: 95541 )
Policy contract numberMULTI-CONTRACTS
Policy instance 68
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered41
Insurance policy start date2017-02-01
Insurance policy end date2018-01-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $340,335
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 )
Policy contract numberMULTI-CONTRACTS
Policy instance 69
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered32
Insurance policy start date2017-12-01
Insurance policy end date2018-11-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $559,895
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 )
Policy contract numberMULTI-CONTRACTS
Policy instance 70
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered56
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $698,926
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 )
Policy contract number468F1GM30
Policy instance 71
Insurance contract or identification number468F1GM30
Number of Individuals Covered43
Insurance policy start date2017-06-01
Insurance policy end date2018-05-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $81,577
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 )
Policy contract numberMULTI-CONTRACTS
Policy instance 72
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered809
Insurance policy start date2017-09-01
Insurance policy end date2018-08-31
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract numberMULTI-CONTRACTS
Policy instance 73
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered145
Insurance policy start date2017-10-01
Insurance policy end date2018-09-30
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $14,901
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract number1012272
Policy instance 74
Insurance contract or identification number1012272
Number of Individuals Covered67
Insurance policy start date2017-09-01
Insurance policy end date2018-08-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $12,742
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 75
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1634
Insurance policy start date2017-04-01
Insurance policy end date2018-03-31
Total amount of commissions paid to insurance brokerUSD $14,123
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $458,144
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,617
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 76
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2295
Insurance policy start date2017-08-01
Insurance policy end date2018-07-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $500,293
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 77
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered453
Insurance policy start date2017-12-01
Insurance policy end date2018-11-30
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $200,467
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 78
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered467
Insurance policy start date2017-02-01
Insurance policy end date2018-01-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $105,782
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 79
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered8664
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $10,859
Total amount of fees paid to insurance companyUSD $1,444
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $2,470,418
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,001
Amount paid for insurance broker fees1444
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 80
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered4739
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $822,827
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 81
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2468
Insurance policy start date2017-06-01
Insurance policy end date2018-05-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $565,672
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 82
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1988
Insurance policy start date2017-03-01
Insurance policy end date2018-02-28
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $297,818
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 83
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2437
Insurance policy start date2017-05-01
Insurance policy end date2018-04-30
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $488,462
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 84
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1930
Insurance policy start date2017-11-01
Insurance policy end date2018-10-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $459,584
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 85
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1792
Insurance policy start date2017-10-01
Insurance policy end date2018-09-30
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $399,386
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 86
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered4941
Insurance policy start date2017-09-01
Insurance policy end date2018-08-31
Total amount of commissions paid to insurance brokerUSD $14,703
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,184,404
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,417
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract numberMULTI-CONTRACTS
Policy instance 87
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered108
Insurance policy start date2017-12-01
Insurance policy end date2018-11-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $855,413
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract numberMULTI-CONTRACTS
Policy instance 88
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered295
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,757,545
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract numberMULTI-CONTRACTS
Policy instance 89
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered119
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,214,602
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract numberMULTI-CONTRACTS
Policy instance 90
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered399
Insurance policy start date2017-06-01
Insurance policy end date2018-05-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,214,017
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract numberMULTI-CONTRACTS
Policy instance 91
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered119
Insurance policy start date2017-05-01
Insurance policy end date2018-04-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $968,912
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract numberMULTI-CONTRACTS
Policy instance 92
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered92
Insurance policy start date2017-09-01
Insurance policy end date2018-08-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $841,921
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 93
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1227
Insurance policy start date2017-04-01
Insurance policy end date2018-03-31
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $116,699
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 )
Policy contract numberMULTI-CONTRACTS
Policy instance 95
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered11291
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $4,435
Total amount of fees paid to insurance companyUSD $1,031
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,176,858
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,432
Amount paid for insurance broker fees956
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 94
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered614
Insurance policy start date2017-12-01
Insurance policy end date2018-11-30
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $110,249
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 96
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2307
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $305,801
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 97
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1337
Insurance policy start date2017-06-01
Insurance policy end date2018-05-31
Total amount of commissions paid to insurance brokerUSD $12,010
Total amount of fees paid to insurance companyUSD $10,127
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $268,302
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,693
Amount paid for insurance broker fees10127
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 98
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1550
Insurance policy start date2017-03-01
Insurance policy end date2018-02-28
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $160,730
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 99
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered341
Insurance policy start date2017-05-01
Insurance policy end date2018-04-30
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $28,735
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 100
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered819
Insurance policy start date2017-11-01
Insurance policy end date2018-10-31
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $112,826
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 101
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1385
Insurance policy start date2017-10-01
Insurance policy end date2018-09-30
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $196,583
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULT-CONTRACTS
Policy instance 102
Insurance contract or identification numberMULT-CONTRACTS
Number of Individuals Covered1414
Insurance policy start date2017-09-01
Insurance policy end date2018-08-31
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $211,065
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5567099
Policy instance 103
Insurance contract or identification number5567099
Number of Individuals Covered76
Insurance policy start date2017-04-01
Insurance policy end date2018-03-31
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $20,008
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number994809
Policy instance 104
Insurance contract or identification number994809
Number of Individuals Covered89
Insurance policy start date2017-12-01
Insurance policy end date2018-11-30
Dental Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $37,754
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number533776
Policy instance 105
Insurance contract or identification number533776
Number of Individuals Covered6492
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,504,447
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberMUTLI-CONTRACTS
Policy instance 106
Insurance contract or identification numberMUTLI-CONTRACTS
Number of Individuals Covered175
Insurance policy start date2017-03-01
Insurance policy end date2018-02-28
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $26,148
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberMULTI-CONTRACTS
Policy instance 107
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered468
Insurance policy start date2017-10-01
Insurance policy end date2018-09-30
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $446,778
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 )
Policy contract numberMULTI-CONTRACTS
Policy instance 108
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered288
Insurance policy start date2017-03-01
Insurance policy end date2018-02-28
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $91,699
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 )
Policy contract numberAL00006267
Policy instance 109
Insurance contract or identification numberAL00006267
Number of Individuals Covered232
Insurance policy start date2017-10-01
Insurance policy end date2018-09-30
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $18,973
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 )
Policy contract numberAL0005931
Policy instance 110
Insurance contract or identification numberAL0005931
Number of Individuals Covered176
Insurance policy start date2017-09-01
Insurance policy end date2018-08-31
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $18,018
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberMULTI-CONTRACTS
Policy instance 111
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1368
Insurance policy start date2017-04-01
Insurance policy end date2018-03-31
Total amount of commissions paid to insurance brokerUSD $35,457
Total amount of fees paid to insurance companyUSD $870
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $135,677
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17,947
Amount paid for insurance broker fees528
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberMULTI-CONTRACTS
Policy instance 112
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2164
Insurance policy start date2017-08-01
Insurance policy end date2018-07-31
Total amount of commissions paid to insurance brokerUSD $39,601
Total amount of fees paid to insurance companyUSD $1,437
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $189,789
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $19,491
Amount paid for insurance broker fees1437
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 113
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered786
Insurance policy start date2017-12-01
Insurance policy end date2018-11-30
Total amount of commissions paid to insurance brokerUSD $16,988
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $122,645
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,157
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 114
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered742
Insurance policy start date2017-02-01
Insurance policy end date2018-01-31
Total amount of commissions paid to insurance brokerUSD $20,704
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $69,653
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,236
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 115
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered3621
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $83,396
Total amount of fees paid to insurance companyUSD $3,425
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $367,198
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $44,456
Amount paid for insurance broker fees2957
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 116
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered333
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $13,776
Total amount of fees paid to insurance companyUSD $1,381
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $53,870
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,736
Amount paid for insurance broker fees1213
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 117
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1075
Insurance policy start date2017-06-01
Insurance policy end date2018-05-31
Total amount of commissions paid to insurance brokerUSD $44,354
Total amount of fees paid to insurance companyUSD $2,619
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $173,244
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $23,339
Amount paid for insurance broker fees2327
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberMULTI-CONTRACTS
Policy instance 118
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered631
Insurance policy start date2017-03-01
Insurance policy end date2018-02-28
Total amount of commissions paid to insurance brokerUSD $11,380
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $51,592
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,619
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberMULTI-CONTRACTS
Policy instance 119
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered215
Insurance policy start date2017-05-01
Insurance policy end date2018-04-30
Total amount of commissions paid to insurance brokerUSD $4,616
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $20,469
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,322
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000ATLW
Policy instance 120
Insurance contract or identification numberG000ATLW
Number of Individuals Covered166
Insurance policy start date2017-11-01
Insurance policy end date2018-10-31
Total amount of commissions paid to insurance brokerUSD $2,225
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $10,419
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,183
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberMULTI-CONTRACTS
Policy instance 121
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2804
Insurance policy start date2017-10-01
Insurance policy end date2018-09-30
Total amount of commissions paid to insurance brokerUSD $27,079
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $572,143
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,987
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberMULTI-CONTRACTS
Policy instance 122
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered342
Insurance policy start date2017-09-01
Insurance policy end date2018-08-31
Total amount of commissions paid to insurance brokerUSD $17,482
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $82,198
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,837
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberHP9360
Policy instance 123
Insurance contract or identification numberHP9360
Number of Individuals Covered91
Insurance policy start date2017-04-01
Insurance policy end date2018-03-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $796,615
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 125
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered520
Insurance policy start date2017-12-01
Insurance policy end date2018-11-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,968,761
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberNY20772
Policy instance 124
Insurance contract or identification numberNY20772
Number of Individuals Covered11
Insurance policy start date2017-08-01
Insurance policy end date2018-07-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $173,631
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 126
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered732
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,893,500
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 127
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered353
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,669,486
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 128
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered167
Insurance policy start date2017-06-01
Insurance policy end date2018-05-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,776,345
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 129
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered455
Insurance policy start date2017-03-01
Insurance policy end date2018-02-28
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,018,731
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 130
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered421
Insurance policy start date2017-05-01
Insurance policy end date2018-04-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,943,980
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 131
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered214
Insurance policy start date2017-11-01
Insurance policy end date2018-10-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,588,246
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 132
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered114
Insurance policy start date2017-10-01
Insurance policy end date2018-09-30
Total amount of commissions paid to insurance brokerUSD $1,936
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,058,497
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,936
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 133
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered137
Insurance policy start date2017-09-01
Insurance policy end date2018-08-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,476,249
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberMULTI-CONTRACTS
Policy instance 134
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered98
Insurance policy start date2017-12-01
Insurance policy end date2018-11-30
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $16,095
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberH44693-1
Policy instance 135
Insurance contract or identification numberH44693-1
Number of Individuals Covered303
Insurance policy start date2017-02-01
Insurance policy end date2018-01-31
Total amount of commissions paid to insurance brokerUSD $15,018
Total amount of fees paid to insurance companyUSD $3,466
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $115,521
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,552
Amount paid for insurance broker fees3466
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberMULTI-CONTRACTS
Policy instance 136
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered304
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $43,402
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberH57741
Policy instance 137
Insurance contract or identification numberH57741
Number of Individuals Covered66
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,872
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1018818-10001
Policy instance 138
Insurance contract or identification number1018818-10001
Number of Individuals Covered22
Insurance policy start date2017-05-01
Insurance policy end date2018-04-30
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,886
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberMULTI-CONTRACTS
Policy instance 139
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered165
Insurance policy start date2017-11-01
Insurance policy end date2018-10-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $46,905
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberH27054-1
Policy instance 140
Insurance contract or identification numberH27054-1
Number of Individuals Covered30
Insurance policy start date2017-10-01
Insurance policy end date2018-09-30
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,787
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number60406
Policy instance 141
Insurance contract or identification number60406
Number of Individuals Covered686
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $10,572
Total amount of fees paid to insurance companyUSD $53
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $58,796
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,026
Amount paid for insurance broker fees53
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number89957
Policy instance 142
Insurance contract or identification number89957
Number of Individuals Covered180
Insurance policy start date2017-05-01
Insurance policy end date2018-04-30
Total amount of commissions paid to insurance brokerUSD $9,441
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $69,447
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,441
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number60266
Policy instance 143
Insurance contract or identification number60266
Number of Individuals Covered146
Insurance policy start date2017-09-01
Insurance policy end date2018-08-31
Total amount of commissions paid to insurance brokerUSD $2,256
Total amount of fees paid to insurance companyUSD $53
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $12,493
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,249
Amount paid for insurance broker fees53
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberMULTI-CONTRACTS
Policy instance 144
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered463
Insurance policy start date2017-04-01
Insurance policy end date2018-03-31
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $46,638
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberMULTI-CONTRACTS
Policy instance 145
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered152
Insurance policy start date2017-09-01
Insurance policy end date2018-08-31
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,548
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberMULTI-CONTRACTS
Policy instance 146
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered222
Insurance policy start date2017-12-01
Insurance policy end date2018-11-30
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $21,731
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberMULTI-CONTRACTS
Policy instance 147
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2946
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $18,650
Total amount of fees paid to insurance companyUSD $182
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $181,315
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,065
Amount paid for insurance broker fees182
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberMULTI-CONTRACTS
Policy instance 148
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered179
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $18,377
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberMULTI-CONTRACTS
Policy instance 149
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered100
Insurance policy start date2017-06-01
Insurance policy end date2018-05-31
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $19,170
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number154539
Policy instance 150
Insurance contract or identification number154539
Number of Individuals Covered50
Insurance policy start date2017-08-01
Insurance policy end date2018-07-31
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $26,841
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract numberMULTI-CONTRACTS
Policy instance 151
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered435
Insurance policy start date2017-12-01
Insurance policy end date2018-11-30
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $55,609
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number122155
Policy instance 152
Insurance contract or identification number122155
Number of Individuals Covered78
Insurance policy start date2017-02-01
Insurance policy end date2018-01-31
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $16,916
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract numberMULTI-CONTRACTS
Policy instance 153
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1903
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $48,502
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $403,540
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $18,500
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract numberMULTI-CONTRACTS
Policy instance 155
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered661
Insurance policy start date2017-06-01
Insurance policy end date2018-05-31
Total amount of commissions paid to insurance brokerUSD $230
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $14,920
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $230
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract numberMULTI-CONTRACTS
Policy instance 154
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered225
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $31,257
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number161350
Policy instance 156
Insurance contract or identification number161350
Number of Individuals Covered95
Insurance policy start date2017-03-01
Insurance policy end date2018-02-28
Total amount of commissions paid to insurance brokerUSD $2,079
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $15,718
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,360
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract numberMULTI-CONTRACTS
Policy instance 157
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered366
Insurance policy start date2017-05-01
Insurance policy end date2018-04-30
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $15,326
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract numberMULTI-CONTRACTS
Policy instance 158
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2970
Insurance policy start date2017-11-01
Insurance policy end date2018-10-31
Total amount of commissions paid to insurance brokerUSD $474
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $268,921
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $474
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number753145
Policy instance 159
Insurance contract or identification number753145
Number of Individuals Covered105
Insurance policy start date2017-09-01
Insurance policy end date2018-08-31
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $46,648
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract number824281
Policy instance 160
Insurance contract or identification number824281
Number of Individuals Covered62
Insurance policy start date2017-04-01
Insurance policy end date2018-03-31
Total amount of commissions paid to insurance brokerUSD $2,074
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $8,922
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,130
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract number818226
Policy instance 161
Insurance contract or identification number818226
Number of Individuals Covered107
Insurance policy start date2017-08-01
Insurance policy end date2018-07-31
Total amount of commissions paid to insurance brokerUSD $4,590
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $43,157
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,008
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract numberMULTI-CONTRACTS
Policy instance 162
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered802
Insurance policy start date2017-12-01
Insurance policy end date2018-11-30
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $40,444
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract numberMULTI-CONTRACTS
Policy instance 163
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered3234
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $19,342
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $500,203
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,198
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract numberMULTI-CONTRACTS
Policy instance 164
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1645
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $24,387
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $359,536
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,352
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract numberMULTI-CONTRACTS
Policy instance 165
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered252
Insurance policy start date2017-06-01
Insurance policy end date2018-05-31
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $67,493
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract numberMULTI-CONTRACTS
Policy instance 166
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered501
Insurance policy start date2017-03-01
Insurance policy end date2018-02-28
Total amount of commissions paid to insurance brokerUSD $12,942
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $102,329
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,849
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract numberMULTI-CONTRACTS
Policy instance 167
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered388
Insurance policy start date2017-05-01
Insurance policy end date2018-04-30
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $45,432
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract numberMULTI-CONTRACTS
Policy instance 168
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered93
Insurance policy start date2017-09-01
Insurance policy end date2018-08-31
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $39,529
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 169
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered129
Insurance policy start date2017-04-01
Insurance policy end date2018-03-31
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $290,710
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 170
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered199
Insurance policy start date2017-08-01
Insurance policy end date2018-07-31
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,036,622
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 171
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered301
Insurance policy start date2017-12-01
Insurance policy end date2018-11-30
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,121,009
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 172
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2298
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $91,911
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $10,552,267
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $47,022
UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 173
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered439
Insurance policy start date2017-02-01
Insurance policy end date2018-01-31
Total amount of commissions paid to insurance brokerUSD $1,458
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,753,359
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,458
UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 174
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered138
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $6,043
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,071,715
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,523
UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 175
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered164
Insurance policy start date2017-06-01
Insurance policy end date2018-05-31
Total amount of commissions paid to insurance brokerUSD $1,274
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,328,707
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,274
UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 176
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1635
Insurance policy start date2017-03-01
Insurance policy end date2018-02-28
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $230,814
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract numberMULTI-CONTRACTS
Policy instance 177
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered527
Insurance policy start date2017-04-01
Insurance policy end date2018-03-31
Total amount of commissions paid to insurance brokerUSD $13,362
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $58,073
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,699
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract numberMULTI-CONTRACTS
Policy instance 178
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered235
Insurance policy start date2017-08-01
Insurance policy end date2018-07-31
Total amount of commissions paid to insurance brokerUSD $4,665
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $23,098
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,759
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract numberMULTI-CONTRACTS
Policy instance 179
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered424
Insurance policy start date2017-12-01
Insurance policy end date2018-11-30
Total amount of commissions paid to insurance brokerUSD $33,216
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $87,134
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,755
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract numberMULTI-CONTRACTS
Policy instance 180
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered231
Insurance policy start date2017-02-01
Insurance policy end date2018-01-31
Total amount of commissions paid to insurance brokerUSD $8,171
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $33,734
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,504
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract numberMULTI-CONTRACTS
Policy instance 181
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered5770
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $137,167
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $869,078
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $72,426
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract numberMULTI-CONTRACTS
Policy instance 182
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1234
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $24,023
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $115,574
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,535
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract numberMULTI-CONTRACTS
Policy instance 183
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1115
Insurance policy start date2017-06-01
Insurance policy end date2018-05-31
Total amount of commissions paid to insurance brokerUSD $31,624
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $169,464
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,148
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract numberMULTI-CONTRACTS
Policy instance 185
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered3833
Insurance policy start date2017-10-01
Insurance policy end date2018-09-30
Total amount of commissions paid to insurance brokerUSD $22,051
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $149,110
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,360
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract numberMULTI-CONTRACTS
Policy instance 184
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered538
Insurance policy start date2017-03-01
Insurance policy end date2018-02-28
Total amount of commissions paid to insurance brokerUSD $21,990
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $99,223
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,879
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract numberMULTI-CONTRACTS
Policy instance 186
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered735
Insurance policy start date2017-05-01
Insurance policy end date2018-04-30
Total amount of commissions paid to insurance brokerUSD $24,831
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $103,559
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,354
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract numberMULTI-CONTRACTS
Policy instance 187
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered261
Insurance policy start date2017-11-01
Insurance policy end date2018-10-31
Total amount of commissions paid to insurance brokerUSD $8,784
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $27,056
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,330
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract numberMULTI-CONTRACTS
Policy instance 188
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2602
Insurance policy start date2017-09-01
Insurance policy end date2018-08-31
Total amount of commissions paid to insurance brokerUSD $282,386
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedPFL
Welfare Benefit Premiums Paid to CarrierUSD $1,399,665
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $138,601
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract numberMULTI-CONTRACTS
Policy instance 189
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered49
Insurance policy start date2017-08-01
Insurance policy end date2018-07-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,276
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract numberMULTI-CONTRACTS
Policy instance 190
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered183
Insurance policy start date2017-12-01
Insurance policy end date2018-11-30
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $22,253
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract numberMULTI-CONTRACTS
Policy instance 191
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1100
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $1,457
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $149,904
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,457
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract numberMULTI-CONTRACTS
Policy instance 192
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered425
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $58,319
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract numberMULTI-CONTRACTS
Policy instance 193
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered53
Insurance policy start date2017-06-01
Insurance policy end date2018-05-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,935
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract numberMULTI-CONTRACTS
Policy instance 194
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered434
Insurance policy start date2017-03-01
Insurance policy end date2018-02-28
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $57,764
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract numberMULTI-CONTRACTS
Policy instance 195
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered114
Insurance policy start date2017-05-01
Insurance policy end date2018-04-30
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $19,420
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract numberMULTI-CONTRACTS
Policy instance 196
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered114
Insurance policy start date2017-11-01
Insurance policy end date2018-10-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $21,218
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract number30029779
Policy instance 197
Insurance contract or identification number30029779
Number of Individuals Covered421
Insurance policy start date2017-10-01
Insurance policy end date2018-09-30
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $44,895
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract number30060743
Policy instance 198
Insurance contract or identification number30060743
Number of Individuals Covered62
Insurance policy start date2017-09-01
Insurance policy end date2018-08-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $9,319
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
WELLCHOICE HMO OF NEW JERSEY (National Association of Insurance Commissioners NAIC id number: 95433 )
Policy contract number300083
Policy instance 199
Insurance contract or identification number300083
Number of Individuals Covered245
Insurance policy start date2017-11-01
Insurance policy end date2018-10-31
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $119,704
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
Policy contract number000900-9230
Policy instance 200
Insurance contract or identification number000900-9230
Number of Individuals Covered44
Insurance policy start date2017-08-01
Insurance policy end date2018-07-31
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $13,307
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
Policy contract number4544
Policy instance 201
Insurance contract or identification number4544
Number of Individuals Covered45
Insurance policy start date2017-12-01
Insurance policy end date2018-11-30
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,353
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
Policy contract numberMULTI-CONTRACTS
Policy instance 202
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered334
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $383,640
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
Policy contract numberMULTI-CONTRACTS
Policy instance 203
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered191
Insurance policy start date2017-05-01
Insurance policy end date2018-04-30
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $9,671
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 204
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered664
Insurance policy start date2017-11-01
Insurance policy end date2018-10-31
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,901,608
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 205
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered142
Insurance policy start date2017-10-01
Insurance policy end date2018-09-30
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $604,945
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 206
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered64
Insurance policy start date2017-09-01
Insurance policy end date2018-08-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $21,618
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract number240697
Policy instance 207
Insurance contract or identification number240697
Number of Individuals Covered845
Insurance policy start date2017-04-01
Insurance policy end date2018-03-31
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $406,917
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AVESIS (National Association of Insurance Commissioners NAIC id number: 66583 )
Policy contract numberMULTI-CONTRACTS
Policy instance 1
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered254
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $1,493
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $17,496
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $336
Insurance broker nameHUB INTERNATIONAL NE (WOODBURY)
ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 )
Policy contract numberMULTI-CONTRACTS
Policy instance 2
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered79
Insurance policy start date2016-08-01
Insurance policy end date2017-07-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $32,873
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONNECTICARE, INC. (National Association of Insurance Commissioners NAIC id number: 95675 )
Policy contract number696715
Policy instance 3
Insurance contract or identification number696715
Number of Individuals Covered38
Insurance policy start date2016-08-01
Insurance policy end date2017-07-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $329,863
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONNECTICARE, INC. (National Association of Insurance Commissioners NAIC id number: 95675 )
Policy contract numberMULTI-CONTRACTS
Policy instance 4
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered136
Insurance policy start date2016-10-01
Insurance policy end date2017-09-30
Total amount of commissions paid to insurance brokerUSD $306
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,261,061
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $306
Insurance broker namePROFESSIONAL PENSIONS INC
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract number9877325
Policy instance 5
Insurance contract or identification number9877325
Number of Individuals Covered32
Insurance policy start date2016-04-01
Insurance policy end date2017-03-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $215
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract number0159850000
Policy instance 6
Insurance contract or identification number0159850000
Number of Individuals Covered59
Insurance policy start date2016-10-01
Insurance policy end date2017-09-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $604,494
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE STANDARD LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 89009 )
Policy contract numberMULTI-CONTRACTS
Policy instance 7
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered653
Insurance policy start date2016-12-01
Insurance policy end date2017-11-30
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $121,661
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE STANDARD LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 89009 )
Policy contract number161350
Policy instance 8
Insurance contract or identification number161350
Number of Individuals Covered239
Insurance policy start date2016-03-01
Insurance policy end date2017-02-28
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $15,301
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 9
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered6486
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $460,798
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,814,617
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $182,712
Insurance broker namePETER M KACHIDURIAN
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 10
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered9740
Insurance policy start date2016-07-01
Insurance policy end date2017-06-30
Total amount of commissions paid to insurance brokerUSD $78,979
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $615,856
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,625
Insurance broker nameEMERSON REID & COMPANY, INC. (LEADE
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 11
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1140
Insurance policy start date2016-05-01
Insurance policy end date2017-04-30
Total amount of commissions paid to insurance brokerUSD $101,888
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,103,033
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $61,796
Insurance broker nameEDGEWOOD PARTNERS INSURANCE CENTER
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract numberMULTI-CONTRACTS
Policy instance 12
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered382
Insurance policy start date2016-06-01
Insurance policy end date2017-05-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,122,724
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 13
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered103
Insurance policy start date2016-04-01
Insurance policy end date2017-03-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $209,953
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 14
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered53
Insurance policy start date2016-08-01
Insurance policy end date2017-07-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $404,534
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA (National Association of Insurance Commissioners NAIC id number: 78700 )
Policy contract numberMULTI-CONTRACTS
Policy instance 15
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered322
Insurance policy start date2016-12-01
Insurance policy end date2017-11-30
Total amount of commissions paid to insurance brokerUSD $148
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,552,963
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $148
Insurance broker namePROFESSIONAL PENSIONS INC
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 16
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2164
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $14,985
Total amount of fees paid to insurance companyUSD $4,550
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $13,412,873
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,985
Amount paid for insurance broker fees4550
Insurance broker nameEXUDE BENEFITS GROUP INC
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 17
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered483
Insurance policy start date2016-11-01
Insurance policy end date2017-10-31
Total amount of commissions paid to insurance brokerUSD $28,242
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,402,206
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,256
Insurance broker nameCAMBRIDGE LIFE BROKERAGE LLC
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 18
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1222
Insurance policy start date2016-10-01
Insurance policy end date2017-09-30
Total amount of commissions paid to insurance brokerUSD $14,060
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,420,019
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,060
Insurance broker namePROFESSIONAL PENSIONS INC
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 19
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2167
Insurance policy start date2016-09-01
Insurance policy end date2017-08-31
Total amount of commissions paid to insurance brokerUSD $187,154
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,198,761
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $128,712
Insurance broker nameALLIANT INSURANCE SERVICES INC.
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract numberMULTI-CONTRACTS
Policy instance 20
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered199
Insurance policy start date2016-03-31
Insurance policy end date2017-02-28
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,012,808
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberMULTI-CONTRACTS
Policy instance 21
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered103
Insurance policy start date2016-04-01
Insurance policy end date2017-03-31
Total amount of commissions paid to insurance brokerUSD $5,045
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $75,100
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,328
Insurance broker nameACRISURE DBA SECURITY FIRST INSURAN
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number10-36239-15
Policy instance 22
Insurance contract or identification number10-36239-15
Number of Individuals Covered15
Insurance policy start date2016-08-01
Insurance policy end date2017-07-31
Total amount of commissions paid to insurance brokerUSD $401
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $10,030
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $401
Insurance broker nameACRISURE DBA SECURITY FIRST INSURAN
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberMULTI-CONTRACTS
Policy instance 23
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered17
Insurance policy start date2016-12-01
Insurance policy end date2017-11-30
Total amount of commissions paid to insurance brokerUSD $1,444
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $14,450
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,337
Insurance broker nameACRISURE, LLC DBA THE HEALTH CONSUL
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number10-41703
Policy instance 24
Insurance contract or identification number10-41703
Number of Individuals Covered63
Insurance policy start date2016-02-01
Insurance policy end date2017-01-31
Total amount of commissions paid to insurance brokerUSD $982
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $10,822
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $982
Insurance broker nameASSOCIATED COMMUNITY BROKERS INC.
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberMULTI-CONTRACTS
Policy instance 25
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered534
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $13,555
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $237,941
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,040
Insurance broker nameYOUR PFO CONSULTING, LLC
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberMULTI-CONTRACTS
Policy instance 26
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered74
Insurance policy start date2016-07-01
Insurance policy end date2017-06-30
Total amount of commissions paid to insurance brokerUSD $2,092
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $12,853
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,120
Insurance broker nameRAYMOND CONGELOSI
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberMULTI-CONTRACTS
Policy instance 27
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered63
Insurance policy start date2016-06-01
Insurance policy end date2017-05-31
Total amount of commissions paid to insurance brokerUSD $849
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $8,499
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $476
Insurance broker nameACRISURE DBA SECURITY FIRST INSURAN
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberMULTI-CONTRACTS
Policy instance 28
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered47
Insurance policy start date2016-03-01
Insurance policy end date2017-02-28
Total amount of commissions paid to insurance brokerUSD $1,258
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $13,723
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $972
Insurance broker nameMARK ABRAMS
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number10-36239-29
Policy instance 29
Insurance contract or identification number10-36239-29
Number of Individuals Covered8
Insurance policy start date2016-05-01
Insurance policy end date2017-04-30
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,981
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberMULTI-CONTRACTS
Policy instance 30
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2
Insurance policy start date2016-11-01
Insurance policy end date2017-10-31
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,631
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberMULTI-CONTRACTS
Policy instance 31
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered35
Insurance policy start date2016-09-01
Insurance policy end date2017-08-30
Total amount of commissions paid to insurance brokerUSD $2,298
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $33,479
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,298
Insurance broker nameACRISURE DBA SECURITY FIRST INSURAN
ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 )
Policy contract numberMULTI-CONTRACTS
Policy instance 32
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1725
Insurance policy start date2016-04-01
Insurance policy end date2017-03-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $654,421
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 )
Policy contract numberMULTI-CONTRACTS
Policy instance 33
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered488
Insurance policy start date2016-12-01
Insurance policy end date2017-11-30
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $176,241
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 )
Policy contract numberMULTI-CONTRACTS
Policy instance 34
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered356
Insurance policy start date2016-02-01
Insurance policy end date2017-01-31
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $933,938
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 )
Policy contract numberMULTI-CONTRACTS
Policy instance 35
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered245
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $740,733
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 )
Policy contract number274885
Policy instance 36
Insurance contract or identification number274885
Number of Individuals Covered118
Insurance policy start date2016-07-01
Insurance policy end date2017-06-30
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $84,834
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 )
Policy contract numberMULTI-CONTRACTS
Policy instance 37
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered122
Insurance policy start date2016-06-01
Insurance policy end date2017-05-31
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $72,365
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 )
Policy contract numberAL00006007
Policy instance 38
Insurance contract or identification numberAL00006007
Number of Individuals Covered174
Insurance policy start date2016-11-01
Insurance policy end date2017-10-31
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $191
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ARKANSAS BLUE CROSS BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 83470 )
Policy contract number111812912
Policy instance 39
Insurance contract or identification number111812912
Number of Individuals Covered188
Insurance policy start date2016-03-01
Insurance policy end date2017-02-28
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,101,766
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 40
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2154
Insurance policy start date2016-04-01
Insurance policy end date2017-03-31
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,106,987
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberMULTI-CONTRACTS
Policy instance 41
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered224
Insurance policy start date2016-08-01
Insurance policy end date2017-07-31
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $41,866
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 42
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered339
Insurance policy start date2016-12-01
Insurance policy end date2017-11-30
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,540,173
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberMULTI-CONTRACTS
Policy instance 43
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered545
Insurance policy start date2016-02-01
Insurance policy end date2017-01-31
Total amount of commissions paid to insurance brokerUSD $5,925
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $237,489
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,365
Insurance broker namePROFESSIONAL PENSIONS INC
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberMULTI-CONTRACTS
Policy instance 44
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered9563
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $12,376
Total amount of fees paid to insurance companyUSD $947
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $21,012,200
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,060
Amount paid for insurance broker fees947
Insurance broker nameGANIM GROUP INC
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 45
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered5592
Insurance policy start date2016-07-01
Insurance policy end date2017-06-30
Total amount of commissions paid to insurance brokerUSD $13,089
Total amount of fees paid to insurance companyUSD $6,545
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $8,261,794
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,089
Amount paid for insurance broker fees6545
Insurance broker namePROFESSIONAL PENSIONS INC
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 46
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1597
Insurance policy start date2016-06-01
Insurance policy end date2017-05-31
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,045,121
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 47
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1292
Insurance policy start date2016-03-01
Insurance policy end date2017-02-28
Total amount of commissions paid to insurance brokerUSD $2,002
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,648,164
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,000
Insurance broker nameMAURICE LYONS
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 48
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2952
Insurance policy start date2016-05-01
Insurance policy end date2017-04-30
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,368,521
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract numberMULTI-CONTRACTS
Policy instance 49
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2004
Insurance policy start date2016-11-01
Insurance policy end date2017-10-01
Total amount of commissions paid to insurance brokerUSD $6,755
Total amount of fees paid to insurance companyUSD $6,982
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $436,688
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,755
Amount paid for insurance broker fees227
Insurance broker namePROFESSIONAL PENSIONS INC
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 50
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered161
Insurance policy start date2016-10-01
Insurance policy end date2017-09-30
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $35,534
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONNECTICARE, INC. (National Association of Insurance Commissioners NAIC id number: 95675 )
Policy contract numberMULTI-CONTRACTS
Policy instance 51
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered235
Insurance policy start date2016-12-01
Insurance policy end date2017-11-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,038,646
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONNECTICARE, INC. (National Association of Insurance Commissioners NAIC id number: 95675 )
Policy contract number007273
Policy instance 52
Insurance contract or identification number007273
Number of Individuals Covered1
Insurance policy start date2016-02-01
Insurance policy end date2017-01-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,573
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONNECTICARE, INC. (National Association of Insurance Commissioners NAIC id number: 95675 )
Policy contract numberMULTI-CONTRACTS
Policy instance 53
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered736
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $9,282,716
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONNECTICARE, INC. (National Association of Insurance Commissioners NAIC id number: 95675 )
Policy contract numberMULTI-CONTRACTS
Policy instance 54
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered118
Insurance policy start date2016-07-01
Insurance policy end date2017-06-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,316,716
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONNECTICARE, INC. (National Association of Insurance Commissioners NAIC id number: 95675 )
Policy contract numberMULTI-CONTRACTS
Policy instance 55
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered120
Insurance policy start date2016-06-01
Insurance policy end date2017-05-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,143,161
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONNECTICARE, INC. (National Association of Insurance Commissioners NAIC id number: 95675 )
Policy contract number007465
Policy instance 56
Insurance contract or identification number007465
Number of Individuals Covered30
Insurance policy start date2016-05-01
Insurance policy end date2017-04-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $352,226
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONNECTICARE, INC. (National Association of Insurance Commissioners NAIC id number: 95675 )
Policy contract number007746
Policy instance 57
Insurance contract or identification number007746
Number of Individuals Covered292
Insurance policy start date2016-11-01
Insurance policy end date2017-10-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,244,307
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract numberMULTI-CONTRACTS
Policy instance 58
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered108
Insurance policy start date2016-12-01
Insurance policy end date2017-11-30
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $11,878
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract numberMULTI-CONTRACTS
Policy instance 59
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered720
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $368
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $95,414
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $368
Insurance broker namePROFESSIONAL PENSIONS INC
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract numberMULTI-CONTRACTS
Policy instance 60
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered439
Insurance policy start date2016-07-01
Insurance policy end date2017-06-30
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $41,803
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract numberMULTI-CONTRACTS
Policy instance 61
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered352
Insurance policy start date2016-06-01
Insurance policy end date2017-05-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $33,507
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract number9813544
Policy instance 62
Insurance contract or identification number9813544
Number of Individuals Covered106
Insurance policy start date2016-03-01
Insurance policy end date2017-02-28
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $12,957
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract number9816570
Policy instance 63
Insurance contract or identification number9816570
Number of Individuals Covered158
Insurance policy start date2016-05-01
Insurance policy end date2017-04-30
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $15,404
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract numberMULTI-CONTRACTS
Policy instance 64
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered78
Insurance policy start date2016-10-01
Insurance policy end date2017-09-30
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $10,049
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract number9826181
Policy instance 65
Insurance contract or identification number9826181
Number of Individuals Covered344
Insurance policy start date2016-09-01
Insurance policy end date2017-08-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $21,010
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 numberF018610
Policy instance 66
Insurance contract or identification numberF018610
Number of Individuals Covered78
Insurance policy start date2016-09-01
Insurance policy end date2017-08-31
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,518
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
WELLCHOICE HMO OF NEW JERSEY (National Association of Insurance Commissioners NAIC id number: 95433 )
Policy contract numberMULTI-CONTRACTS
Policy instance 67
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered371
Insurance policy start date2016-03-01
Insurance policy end date2017-02-28
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,506,673
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
FALLON COMMUNITY HEALTH PLAN -MEDICARE (National Association of Insurance Commissioners NAIC id number: 95541 )
Policy contract numberMULTI-CONTRACTS
Policy instance 68
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered39
Insurance policy start date2016-02-01
Insurance policy end date2017-01-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $305,549
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 )
Policy contract numberMULTI-CONTRACTS
Policy instance 69
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered30
Insurance policy start date2016-12-01
Insurance policy end date2017-11-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $467,946
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 )
Policy contract numberMULTI-CONTRACTS
Policy instance 70
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered51
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $616,968
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 )
Policy contract number468F1GM30
Policy instance 71
Insurance contract or identification number468F1GM30
Number of Individuals Covered45
Insurance policy start date2016-06-01
Insurance policy end date2017-05-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $558,921
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 )
Policy contract numberMULTI-CONTRACTS
Policy instance 72
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1424
Insurance policy start date2016-09-01
Insurance policy end date2017-08-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,183,811
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract number0103590000
Policy instance 73
Insurance contract or identification number0103590000
Number of Individuals Covered1
Insurance policy start date2016-08-01
Insurance policy end date2017-07-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,820
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract numberMULTI-CONTRACTS
Policy instance 74
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered636
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,851,537
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 75
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2054
Insurance policy start date2016-04-01
Insurance policy end date2017-03-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $548,138
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 76
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered3792
Insurance policy start date2016-08-01
Insurance policy end date2017-07-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $550,693
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 77
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered440
Insurance policy start date2016-12-01
Insurance policy end date2017-11-30
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $217,188
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 78
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered499
Insurance policy start date2016-02-01
Insurance policy end date2017-01-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $117,658
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 79
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered7760
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $223,270
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 80
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered5581
Insurance policy start date2016-07-01
Insurance policy end date2017-06-30
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $889,564
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 81
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1415
Insurance policy start date2016-06-01
Insurance policy end date2017-05-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $511,927
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 82
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1478
Insurance policy start date2016-03-01
Insurance policy end date2017-02-28
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $413,505
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 83
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2720
Insurance policy start date2016-05-01
Insurance policy end date2017-04-30
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $542,972
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 84
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1327
Insurance policy start date2016-11-01
Insurance policy end date2017-10-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $345,151
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 85
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1387
Insurance policy start date2016-10-01
Insurance policy end date2017-09-30
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $226,914
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 86
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered5076
Insurance policy start date2016-09-01
Insurance policy end date2017-08-30
Total amount of commissions paid to insurance brokerUSD $11,771
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,130,697
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,236
Insurance broker namePROFESSIONAL PENSIONS INC
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract numberMULTI-CONTRACTS
Policy instance 87
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered193
Insurance policy start date2016-05-01
Insurance policy end date2017-04-01
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,746,288
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract numberMULTI-CONTRACTS
Policy instance 88
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered126
Insurance policy start date2016-12-01
Insurance policy end date2017-11-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,302,023
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract numberMULTI-CONTRACTS
Policy instance 89
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered172
Insurance policy start date2016-02-01
Insurance policy end date2017-01-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,742,510
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract numberMULTI-CONTRACTS
Policy instance 90
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered50
Insurance policy start date2016-07-01
Insurance policy end date2017-06-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $485,548
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract numberMULTI-CONTRACTS
Policy instance 91
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered84
Insurance policy start date2016-06-01
Insurance policy end date2017-05-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $919,496
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract numberMULTI-CONTRACTS
Policy instance 92
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered59
Insurance policy start date2016-03-01
Insurance policy end date2017-02-28
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $572,451
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HEALTHYCT (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberMULTICONTRACTS
Policy instance 93
Insurance contract or identification numberMULTICONTRACTS
Number of Individuals Covered210
Insurance policy start date2016-04-01
Insurance policy end date2017-03-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,449,505
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HEALTHYCT (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberMULTI-CONTRACTS
Policy instance 94
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered3
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,362
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HEALTHYCT (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberMULTI-CONTRACTS
Policy instance 95
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered185
Insurance policy start date2016-07-01
Insurance policy end date2017-06-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $957,105
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 96
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1204
Insurance policy start date2016-04-01
Insurance policy end date2017-03-31
Total amount of commissions paid to insurance brokerUSD $849
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $141,391
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $849
Insurance broker namePROFESSIONAL PENSIONS INC
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 97
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered252
Insurance policy start date2016-08-01
Insurance policy end date2017-07-31
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $10,756
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 98
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered278
Insurance policy start date2016-12-01
Insurance policy end date2017-11-30
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $51,074
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 99
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered312
Insurance policy start date2016-02-01
Insurance policy end date2017-01-31
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $87,845
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 100
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered5256
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $869,746
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 101
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1490
Insurance policy start date2016-07-01
Insurance policy end date2017-06-30
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $203,990
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 102
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1018
Insurance policy start date2016-06-01
Insurance policy end date2017-05-31
Total amount of commissions paid to insurance brokerUSD $1,132
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $242,813
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,132
Insurance broker namePROFESSIONAL PENSIONS INC
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 103
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered958
Insurance policy start date2016-03-01
Insurance policy end date2017-02-28
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $65,443
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 104
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered568
Insurance policy start date2016-05-01
Insurance policy end date2017-04-30
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $96,659
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULT-CONTRACTS
Policy instance 105
Insurance contract or identification numberMULT-CONTRACTS
Number of Individuals Covered533
Insurance policy start date2016-11-01
Insurance policy end date2017-10-31
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $64,752
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 106
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1475
Insurance policy start date2016-10-01
Insurance policy end date2017-09-30
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $166,936
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 107
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1266
Insurance policy start date2016-09-01
Insurance policy end date2017-08-31
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $202,730
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number9160602
Policy instance 108
Insurance contract or identification number9160602
Number of Individuals Covered32
Insurance policy start date2016-04-01
Insurance policy end date2017-03-31
Other welfare benefits providedOTHER (SPECIFY)
Welfare Benefit Premiums Paid to CarrierUSD $8,880
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberMULTI-CONTRACTS
Policy instance 109
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered179
Insurance policy start date2016-12-01
Insurance policy end date2017-11-30
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $42,698
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5595669
Policy instance 110
Insurance contract or identification number5595669
Number of Individuals Covered160
Insurance policy start date2016-07-01
Insurance policy end date2017-06-30
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $21,350
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5333776
Policy instance 111
Insurance contract or identification number5333776
Number of Individuals Covered7977
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $24,800
Total amount of fees paid to insurance companyUSD $1,723
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,549,067
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,444
Amount paid for insurance broker fees1685
Insurance broker nameHEFFERNAN INS BROKERS
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberMULTI-CONTRACTS
Policy instance 112
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered294
Insurance policy start date2016-03-01
Insurance policy end date2017-02-28
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $51,997
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberMULTI-CONTRACTS
Policy instance 113
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered456
Insurance policy start date2016-11-01
Insurance policy end date2017-10-31
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $41,300
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberMULTI-CONTRACTS
Policy instance 114
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered436
Insurance policy start date2016-10-01
Insurance policy end date2017-09-30
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $345,971
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5920093
Policy instance 115
Insurance contract or identification number5920093
Number of Individuals Covered92
Insurance policy start date2016-09-01
Insurance policy end date2017-08-31
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $9,612
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 116
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered512
Insurance policy start date2016-04-01
Insurance policy end date2017-03-31
Total amount of commissions paid to insurance brokerUSD $11,782
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $56,681
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,072
Insurance broker nameBROWN & BROWN OF CT DBA DILL JOYCE
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberMULTI-CONTRACTS
Policy instance 117
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1120
Insurance policy start date2016-08-01
Insurance policy end date2017-07-31
Total amount of commissions paid to insurance brokerUSD $30,409
Total amount of fees paid to insurance companyUSD $11,180
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $141,530
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,176
Amount paid for insurance broker fees11180
Insurance broker nameMDG ASSOCIATES OF CT, LLC
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 118
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered811
Insurance policy start date2016-12-01
Insurance policy end date2017-11-30
Total amount of commissions paid to insurance brokerUSD $19,743
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $130,384
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,884
Insurance broker nameEDWIN R MEYER
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 119
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered678
Insurance policy start date2016-02-01
Insurance policy end date2017-01-31
Total amount of commissions paid to insurance brokerUSD $19,467
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $69,570
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,989
Insurance broker nameHOLLISTER INSURANCE BROKERAGE(CLINT
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 120
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2306
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $65,742
Total amount of fees paid to insurance companyUSD $11,744
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $314,472
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $30,948
Amount paid for insurance broker fees8858
Insurance broker nameACRISURE, LLC DBA COMPAIN ANDERSON
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 121
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered289
Insurance policy start date2016-07-01
Insurance policy end date2017-06-30
Total amount of commissions paid to insurance brokerUSD $7,320
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $46,376
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,279
Insurance broker nameHP PLANNING LLC
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 122
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1097
Insurance policy start date2016-06-01
Insurance policy end date2017-05-31
Total amount of commissions paid to insurance brokerUSD $34,597
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $151,324
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,540
Insurance broker namePOWER & WALSH INSURANCE ADVISORS
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberMULTI-CONTRACTS
Policy instance 123
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered582
Insurance policy start date2016-03-01
Insurance policy end date2017-02-28
Total amount of commissions paid to insurance brokerUSD $12,641
Total amount of fees paid to insurance companyUSD $2,868
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $98,701
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,888
Amount paid for insurance broker fees2868
Insurance broker nameBENEFITS CONSULTING GROUP
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberMULTI-CONTRACTS
Policy instance 124
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered206
Insurance policy start date2016-05-01
Insurance policy end date2017-04-30
Total amount of commissions paid to insurance brokerUSD $12,308
Total amount of fees paid to insurance companyUSD $1,494
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $19,936
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,903
Amount paid for insurance broker fees1494
Insurance broker nameRSC INSURANCE BROKERAGE INC. DBA SI
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberMULTI-CONTRACTS
Policy instance 125
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1165
Insurance policy start date2016-11-01
Insurance policy end date2017-10-31
Total amount of commissions paid to insurance brokerUSD $3,372
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $56,184
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,384
Insurance broker nameADAM ROSENFELD
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberMULTI-CONTRACTS
Policy instance 126
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1336
Insurance policy start date2016-10-01
Insurance policy end date2017-09-30
Total amount of commissions paid to insurance brokerUSD $1,355
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $259,050
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $899
Insurance broker nameHEFFERNAN INSURANCE BROKER/PILOT BE
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLTD91A8
Policy instance 127
Insurance contract or identification numberGLTD91A8
Number of Individuals Covered20
Insurance policy start date2016-09-01
Insurance policy end date2017-08-31
Total amount of commissions paid to insurance brokerUSD $5,228
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $16,375
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,841
Insurance broker nameWILLIS OF NEW JERSEY
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberHP9360
Policy instance 128
Insurance contract or identification numberHP9360
Number of Individuals Covered94
Insurance policy start date2016-04-01
Insurance policy end date2017-03-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $769,318
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberNY20772
Policy instance 129
Insurance contract or identification numberNY20772
Number of Individuals Covered17
Insurance policy start date2016-08-01
Insurance policy end date2017-07-31
Total amount of commissions paid to insurance brokerUSD $2,841
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $219,617
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,841
Insurance broker namePROFESSIONAL PENSIONS INC
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 130
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered460
Insurance policy start date2016-12-01
Insurance policy end date2017-11-30
Total amount of commissions paid to insurance brokerUSD $5,376
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,356,501
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,376
Insurance broker namePROFESSIONAL PENSIONS INC
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberRP15275
Policy instance 131
Insurance contract or identification numberRP15275
Number of Individuals Covered18
Insurance policy start date2016-02-01
Insurance policy end date2017-01-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $461,964
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 132
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1166
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $11,273,227
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 133
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered424
Insurance policy start date2016-07-01
Insurance policy end date2017-06-30
Total amount of commissions paid to insurance brokerUSD $30,215
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,440,877
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $29,638
Insurance broker nameCAMBRIDGE LIFE BROKERAGE LLC
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 134
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered88
Insurance policy start date2016-06-01
Insurance policy end date2017-05-31
Total amount of commissions paid to insurance brokerUSD $1,056
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,288,229
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,056
Insurance broker namePROFESSIONAL PENSIONS INC
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 135
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered191
Insurance policy start date2016-03-01
Insurance policy end date2017-02-28
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,455,473
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 136
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered405
Insurance policy start date2016-05-01
Insurance policy end date2017-04-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,475,011
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 137
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered327
Insurance policy start date2016-11-01
Insurance policy end date2017-10-31
Total amount of commissions paid to insurance brokerUSD $1,008
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,481,415
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,008
Insurance broker namePROFESSIONAL PENSIONS INC
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 138
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered115
Insurance policy start date2016-10-01
Insurance policy end date2016-09-30
Total amount of commissions paid to insurance brokerUSD $8,113
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,017,791
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,077
Insurance broker namePROFESSIONAL PENSIONS INC
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 139
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered101
Insurance policy start date2016-09-01
Insurance policy end date2017-08-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $922,535
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberH29253-1
Policy instance 140
Insurance contract or identification numberH29253-1
Number of Individuals Covered9
Insurance policy start date2016-12-01
Insurance policy end date2017-11-30
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $10,287
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberH44693-1
Policy instance 141
Insurance contract or identification numberH44693-1
Number of Individuals Covered294
Insurance policy start date2016-02-01
Insurance policy end date2017-01-31
Total amount of commissions paid to insurance brokerUSD $14,558
Total amount of fees paid to insurance companyUSD $3,360
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $111,984
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,198
Amount paid for insurance broker fees3360
Insurance broker namePROFESSIONAL PENSIONS INC
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberH43785-1
Policy instance 142
Insurance contract or identification numberH43785-1
Number of Individuals Covered4
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,736
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberH57741
Policy instance 143
Insurance contract or identification numberH57741
Number of Individuals Covered68
Insurance policy start date2016-07-01
Insurance policy end date2017-06-30
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,682
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1018818-10001
Policy instance 144
Insurance contract or identification number1018818-10001
Number of Individuals Covered19
Insurance policy start date2016-05-01
Insurance policy end date2017-04-30
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,091
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberH41186-1
Policy instance 145
Insurance contract or identification numberH41186-1
Number of Individuals Covered84
Insurance policy start date2016-11-01
Insurance policy end date2017-10-31
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $37,437
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberMULTI-CONTRACTS
Policy instance 146
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered43
Insurance policy start date2016-10-01
Insurance policy end date2017-09-30
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $10,875
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number06452
Policy instance 147
Insurance contract or identification number06452
Number of Individuals Covered40
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,962
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number89957
Policy instance 148
Insurance contract or identification number89957
Number of Individuals Covered190
Insurance policy start date2016-05-01
Insurance policy end date2017-04-30
Total amount of commissions paid to insurance brokerUSD $9,322
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $70,150
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,322
Insurance broker namePROFESSIONAL PENSIONS INC
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number23387
Policy instance 149
Insurance contract or identification number23387
Number of Individuals Covered225
Insurance policy start date2016-09-01
Insurance policy end date2017-08-31
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $319
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberMULTI-CONTRACTS
Policy instance 150
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered178
Insurance policy start date2016-04-01
Insurance policy end date2017-03-31
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $12,129
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberMULTI-CONTRACTS
Policy instance 151
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered21
Insurance policy start date2016-12-01
Insurance policy end date2017-11-30
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,543
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberMULTI-CONTRACTS
Policy instance 152
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered911
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $5,462
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $143,217
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,356
Insurance broker namePROFESSIONAL PENSIONS INC
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberMULTI-CONTRACTS
Policy instance 153
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered87
Insurance policy start date2016-05-01
Insurance policy end date2017-04-30
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $11,232
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberMULTI-CONTRACTS
Policy instance 154
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered33
Insurance policy start date2016-10-01
Insurance policy end date2017-09-30
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,528
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberMULTI-CONTRACTS
Policy instance 155
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1281
Insurance policy start date2016-09-01
Insurance policy end date2017-08-31
Total amount of commissions paid to insurance brokerUSD $1,629
Total amount of fees paid to insurance companyUSD $182
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $50,681
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,629
Amount paid for insurance broker fees182
Insurance broker nameHUNTINGTON INSURANCE INC
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number154539
Policy instance 156
Insurance contract or identification number154539
Number of Individuals Covered50
Insurance policy start date2016-04-01
Insurance policy end date2017-03-31
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $11,281
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract numberMULTI-CONTRACTS
Policy instance 157
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1176
Insurance policy start date2016-08-01
Insurance policy end date2017-07-31
Total amount of commissions paid to insurance brokerUSD $31,645
Total amount of fees paid to insurance companyUSD $182
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $245,195
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,144
Amount paid for insurance broker fees182
Insurance broker nameCLARK AGENCY LLC
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number122155
Policy instance 158
Insurance contract or identification number122155
Number of Individuals Covered78
Insurance policy start date2016-02-01
Insurance policy end date2017-01-31
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $16,359
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE STANDARD LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 89009 )
Policy contract numberMULTI-CONTRACTS
Policy instance 159
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered3036
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $24,908
Total amount of fees paid to insurance companyUSD $182
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $480,986
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,365
Amount paid for insurance broker fees182
Insurance broker nameE PAUL AMATA NORTHWESTERN MUTUAL
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract numberMULTI-CONTRACTS
Policy instance 160
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered232
Insurance policy start date2016-07-01
Insurance policy end date2017-06-30
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $40,947
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number158357
Policy instance 161
Insurance contract or identification number158357
Number of Individuals Covered56
Insurance policy start date2016-06-01
Insurance policy end date2017-05-31
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $8,844
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract numberMULTI-CONTACTS
Policy instance 162
Insurance contract or identification numberMULTI-CONTACTS
Number of Individuals Covered452
Insurance policy start date2016-05-01
Insurance policy end date2017-04-30
Total amount of commissions paid to insurance brokerUSD $13,692
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $60,875
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,168
Insurance broker namePROFESSIONAL PENSIONS INC
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract numberMULTI-CONTRACTS
Policy instance 163
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered643
Insurance policy start date2016-11-01
Insurance policy end date2017-10-31
Total amount of commissions paid to insurance brokerUSD $3,461
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $52,204
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,461
Insurance broker namePROFESSIONAL PENSIONS INC
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract numberMULTI-CONTRACTS
Policy instance 164
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered246
Insurance policy start date2016-10-01
Insurance policy end date2017-09-30
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $45,178
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number753145
Policy instance 165
Insurance contract or identification number753145
Number of Individuals Covered105
Insurance policy start date2016-09-01
Insurance policy end date2017-08-31
Total amount of commissions paid to insurance brokerUSD $594
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $35,306
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $594
Insurance broker namePROFESSIONAL PENSIONS INC
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract numberMULTI-CONTRACTS
Policy instance 166
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered166
Insurance policy start date2016-12-01
Insurance policy end date2017-11-30
Total amount of commissions paid to insurance brokerUSD $4,515
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $31,278
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,101
Insurance broker namePROFESSIONAL PENSIONS INC
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract number818226
Policy instance 167
Insurance contract or identification number818226
Number of Individuals Covered251
Insurance policy start date2016-08-01
Insurance policy end date2017-07-31
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $42,101
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract numberMULTI-CONTRACTS
Policy instance 168
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered3766
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $52,592
Total amount of fees paid to insurance companyUSD $16,758
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $796,887
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $20,440
Amount paid for insurance broker fees16758
Insurance broker nameKEY INSURANCE & BENEFITS SERVICES I
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract numberMULTI-CONTRACTS
Policy instance 169
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2410
Insurance policy start date2016-07-01
Insurance policy end date2017-06-30
Total amount of commissions paid to insurance brokerUSD $2,099
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $391,481
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,388
Insurance broker namePROFESSIONAL PENSIONS INC
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract number244538
Policy instance 170
Insurance contract or identification number244538
Number of Individuals Covered370
Insurance policy start date2016-06-01
Insurance policy end date2017-05-31
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $72,196
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract number819037
Policy instance 171
Insurance contract or identification number819037
Number of Individuals Covered540
Insurance policy start date2016-03-01
Insurance policy end date2017-02-28
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $94,893
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number245417
Policy instance 172
Insurance contract or identification number245417
Number of Individuals Covered246
Insurance policy start date2016-05-01
Insurance policy end date2017-04-30
Total amount of commissions paid to insurance brokerUSD $8,626
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $44,801
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,651
Insurance broker namePROFESSIONAL PENSIONS INC
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract numberMULTI-CONTRACTS
Policy instance 173
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered15621
Insurance policy start date2016-04-01
Insurance policy end date2017-03-31
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,097,490
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract number028-3316-00
Policy instance 174
Insurance contract or identification number028-3316-00
Number of Individuals Covered36
Insurance policy start date2016-10-01
Insurance policy end date2017-09-30
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $783
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 175
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered200
Insurance policy start date2016-08-01
Insurance policy end date2017-07-31
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $988,575
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 176
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered745
Insurance policy start date2016-12-01
Insurance policy end date2017-11-30
Total amount of commissions paid to insurance brokerUSD $37,672
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,774,456
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $27,314
Insurance broker nameLYNN K GURNHAM
UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 177
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered138
Insurance policy start date2016-02-01
Insurance policy end date2017-01-31
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $406,288
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 178
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered3348
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $354,251
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $9,838,213
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $152,686
Insurance broker namePREFERRED BENEFITS GROUP INC
UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 179
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered544
Insurance policy start date2016-07-01
Insurance policy end date2017-06-30
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,120,253
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 180
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered190
Insurance policy start date2016-06-01
Insurance policy end date2017-05-31
Total amount of commissions paid to insurance brokerUSD $1,066
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $696,356
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,066
Insurance broker namePROFESSIONAL PENSIONS INC
UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 181
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1469
Insurance policy start date2016-03-01
Insurance policy end date2017-02-28
Total amount of commissions paid to insurance brokerUSD $7,640
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $935,572
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,643
Insurance broker nameGALLAGHER BENEFIT SERVICES INC
UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 182
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered327
Insurance policy start date2016-05-01
Insurance policy end date2017-04-30
Total amount of commissions paid to insurance brokerUSD $42,553
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,259,388
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $34,038
Insurance broker namePROFESSIONAL PENSIONS INC
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract numberMULTI-CONTRACTS
Policy instance 183
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered909
Insurance policy start date2016-04-01
Insurance policy end date2017-03-31
Total amount of commissions paid to insurance brokerUSD $15,495
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $66,599
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,756
Insurance broker nameTM BURROWS ASSOC, LLC(WATERFORD,CT)
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract number406002
Policy instance 184
Insurance contract or identification number406002
Number of Individuals Covered165
Insurance policy start date2016-08-01
Insurance policy end date2017-07-31
Total amount of commissions paid to insurance brokerUSD $3,470
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $12,921
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,738
Insurance broker nameJS BENEFITS GROUP
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract numberMULTI-CONTRACTS
Policy instance 185
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered892
Insurance policy start date2016-12-01
Insurance policy end date2017-11-30
Total amount of commissions paid to insurance brokerUSD $54,713
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $150,592
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $27,886
Insurance broker nameRAYMOND CONGELOSI
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract numberMULTI-CONTRACTS
Policy instance 186
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered563
Insurance policy start date2016-02-01
Insurance policy end date2017-01-31
Total amount of commissions paid to insurance brokerUSD $18,536
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $75,334
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,471
Insurance broker namePOWER & WALSH INSURANCE ADVISORS
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract numberMULTI-CONTRACTS
Policy instance 187
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered5296
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $183,529
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,022,055
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $90,178
Insurance broker nameATLANTIC AGENTS LLC
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract numberMULTI-CONTRACTS
Policy instance 188
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1256
Insurance policy start date2016-07-01
Insurance policy end date2017-06-30
Total amount of commissions paid to insurance brokerUSD $24,723
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $107,386
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,714
Insurance broker nameLILIAN DE SOUZA
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract numberMULTI-CONTRACTS
Policy instance 189
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered646
Insurance policy start date2016-06-01
Insurance policy end date2017-05-31
Total amount of commissions paid to insurance brokerUSD $22,787
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $124,958
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,203
Insurance broker nameTHE MEDICAL LINK, LLC
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract numberMULTI-CONTRACTS
Policy instance 190
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered747
Insurance policy start date2016-03-01
Insurance policy end date2017-02-28
Total amount of commissions paid to insurance brokerUSD $30,377
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $112,382
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,566
Insurance broker nameJASON MINNELLA
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract numberMULTI-CONTRACTS
Policy instance 191
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered754
Insurance policy start date2016-05-01
Insurance policy end date2017-04-30
Total amount of commissions paid to insurance brokerUSD $30,654
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $120,744
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,740
Insurance broker namePROFESSIONAL BENEFITS SERVICE
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract numberMULTI-CONTRACTS
Policy instance 192
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered130
Insurance policy start date2016-11-01
Insurance policy end date2017-10-31
Total amount of commissions paid to insurance brokerUSD $4,183
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $12,378
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,198
Insurance broker nameACRISURE, LLC DBA COMPAIN ANDERSON
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract numberMULTI-CONTRACTS
Policy instance 193
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered3244
Insurance policy start date2016-10-01
Insurance policy end date2017-09-30
Total amount of commissions paid to insurance brokerUSD $19,817
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $128,972
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,016
Insurance broker nameASCELA PARTNERS, LLC
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract numberMULTI-CONTRACTS
Policy instance 194
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered4382
Insurance policy start date2016-09-01
Insurance policy end date2017-08-31
Total amount of commissions paid to insurance brokerUSD $294,041
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,497,117
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $144,388
Insurance broker nameHOLLISTER INSURANCE BROKERAGE(CLINT
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract numberMULTI-CONTRACTS
Policy instance 195
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered124
Insurance policy start date2016-08-01
Insurance policy end date2017-07-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,544
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract numberMULTI-CONTRACTS
Policy instance 196
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered115
Insurance policy start date2016-12-01
Insurance policy end date2017-11-30
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $13,305
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract numberMULTI-CONTRACTS
Policy instance 197
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1003
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $139,661
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract numberMULTI-CONTRACTS
Policy instance 198
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered382
Insurance policy start date2016-07-01
Insurance policy end date2017-06-30
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $54,045
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract numberMULTI-CONTRACTS
Policy instance 199
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered87
Insurance policy start date2016-06-01
Insurance policy end date2017-05-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $13,885
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract numberMULTI-CONTRACTS
Policy instance 200
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered444
Insurance policy start date2016-03-01
Insurance policy end date2017-02-28
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $64,022
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract numberMULTI-CONTRACTS
Policy instance 201
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered115
Insurance policy start date2016-05-01
Insurance policy end date2017-04-30
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $8,150
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract numberMULTI-CONTRACTS
Policy instance 202
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered101
Insurance policy start date2016-11-01
Insurance policy end date2017-10-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $17,880
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract number30029779
Policy instance 203
Insurance contract or identification number30029779
Number of Individuals Covered303
Insurance policy start date2016-10-01
Insurance policy end date2017-09-30
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $28,841
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract numberMULTI-CONTRACTS
Policy instance 204
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered132
Insurance policy start date2016-09-01
Insurance policy end date2017-08-30
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $8,355
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 205
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2289
Insurance policy start date2016-09-01
Insurance policy end date2017-08-31
Total amount of commissions paid to insurance brokerUSD $550
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,727,391
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $550
Insurance broker namePROFESSIONAL PENSIONS INC
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
Policy contract number000900-9230
Policy instance 206
Insurance contract or identification number000900-9230
Number of Individuals Covered44
Insurance policy start date2016-08-01
Insurance policy end date2017-07-31
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $38,181
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
Policy contract number4544
Policy instance 207
Insurance contract or identification number4544
Number of Individuals Covered42
Insurance policy start date2016-12-01
Insurance policy end date2017-11-30
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,294
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
Policy contract numberMULTI-CONTRACTS
Policy instance 208
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered305
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $343,478
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
Policy contract numberMULTI-CONTRACTS
Policy instance 209
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered191
Insurance policy start date2016-05-01
Insurance policy end date2017-04-30
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $9,461
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 210
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered732
Insurance policy start date2016-11-01
Insurance policy end date2017-10-31
Total amount of commissions paid to insurance brokerUSD $3,060
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $792,409
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,836
Insurance broker nameBRAD M KING ASSO INC
UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 211
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered177
Insurance policy start date2016-10-01
Insurance policy end date2017-09-30
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $150,313
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 212
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered489
Insurance policy start date2016-09-01
Insurance policy end date2017-08-31
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,170,635
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HEALTHYCT (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberHCTFXL0000
Policy instance 213
Insurance contract or identification numberHCTFXL0000
Number of Individuals Covered1
Insurance policy start date2016-03-01
Insurance policy end date2017-02-28
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,615
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HEALTHYCT (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberMULTI-CONTRACTS
Policy instance 214
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered29
Insurance policy start date2016-05-01
Insurance policy end date2017-04-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $240,974
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HEALTHYCT (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberHCTFXL000
Policy instance 215
Insurance contract or identification numberHCTFXL000
Number of Individuals Covered1
Insurance policy start date2016-10-01
Insurance policy end date2017-09-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,640
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberMULTI-CONTRACTS
Policy instance 216
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered3270
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $500,664
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract number240697
Policy instance 217
Insurance contract or identification number240697
Number of Individuals Covered633
Insurance policy start date2016-04-01
Insurance policy end date2017-03-31
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $191,103
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HEALTHYCT (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberMULTI-CONTRACTS
Policy instance 218
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered121
Insurance policy start date2016-06-01
Insurance policy end date2017-05-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $585,271
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number01W7587
Policy instance 219
Insurance contract or identification number01W7587
Number of Individuals Covered78
Insurance policy start date2016-04-01
Insurance policy end date2017-03-31
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $316,060
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 1
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered8188
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $541,448
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,504,732
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $211,815
Insurance broker namePIERSON & SMITH, A DIVISION OF FIRS
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number772654
Policy instance 2
Insurance contract or identification number772654
Number of Individuals Covered335
Insurance policy start date2014-10-01
Insurance policy end date2015-09-30
Total amount of commissions paid to insurance brokerUSD $5,668
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $78,163
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,668
Insurance broker nameEXUDE BENEFITS GROUP INC
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number696715
Policy instance 3
Insurance contract or identification number696715
Number of Individuals Covered1246
Insurance policy start date2014-09-01
Insurance policy end date2015-08-31
Total amount of commissions paid to insurance brokerUSD $93,991
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $890,741
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $38,609
Insurance broker nameEMERSON REID & COMPANY, INC. (LEADE
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 4
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered278
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Vision Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $11,009
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number617383
Policy instance 5
Insurance contract or identification number617383
Number of Individuals Covered6230
Insurance policy start date2014-07-01
Insurance policy end date2015-06-30
Total amount of commissions paid to insurance brokerUSD $53,613
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $497,947
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,619
Insurance broker nameLOCKTON COMPANIES, LLC (HARTFORD SE
AETNA (National Association of Insurance Commissioners NAIC id number: 78700 )
Policy contract numberTR7297
Policy instance 6
Insurance contract or identification numberTR7297
Number of Individuals Covered38
Insurance policy start date2014-05-01
Insurance policy end date2015-04-30
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,971
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA (National Association of Insurance Commissioners NAIC id number: 78700 )
Policy contract number772646
Policy instance 7
Insurance contract or identification number772646
Number of Individuals Covered149
Insurance policy start date2014-09-01
Insurance policy end date2015-08-31
Total amount of commissions paid to insurance brokerUSD $222
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $33,133
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $222
Insurance broker namePROFESSIONAL PENSIONS INC
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 8
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered452
Insurance policy start date2014-04-01
Insurance policy end date2015-03-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,460,719
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 9
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered205
Insurance policy start date2014-08-01
Insurance policy end date2015-07-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,560,715
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 10
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered305
Insurance policy start date2014-12-01
Insurance policy end date2015-11-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,513,495
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract numberMULTI-CONTRACTS
Policy instance 11
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered209
Insurance policy start date2014-02-01
Insurance policy end date2015-01-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,456,386
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTACTS
Policy instance 12
Insurance contract or identification numberMULTI-CONTACTS
Number of Individuals Covered1416
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $35,527
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $12,597,066
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $35,527
Insurance broker namePROFESSIONAL PENSIONS INC
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract numberMULTI-CONTRACTS
Policy instance 13
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered415
Insurance policy start date2014-07-01
Insurance policy end date2015-06-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,174,916
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract numberMULTI-CONTRACTS
Policy instance 14
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered149
Insurance policy start date2014-06-30
Insurance policy end date2015-05-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,766,320
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract numberMULTI-CONTRACTS
Policy instance 15
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered798
Insurance policy start date2014-03-01
Insurance policy end date2015-02-28
Total amount of commissions paid to insurance brokerUSD $6,848
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $8,178,328
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,848
Insurance broker namePROFESSIONAL PENSIONS INC
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 16
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered171
Insurance policy start date2014-05-01
Insurance policy end date2015-04-30
Total amount of commissions paid to insurance brokerUSD $113
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $915,269
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $113
Insurance broker namePROFESSIONAL PENSIONS INC
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number772657
Policy instance 17
Insurance contract or identification number772657
Number of Individuals Covered189
Insurance policy start date2014-11-01
Insurance policy end date2015-10-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,910,630
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 18
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered352
Insurance policy start date2014-10-01
Insurance policy end date2015-09-30
Total amount of commissions paid to insurance brokerUSD $2,534
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,408,610
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,534
Insurance broker namePROFESSIONAL PENSIONS INC
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 19
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered262
Insurance policy start date2014-09-01
Insurance policy end date2015-08-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,007,121
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number450543
Policy instance 20
Insurance contract or identification number450543
Number of Individuals Covered39
Insurance policy start date2014-04-01
Insurance policy end date2015-03-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,218
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberMULTI-CONTACTS
Policy instance 21
Insurance contract or identification numberMULTI-CONTACTS
Number of Individuals Covered156
Insurance policy start date2014-04-01
Insurance policy end date2015-03-31
Total amount of commissions paid to insurance brokerUSD $1,592
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $15,920
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $655
Insurance broker nameCORPORATE CONSULTING SERVICES LIMIT
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberMULTI-CONTRACTS
Policy instance 22
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered13
Insurance policy start date2014-08-01
Insurance policy end date2015-07-31
Total amount of commissions paid to insurance brokerUSD $387
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $9,674
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $387
Insurance broker nameSECURITY FIRST INSURANCE GROUP(WATE
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberMULTI-CONTRACTS
Policy instance 23
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered5
Insurance policy start date2014-12-01
Insurance policy end date2015-11-30
Total amount of commissions paid to insurance brokerUSD $288
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,880
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $288
Insurance broker nameSECURITY FIRST INSURANCE GROUP(WATE
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberMULTI-CONTRACTS
Policy instance 24
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered58
Insurance policy start date2014-02-01
Insurance policy end date2015-01-31
Total amount of commissions paid to insurance brokerUSD $833
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,756
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $57
Insurance broker nameTHE HEALTH CONSULTANTS GROUP LLC
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberMULTI-CONTRACTS
Policy instance 25
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered581
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $16,506
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $312,006
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,447
Insurance broker nameFINANCIAL LIBERTY GROUP
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberMULTI-CONTRACTS
Policy instance 26
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered73
Insurance policy start date2014-07-01
Insurance policy end date2015-06-30
Total amount of commissions paid to insurance brokerUSD $1,394
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $28,424
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $428
Insurance broker nameSECURITY FIRST INSURANCE GROUP(WATE
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberMULTI-CONTRACTS
Policy instance 27
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered25
Insurance policy start date2014-06-01
Insurance policy end date2015-05-31
Total amount of commissions paid to insurance brokerUSD $392
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,914
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $305
Insurance broker nameSECURITY FIRST INSURANCE GROUP(WATE
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberMULTI-CONTRACTS
Policy instance 28
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered57
Insurance policy start date2014-03-01
Insurance policy end date2015-02-28
Total amount of commissions paid to insurance brokerUSD $2,739
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $34,984
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,303
Insurance broker nameMARK ABRAMS
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberMULTI-CONTRACTS
Policy instance 29
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered44
Insurance policy start date2014-05-01
Insurance policy end date2015-04-30
Total amount of commissions paid to insurance brokerUSD $2,600
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $55,011
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,570
Insurance broker nameSECURITY FIRST INSURANCE GROUP(WATE
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberMULTI-CONTRACTS
Policy instance 30
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered155
Insurance policy start date2014-10-01
Insurance policy end date2015-09-30
Total amount of commissions paid to insurance brokerUSD $3,386
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $50,381
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,908
Insurance broker nameTHE HEALTH CONSULTANTS GROUP LLC
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberMULTI-CONTRACTS
Policy instance 31
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered114
Insurance policy start date2014-09-01
Insurance policy end date2015-08-31
Total amount of commissions paid to insurance brokerUSD $537
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $32,741
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $533
Insurance broker nameJOHN J GARRISH
ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 )
Policy contract numberMULTI-CONTRACTS
Policy instance 32
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1819
Insurance policy start date2014-04-01
Insurance policy end date2015-03-31
Total amount of commissions paid to insurance brokerUSD $20,599
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $407,419
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $20,599
Insurance broker namePIERSON & SMITH INC
ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 )
Policy contract number180409
Policy instance 33
Insurance contract or identification number180409
Number of Individuals Covered45
Insurance policy start date2014-12-01
Insurance policy end date2015-11-30
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $30,598
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 )
Policy contract numberMULTI-CONTRACTS
Policy instance 34
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered365
Insurance policy start date2014-02-01
Insurance policy end date2015-01-31
Health Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $458,122
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 )
Policy contract numberMULTI-CONTRACTS
Policy instance 35
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered194
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $575,007
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 )
Policy contract number30790-1706
Policy instance 36
Insurance contract or identification number30790-1706
Number of Individuals Covered36
Insurance policy start date2014-08-01
Insurance policy end date2015-07-31
Total amount of commissions paid to insurance brokerUSD $471
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,372
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $235
Insurance broker nameEXUDE BENEFITS GROUP INC
NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 )
Policy contract numberMULTI-CONTRACTS
Policy instance 37
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered274
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $1,810
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $26,495
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $480
Insurance broker nameDARREN J WALSH
NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 )
Policy contract number30790-1716
Policy instance 38
Insurance contract or identification number30790-1716
Number of Individuals Covered47
Insurance policy start date2014-10-01
Insurance policy end date2015-09-30
Total amount of commissions paid to insurance brokerUSD $234
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,568
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $106
Insurance broker nameEXUDE BENEFITS GROUP INC
ARKANSAS BLUE CROSS BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 83470 )
Policy contract number111812912
Policy instance 39
Insurance contract or identification number111812912
Number of Individuals Covered187
Insurance policy start date2014-03-01
Insurance policy end date2015-02-28
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $774,805
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 40
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1186
Insurance policy start date2014-04-01
Insurance policy end date2015-03-31
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,330,394
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 41
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered569
Insurance policy start date2014-12-01
Insurance policy end date2015-11-30
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $581,498
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberMULTI-CONTRACTS
Policy instance 42
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered553
Insurance policy start date2014-02-01
Insurance policy end date2015-01-31
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $530,700
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberMULTI-CONTRACTS
Policy instance 43
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered8798
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $27,388
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $20,435,202
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17,856
Insurance broker nameTHE HEALTH CONSULTANTS GROUP LLC
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 44
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2190
Insurance policy start date2014-07-01
Insurance policy end date2015-06-30
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,221,889
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 45
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1312
Insurance policy start date2014-06-01
Insurance policy end date2015-05-31
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,039,670
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 46
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered961
Insurance policy start date2014-03-01
Insurance policy end date2015-02-28
Total amount of commissions paid to insurance brokerUSD $2,015
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,339,380
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $962
Insurance broker nameMAURICE LYONS
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 47
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2231
Insurance policy start date2014-05-01
Insurance policy end date2015-04-30
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,518,831
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 48
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered578
Insurance policy start date2014-11-01
Insurance policy end date2015-10-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $271,567
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 49
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1758
Insurance policy start date2014-10-01
Insurance policy end date2015-09-30
Total amount of commissions paid to insurance brokerUSD $12,947
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,742,376
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,329
Insurance broker namePROFESSIONAL PENSIONS INC
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 50
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2447
Insurance policy start date2014-09-01
Insurance policy end date2015-08-31
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $724,019
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONNECTICARE, INC. (National Association of Insurance Commissioners NAIC id number: 95675 )
Policy contract numberMULTI-CONTRACTS
Policy instance 51
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered78
Insurance policy start date2014-12-01
Insurance policy end date2015-11-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $740,175
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONNECTICARE, INC. (National Association of Insurance Commissioners NAIC id number: 95675 )
Policy contract number007273
Policy instance 52
Insurance contract or identification number007273
Number of Individuals Covered84
Insurance policy start date2014-02-01
Insurance policy end date2015-01-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $799,011
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONNECTICARE, INC. (National Association of Insurance Commissioners NAIC id number: 95675 )
Policy contract number007382
Policy instance 53
Insurance contract or identification number007382
Number of Individuals Covered68
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $626,071
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONNECTICARE, INC. (National Association of Insurance Commissioners NAIC id number: 95675 )
Policy contract number007326
Policy instance 54
Insurance contract or identification number007326
Number of Individuals Covered49
Insurance policy start date2014-07-01
Insurance policy end date2015-06-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $487,990
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONNECTICARE, INC. (National Association of Insurance Commissioners NAIC id number: 95675 )
Policy contract numberMULTI-CONTRACTS
Policy instance 55
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered147
Insurance policy start date2014-06-01
Insurance policy end date2015-05-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,570,316
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
Policy contract number000900-923
Policy instance 56
Insurance contract or identification number000900-923
Number of Individuals Covered34
Insurance policy start date2014-08-01
Insurance policy end date2015-07-31
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,711
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
Policy contract number4544
Policy instance 57
Insurance contract or identification number4544
Number of Individuals Covered49
Insurance policy start date2014-12-01
Insurance policy end date2015-11-30
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,494
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract number1000807
Policy instance 58
Insurance contract or identification number1000807
Number of Individuals Covered42
Insurance policy start date2014-12-01
Insurance policy end date2015-11-30
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,215
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract numberMULTI-CONTRACTS
Policy instance 59
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered536
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $70,783
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract number9851346
Policy instance 60
Insurance contract or identification number9851346
Number of Individuals Covered121
Insurance policy start date2014-07-01
Insurance policy end date2015-06-30
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $9,499
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract numberMULTI-CONTRACTS
Policy instance 61
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered20
Insurance policy start date2014-06-01
Insurance policy end date2015-05-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,261
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract numberMULTI-CONTRACTS
Policy instance 62
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered291
Insurance policy start date2014-03-01
Insurance policy end date2015-02-28
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $22,358
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract number9816570
Policy instance 63
Insurance contract or identification number9816570
Number of Individuals Covered220
Insurance policy start date2014-05-01
Insurance policy end date2015-04-30
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $20,479
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract numberMULTI-CONTRACTS
Policy instance 64
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered206
Insurance policy start date2014-10-01
Insurance policy end date2015-09-30
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $19,322
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract number9826181
Policy instance 65
Insurance contract or identification number9826181
Number of Individuals Covered332
Insurance policy start date2014-09-01
Insurance policy end date2015-08-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $59,457
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 numberF018610
Policy instance 66
Insurance contract or identification numberF018610
Number of Individuals Covered48
Insurance policy start date2014-09-01
Insurance policy end date2015-08-31
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,710
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract number245-6954-00
Policy instance 67
Insurance contract or identification number245-6954-00
Number of Individuals Covered375
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $4,186
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $40,142
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,138
Insurance broker nameJ A ARCHAMBAULT & SON
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number217552
Policy instance 68
Insurance contract or identification number217552
Number of Individuals Covered42
Insurance policy start date2014-03-01
Insurance policy end date2015-02-28
Total amount of commissions paid to insurance brokerUSD $515
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,848
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $294
Insurance broker namePROFESSIONAL PENSIONS INC
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract number028-3316-00
Policy instance 69
Insurance contract or identification number028-3316-00
Number of Individuals Covered38
Insurance policy start date2014-10-01
Insurance policy end date2015-09-30
Total amount of commissions paid to insurance brokerUSD $939
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,860
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $704
Insurance broker namePROFESSIONAL PENSIONS INC
EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 )
Policy contract number468F1GP01
Policy instance 70
Insurance contract or identification number468F1GP01
Number of Individuals Covered1
Insurance policy start date2014-12-01
Insurance policy end date2015-11-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $29,628
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 )
Policy contract numberMULTI-CONTRACTS
Policy instance 71
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered33
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $386,367
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 )
Policy contract number468F1GM30
Policy instance 72
Insurance contract or identification number468F1GM30
Number of Individuals Covered168
Insurance policy start date2014-06-01
Insurance policy end date2015-05-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,633,007
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 )
Policy contract number818B1GF99
Policy instance 73
Insurance contract or identification number818B1GF99
Number of Individuals Covered10
Insurance policy start date2014-10-01
Insurance policy end date2015-09-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,792
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 )
Policy contract numberMULTI-CONTRACTS
Policy instance 74
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered385
Insurance policy start date2014-09-01
Insurance policy end date2015-08-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,540,158
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 75
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1771
Insurance policy start date2014-04-01
Insurance policy end date2015-03-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $418,707
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 76
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered3028
Insurance policy start date2014-08-01
Insurance policy end date2015-07-31
Total amount of commissions paid to insurance brokerUSD $211
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $310,428
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $211
Insurance broker namePROFESSIONAL PENSIONS INC
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 77
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered560
Insurance policy start date2014-12-01
Insurance policy end date2015-11-30
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $281,056
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 78
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered363
Insurance policy start date2014-02-01
Insurance policy end date2015-01-20
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $63,057
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 79
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered8018
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,509,355
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 80
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered3862
Insurance policy start date2014-07-01
Insurance policy end date2015-06-30
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $601,916
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 81
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered827
Insurance policy start date2014-06-01
Insurance policy end date2015-05-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $185,175
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 82
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1474
Insurance policy start date2014-03-01
Insurance policy end date2015-02-28
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $459,532
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 83
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2468
Insurance policy start date2014-05-01
Insurance policy end date2015-04-30
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $417,552
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 84
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1308
Insurance policy start date2014-11-01
Insurance policy end date2015-10-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $460,676
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 85
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered872
Insurance policy start date2014-10-01
Insurance policy end date2015-09-30
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $218,817
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 86
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered5469
Insurance policy start date2014-09-01
Insurance policy end date2015-08-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,375,323
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )
Policy contract numberMULTI-CONTRACTS
Policy instance 87
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered103
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $763,454
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HIP HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 88
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered94
Insurance policy start date2014-12-01
Insurance policy end date2015-11-30
Total amount of commissions paid to insurance brokerUSD $64,929
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $885,879
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $30,038
Insurance broker nameGALLAGHER BENEFIT SERVICES, INC.
HIP HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number1076861000
Policy instance 89
Insurance contract or identification number1076861000
Number of Individuals Covered35
Insurance policy start date2014-07-01
Insurance policy end date2015-06-30
Total amount of commissions paid to insurance brokerUSD $27,256
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $355,456
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,218
Insurance broker namePROFESSIONAL PENSIONS INC
HEALTHYCT (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberMULTI-CONTRACTS
Policy instance 90
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered250
Insurance policy start date2014-12-01
Insurance policy end date2015-11-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,690,472
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HEALTHYCT (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberMULTI-CONTRACTS
Policy instance 91
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered793
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,885,167
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HEALTHYCT (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberHCTFXL000030
Policy instance 92
Insurance contract or identification numberHCTFXL000030
Number of Individuals Covered47
Insurance policy start date2014-10-01
Insurance policy end date2015-09-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $503,222
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberSR-83114532
Policy instance 93
Insurance contract or identification numberSR-83114532
Number of Individuals Covered354
Insurance policy start date2014-12-01
Insurance policy end date2015-11-30
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,603
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract number877012
Policy instance 94
Insurance contract or identification number877012
Number of Individuals Covered388
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,382
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 95
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1937
Insurance policy start date2014-04-01
Insurance policy end date2015-03-31
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $220,829
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 96
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered216
Insurance policy start date2014-08-01
Insurance policy end date2015-07-31
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $16,088
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 97
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered186
Insurance policy start date2014-12-01
Insurance policy end date2015-11-30
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $24,418
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number0001D027728
Policy instance 98
Insurance contract or identification number0001D027728
Number of Individuals Covered51
Insurance policy start date2014-02-01
Insurance policy end date2015-01-31
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $40,493
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number01-0139064
Policy instance 99
Insurance contract or identification number01-0139064
Number of Individuals Covered127
Insurance policy start date2014-02-01
Insurance policy end date2015-01-31
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,245
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 100
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered7187
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $259
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,092,774
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $259
Insurance broker namePROFESSIONAL PENSIONS INC
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 101
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered637
Insurance policy start date2014-07-01
Insurance policy end date2015-06-30
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $109,239
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 102
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered40
Insurance policy start date2014-06-01
Insurance policy end date2015-05-31
Total amount of commissions paid to insurance brokerUSD $262
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $41,717
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $262
Insurance broker namePROFESSIONAL PENSIONS INC
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 103
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1261
Insurance policy start date2014-03-01
Insurance policy end date2015-02-28
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $97,766
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 104
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1300
Insurance policy start date2014-05-01
Insurance policy end date2015-04-30
Total amount of commissions paid to insurance brokerUSD $1,116
Total amount of fees paid to insurance companyUSD $372
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $127,017
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,116
Amount paid for insurance broker fees372
Insurance broker namePROFESSIONAL PENSIONS INC
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULT-CONTRACTS
Policy instance 105
Insurance contract or identification numberMULT-CONTRACTS
Number of Individuals Covered656
Insurance policy start date2014-11-01
Insurance policy end date2015-10-31
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $106,247
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 106
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered65676
Insurance policy start date2014-10-01
Insurance policy end date2015-09-30
Total amount of commissions paid to insurance brokerUSD $462
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $165,322
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $462
Insurance broker namePROFESSIONAL PENSIONS INC
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 107
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered800
Insurance policy start date2014-09-01
Insurance policy end date2015-08-31
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $98,660
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberMULTI-CONTRACTS
Policy instance 108
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered854
Insurance policy start date2014-12-01
Insurance policy end date2015-11-30
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $76,762
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberMULTI-CONTRACTS
Policy instance 109
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered31
Insurance policy start date2014-02-01
Insurance policy end date2015-01-31
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $20,969
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberMULTI-CONTRACTS
Policy instance 110
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered6441
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $3,050
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,628,453
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,050
Insurance broker nameEMERSON REID & COMPANY, INC. (LEADE
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberMULTI-CONTRACTS
Policy instance 111
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered149
Insurance policy start date2014-07-01
Insurance policy end date2015-06-30
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $120,512
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberMULTI-CONTRACTS
Policy instance 112
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered144
Insurance policy start date2014-03-01
Insurance policy end date2015-02-28
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $17,237
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberMULTI-CONTRACTS
Policy instance 113
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered224
Insurance policy start date2014-10-01
Insurance policy end date2015-09-30
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $8,877
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberMULTI-CONTRACTS
Policy instance 114
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered86
Insurance policy start date2014-09-01
Insurance policy end date2015-08-31
Total amount of commissions paid to insurance brokerUSD $213
Total amount of fees paid to insurance companyUSD $123
Health Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $16,227
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $114
Amount paid for insurance broker fees123
Insurance broker namePROFESSIONAL PENSIONS INC
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 115
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered167
Insurance policy start date2014-04-01
Insurance policy end date2015-03-31
Total amount of commissions paid to insurance brokerUSD $2,735
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $11,511
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,511
Insurance broker nameTIMOTHY G SEIBERT
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberG000AGPG
Policy instance 116
Insurance contract or identification numberG000AGPG
Number of Individuals Covered246
Insurance policy start date2014-08-01
Insurance policy end date2015-07-31
Total amount of commissions paid to insurance brokerUSD $2,089
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $10,544
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,054
Insurance broker namePROFESSIONAL PENSIONS INC
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 117
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1152
Insurance policy start date2014-12-01
Insurance policy end date2015-11-30
Total amount of commissions paid to insurance brokerUSD $24,314
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $133,650
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,824
Insurance broker nameRAYMOND CONGELOSI
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 118
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered105
Insurance policy start date2014-02-01
Insurance policy end date2015-01-31
Total amount of commissions paid to insurance brokerUSD $2,214
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $10,025
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,004
Insurance broker nameCAPACITY BENEFITS & FINANCIAL SERVI
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 119
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2056
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $53,085
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $207,243
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $27,875
Insurance broker nameTHE TARPEY GROUP, LLC
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 120
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered132
Insurance policy start date2014-07-01
Insurance policy end date2015-06-30
Total amount of commissions paid to insurance brokerUSD $6,031
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $27,968
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,847
Insurance broker nameWILLIS OF NEW JERSEY
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 121
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1227
Insurance policy start date2014-06-01
Insurance policy end date2014-05-31
Total amount of commissions paid to insurance brokerUSD $26,044
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $94,181
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,590
Insurance broker nameNFP CORPORATE SERVICES (PA)
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 122
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered225
Insurance policy start date2014-03-01
Insurance policy end date2015-02-28
Total amount of commissions paid to insurance brokerUSD $10,620
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $45,518
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,272
Insurance broker nameCORPORATE CONSULTING SERVICES LIMIT
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberMULTI-CONTRACTS
Policy instance 123
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered88
Insurance policy start date2014-05-01
Insurance policy end date2015-04-30
Total amount of commissions paid to insurance brokerUSD $1,731
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $9,511
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $832
Insurance broker nameSINGER NELSON CHARLMERS, INC.
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 124
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1339
Insurance policy start date2014-11-01
Insurance policy end date2014-10-31
Total amount of commissions paid to insurance brokerUSD $12,264
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $91,703
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,937
Insurance broker nameADAM ROSENFELD
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberMULTI-CONTRACTS
Policy instance 125
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered360
Insurance policy start date2014-10-01
Insurance policy end date2015-09-30
Total amount of commissions paid to insurance brokerUSD $6,508
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $29,107
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,222
Insurance broker nameCORPORATE CONSULTING SERVICES LIMIT
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberMULTI-CONTRACTS
Policy instance 126
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered211
Insurance policy start date2014-09-01
Insurance policy end date2015-08-31
Total amount of commissions paid to insurance brokerUSD $16,270
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $59,022
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,409
Insurance broker nameCORPORATE CONSULTING SERVICES LIMIT
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 127
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered49
Insurance policy start date2014-08-01
Insurance policy end date2015-07-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $439,774
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 128
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered104
Insurance policy start date2014-12-01
Insurance policy end date2015-11-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $309,521
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 129
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered69
Insurance policy start date2014-02-01
Insurance policy end date2015-01-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $949,744
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 130
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered673
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $650
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,326,612
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $650
Insurance broker namePROFESSIONAL PENSIONS INC
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 131
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered218
Insurance policy start date2014-07-01
Insurance policy end date2015-06-30
Total amount of commissions paid to insurance brokerUSD $997
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,995,476
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $997
Insurance broker nameCAMBRIDGE LIFE BROKERAGE LLC
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 132
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered45
Insurance policy start date2014-06-30
Insurance policy end date2015-05-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $614,290
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 133
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered143
Insurance policy start date2014-03-01
Insurance policy end date2015-02-28
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,663,106
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 134
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered99
Insurance policy start date2014-05-31
Insurance policy end date2015-04-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $287,115
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberLR8085
Policy instance 135
Insurance contract or identification numberLR8085
Number of Individuals Covered95
Insurance policy start date2014-11-01
Insurance policy end date2015-10-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,090,860
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 136
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered294
Insurance policy start date2014-10-01
Insurance policy end date2015-09-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,398,688
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 137
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered92
Insurance policy start date2014-09-01
Insurance policy end date2015-08-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $825,450
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberMULTI-CONTRACTS
Policy instance 138
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered44
Insurance policy start date2014-12-01
Insurance policy end date2015-11-30
Total amount of commissions paid to insurance brokerUSD $148
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $38,857
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $148
Insurance broker namePROFESSIONAL PENSIONS INC
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberH44693-1
Policy instance 139
Insurance contract or identification numberH44693-1
Number of Individuals Covered315
Insurance policy start date2014-02-01
Insurance policy end date2015-01-31
Total amount of commissions paid to insurance brokerUSD $13,328
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $102,525
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,076
Insurance broker nameEBENEFITS GROUP NORTHEAST INC
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberMULTI-CONTRACTS
Policy instance 140
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered6
Insurance policy start date2014-07-01
Insurance policy end date2015-06-30
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $783
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberH41186-1
Policy instance 141
Insurance contract or identification numberH41186-1
Number of Individuals Covered29
Insurance policy start date2014-11-01
Insurance policy end date2015-10-31
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $28,282
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberH57741
Policy instance 142
Insurance contract or identification numberH57741
Number of Individuals Covered72
Insurance policy start date2014-07-01
Insurance policy end date2015-06-30
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,836
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberH41186-1
Policy instance 143
Insurance contract or identification numberH41186-1
Number of Individuals Covered58
Insurance policy start date2014-11-01
Insurance policy end date2015-10-31
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,208
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberH27054-1
Policy instance 144
Insurance contract or identification numberH27054-1
Number of Individuals Covered22
Insurance policy start date2014-10-01
Insurance policy end date2015-09-30
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,145
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberH69494-1
Policy instance 145
Insurance contract or identification numberH69494-1
Number of Individuals Covered56
Insurance policy start date2014-09-01
Insurance policy end date2015-08-31
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,725
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberH43785-1
Policy instance 146
Insurance contract or identification numberH43785-1
Number of Individuals Covered5
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,742
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberH65245-1
Policy instance 147
Insurance contract or identification numberH65245-1
Number of Individuals Covered21
Insurance policy start date2014-06-01
Insurance policy end date2015-05-31
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,428
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberH65588-1
Policy instance 148
Insurance contract or identification numberH65588-1
Number of Individuals Covered22
Insurance policy start date2014-10-01
Insurance policy end date2015-09-30
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,625
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract numberMULTI-CONTRACTS
Policy instance 149
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered14
Insurance policy start date2014-08-01
Insurance policy end date2015-07-31
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $869
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract numberMULTI-CONTRACTS
Policy instance 150
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered214
Insurance policy start date2014-02-01
Insurance policy end date2015-01-31
Total amount of commissions paid to insurance brokerUSD $9,230
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $22,088
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,713
Insurance broker namePROFESSIONAL PENSIONS INC
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract numberMULTI-CONTRACTS
Policy instance 151
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered730
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $7,726
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $47,109
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,334
Insurance broker nameEXUDE
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract numberMULTI-CONTRACTS
Policy instance 152
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered166
Insurance policy start date2014-07-01
Insurance policy end date2015-06-30
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $11,591
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract numberMULTI-CONTRACTS
Policy instance 153
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered126
Insurance policy start date2014-06-01
Insurance policy end date2015-05-31
Total amount of commissions paid to insurance brokerUSD $447
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,190
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $245
Insurance broker nameEXUDE
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract numberMULTI-CONTRACTS
Policy instance 154
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered351
Insurance policy start date2014-03-01
Insurance policy end date2015-02-28
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $76,323
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number89957
Policy instance 155
Insurance contract or identification number89957
Number of Individuals Covered218
Insurance policy start date2014-05-01
Insurance policy end date2015-04-30
Total amount of commissions paid to insurance brokerUSD $10,149
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $80,395
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,149
Insurance broker namePROFESSIONAL PENSIONS INC
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number89950
Policy instance 156
Insurance contract or identification number89950
Number of Individuals Covered40
Insurance policy start date2014-11-01
Insurance policy end date2015-10-31
Total amount of commissions paid to insurance brokerUSD $673
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,203
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $513
Insurance broker nameDARREN J WALSH
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract numberMULTI=CONTRACTS
Policy instance 157
Insurance contract or identification numberMULTI=CONTRACTS
Number of Individuals Covered131
Insurance policy start date2014-10-01
Insurance policy end date2015-09-30
Total amount of commissions paid to insurance brokerUSD $2,626
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $15,018
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,600
Insurance broker namePROFESSIONAL PENSIONS INC
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract numberMULTI-CONTRACTS
Policy instance 158
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1997
Insurance policy start date2014-09-01
Insurance policy end date2015-08-31
Total amount of commissions paid to insurance brokerUSD $4,766
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $85,646
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,098
Insurance broker namePROFESSIONAL PENSIONS INC
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberMULTI-CONTRACTS
Policy instance 159
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered402
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $1,698
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $20,102
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,698
Insurance broker nameWILLIS OF CONNECTICUT LLC
THE STANDARD LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 89009 )
Policy contract numberMULTI-CONTRACTS
Policy instance 160
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered63
Insurance policy start date2014-04-01
Insurance policy end date2015-03-31
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $11,622
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE STANDARD LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 89009 )
Policy contract numberMULTI-CONTRACTS
Policy instance 161
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered590
Insurance policy start date2014-08-01
Insurance policy end date2015-07-31
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $205,780
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE STANDARD LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 89009 )
Policy contract numberMULTI-CONTRACTS
Policy instance 162
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered527
Insurance policy start date2014-02-01
Insurance policy end date2015-01-31
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $88,505
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE STANDARD LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 89009 )
Policy contract numberMULTI-CONTRACTS
Policy instance 163
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1129
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $162,553
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE STANDARD LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 89009 )
Policy contract number158357
Policy instance 164
Insurance contract or identification number158357
Number of Individuals Covered28
Insurance policy start date2014-06-01
Insurance policy end date2015-05-31
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,437
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE STANDARD LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 89009 )
Policy contract number158898
Policy instance 165
Insurance contract or identification number158898
Number of Individuals Covered106
Insurance policy start date2014-11-01
Insurance policy end date2015-10-31
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,532
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE STANDARD LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 89009 )
Policy contract number430690
Policy instance 166
Insurance contract or identification number430690
Number of Individuals Covered857
Insurance policy start date2014-09-01
Insurance policy end date2015-08-31
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $866,989
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract numberMULTI-CONTRACTS
Policy instance 167
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered309
Insurance policy start date2014-08-01
Insurance policy end date2015-07-31
Total amount of commissions paid to insurance brokerUSD $14,311
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $134,894
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,611
Insurance broker nameRUDOLF DAVID
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract numberMULTI-CONTRACTS
Policy instance 168
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered135
Insurance policy start date2014-04-01
Insurance policy end date2015-03-31
Total amount of commissions paid to insurance brokerUSD $5,754
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $26,155
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,379
Insurance broker nameCONGELOSI RAYMOND
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract numberMULTI-CONTRACTS
Policy instance 169
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered24
Insurance policy start date2014-12-01
Insurance policy end date2015-11-30
Total amount of commissions paid to insurance brokerUSD $694
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,574
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $495
Insurance broker namePROFESSIONAL PENSIONS INC
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract numberMULTI-CONTRACTS
Policy instance 170
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered3976
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $58,393
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $643,685
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,342
Insurance broker namePILOT BENEFITS GROUP LLC
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract numberMULTI-CONTRACTS
Policy instance 171
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1298
Insurance policy start date2014-07-01
Insurance policy end date2015-06-30
Total amount of commissions paid to insurance brokerUSD $21,529
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $223,297
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,040
Insurance broker nameALLIANT INSURANCE SERVICES INC
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract numberMULTI-CONTRACTS
Policy instance 172
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered275
Insurance policy start date2014-06-01
Insurance policy end date2015-05-31
Total amount of commissions paid to insurance brokerUSD $2,235
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $33,070
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,610
Insurance broker namePROFESSIONAL PENSIONS INC
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract numberMULTI-CONTRACTS
Policy instance 173
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered674
Insurance policy start date2014-03-01
Insurance policy end date2015-02-28
Total amount of commissions paid to insurance brokerUSD $1,420
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $75,266
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $625
Insurance broker nameKOHLER THOMAS
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract number819256
Policy instance 174
Insurance contract or identification number819256
Number of Individuals Covered60
Insurance policy start date2014-05-01
Insurance policy end date2015-04-30
Total amount of commissions paid to insurance brokerUSD $2,331
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $12,202
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,680
Insurance broker namePROFESSIONAL PENSIONS INC
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract numberMULTI-CONTRACTS
Policy instance 175
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered880
Insurance policy start date2014-11-01
Insurance policy end date2015-10-31
Total amount of commissions paid to insurance brokerUSD $13,359
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $78,937
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,393
Insurance broker nameCAPACITY BENEFITS AND FINANCIAL SER
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract numberMULTI-CONTRACTS
Policy instance 176
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered32
Insurance policy start date2014-10-01
Insurance policy end date2015-09-30
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,447
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 177
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered107
Insurance policy start date2014-12-01
Insurance policy end date2015-11-30
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $296,076
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 178
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2232
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $73,023
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $8,398,617
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $50,593
Insurance broker nameHUB INTERNATIONAL NORTHEAST
UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 179
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered30
Insurance policy start date2014-06-01
Insurance policy end date2015-05-31
Total amount of commissions paid to insurance brokerUSD $109
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,680
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $109
Insurance broker namePROFESSIONAL PENSIONS INC
UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 180
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered463
Insurance policy start date2014-03-01
Insurance policy end date2015-02-28
Total amount of commissions paid to insurance brokerUSD $4,575
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $75,031
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,575
Insurance broker nameGALLAGHER BENEFIT SERVICES
UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 181
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered498
Insurance policy start date2014-05-01
Insurance policy end date2015-04-30
Total amount of commissions paid to insurance brokerUSD $57,273
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,564,796
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $29,463
Insurance broker nameMERCER HEALTH & BENEFITS LLC
UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 182
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1074
Insurance policy start date2014-09-01
Insurance policy end date2015-08-31
Total amount of commissions paid to insurance brokerUSD $210,860
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,524,372
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $167,350
Insurance broker namePROFESSIONAL PENSIONS INC
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 183
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered850
Insurance policy start date2014-04-01
Insurance policy end date2015-03-31
Total amount of commissions paid to insurance brokerUSD $16,049
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $70,310
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,635
Insurance broker nameRAYMOND CONGELOSI
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 184
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered335
Insurance policy start date2014-08-01
Insurance policy end date2015-07-31
Total amount of commissions paid to insurance brokerUSD $8,189
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $26,574
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,262
Insurance broker nameHUB INTERNATIONAL NE (WOODBURY)
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 185
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered538
Insurance policy start date2014-12-01
Insurance policy end date2015-11-30
Total amount of commissions paid to insurance brokerUSD $35,284
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $105,008
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17,269
Insurance broker nameRAYMOND CONGELOSI
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 186
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered500
Insurance policy start date2014-02-01
Insurance policy end date2015-01-31
Total amount of commissions paid to insurance brokerUSD $14,437
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $54,176
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,925
Insurance broker nameDARREN J WALSH
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 187
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered3929
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $151,029
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $633,756
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $81,067
Insurance broker nameJEFFREY M TABMAN
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 188
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered577
Insurance policy start date2014-07-01
Insurance policy end date2015-06-30
Total amount of commissions paid to insurance brokerUSD $17,245
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $67,184
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,322
Insurance broker nameLILIAN DE SOUZA
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 189
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered256
Insurance policy start date2014-06-01
Insurance policy end date2015-05-31
Total amount of commissions paid to insurance brokerUSD $12,736
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $41,819
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,659
Insurance broker nameMICHAEL PONTILLO
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 190
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered250
Insurance policy start date2014-03-01
Insurance policy end date2015-02-28
Total amount of commissions paid to insurance brokerUSD $11,901
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $45,757
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,272
Insurance broker namePREFERRED BENEFITS GROUP, INC
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 191
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered998
Insurance policy start date2014-05-31
Insurance policy end date2015-04-30
Total amount of commissions paid to insurance brokerUSD $21,587
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $87,127
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,333
Insurance broker nameWILLIAM P. MCCARTHY
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 192
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered197
Insurance policy start date2014-11-01
Insurance policy end date2015-10-31
Total amount of commissions paid to insurance brokerUSD $8,497
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $33,142
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,139
Insurance broker nameRICHARD R DAMICO, LUTCF
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 193
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1392
Insurance policy start date2014-10-01
Insurance policy end date2015-09-30
Total amount of commissions paid to insurance brokerUSD $28,656
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $128,505
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,180
Insurance broker nameSCHUSTER DRISCOLL LLC.(FARMINGTON,C
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 194
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered3566
Insurance policy start date2014-09-01
Insurance policy end date2015-08-31
Total amount of commissions paid to insurance brokerUSD $76,129
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $376,462
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $38,560
Insurance broker nameRAYMOND CONGELOSI
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract number30050123
Policy instance 195
Insurance contract or identification number30050123
Number of Individuals Covered16
Insurance policy start date2014-08-01
Insurance policy end date2015-07-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,131
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract number30053269
Policy instance 196
Insurance contract or identification number30053269
Number of Individuals Covered68
Insurance policy start date2014-12-01
Insurance policy end date2015-11-30
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,648
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract numberMULTI-CONTRACTS
Policy instance 197
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered320
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $41,243
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract numberMULTI-CONTRACTS
Policy instance 198
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered324
Insurance policy start date2014-07-01
Insurance policy end date2015-06-30
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $48,160
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract numberMULTI-CONTRACTS
Policy instance 199
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered159
Insurance policy start date2014-06-01
Insurance policy end date2015-05-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $20,163
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract numberMULTI-CONTRACTS
Policy instance 200
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered290
Insurance policy start date2014-03-01
Insurance policy end date2015-02-28
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $40,077
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract number30048120
Policy instance 201
Insurance contract or identification number30048120
Number of Individuals Covered54
Insurance policy start date2014-05-01
Insurance policy end date2015-03-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $881
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract number30035853
Policy instance 202
Insurance contract or identification number30035853
Number of Individuals Covered22
Insurance policy start date2014-10-01
Insurance policy end date2015-09-30
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,217
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 1
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered10022
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $604,354
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,787,330
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $147,504
Insurance broker nameALLIANT INSURANCE SERVICES INC.
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number696715
Policy instance 2
Insurance contract or identification number696715
Number of Individuals Covered950
Insurance policy start date2013-09-01
Insurance policy end date2014-08-31
Total amount of commissions paid to insurance brokerUSD $74,664
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $656,237
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $74,664
Insurance broker namePROFESSIONAL PENSIONS INC
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number861323
Policy instance 3
Insurance contract or identification number861323
Number of Individuals Covered159
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $1,742
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $11,488
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,742
Insurance broker nameSCHUSTER DRISCOLL LLC.(FARMINGTON,C
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number617383
Policy instance 4
Insurance contract or identification number617383
Number of Individuals Covered7731
Insurance policy start date2013-07-01
Insurance policy end date2014-06-30
Total amount of commissions paid to insurance brokerUSD $54,182
Total amount of fees paid to insurance companyUSD $479
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $509,532
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,115
Amount paid for insurance broker fees479
Insurance broker nameJAMES F MAIELLA
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 5
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered350
Insurance policy start date2013-04-01
Insurance policy end date2014-03-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,402,831
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 6
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered114
Insurance policy start date2013-08-01
Insurance policy end date2014-07-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $956,597
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 7
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered84
Insurance policy start date2013-12-01
Insurance policy end date2014-11-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $720,205
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract numberMULTI-CONTRACTS
Policy instance 8
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered216
Insurance policy start date2013-02-01
Insurance policy end date2014-01-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,599,888
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract numberMULTI-CONTRACTS
Policy instance 10
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered451
Insurance policy start date2013-07-01
Insurance policy end date2014-06-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,422,991
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract numberMULTI-CONTRACTS
Policy instance 9
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2306
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $13,079,193
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number615188
Policy instance 11
Insurance contract or identification number615188
Number of Individuals Covered26
Insurance policy start date2013-06-01
Insurance policy end date2014-05-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $345,446
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract numberMULTI-CONTRACTS
Policy instance 12
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered621
Insurance policy start date2013-03-01
Insurance policy end date2014-02-28
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,045,809
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 13
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered139
Insurance policy start date2013-05-01
Insurance policy end date2014-04-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,419,297
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 14
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered148
Insurance policy start date2013-10-01
Insurance policy end date2014-09-30
Total amount of commissions paid to insurance brokerUSD $1,298
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,767,317
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,298
Insurance broker namePROFESSIONAL PENSIONS INC
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract numberMULTI-CONTRACTS
Policy instance 15
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered177
Insurance policy start date2013-04-01
Insurance policy end date2014-03-31
Total amount of commissions paid to insurance brokerUSD $26,715
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $877,774
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $26,715
Insurance broker nameLEFF COMPANY
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number387883
Policy instance 16
Insurance contract or identification number387883
Number of Individuals Covered84
Insurance policy start date2013-05-01
Insurance policy end date2014-04-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,608
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number385380
Policy instance 17
Insurance contract or identification number385380
Number of Individuals Covered35
Insurance policy start date2013-03-01
Insurance policy end date2014-02-28
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $433,768
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number456320
Policy instance 18
Insurance contract or identification number456320
Number of Individuals Covered76
Insurance policy start date2013-10-01
Insurance policy end date2014-09-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $230,348
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMERIHEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60061 )
Policy contract numberMULTI-CONTRACTS
Policy instance 19
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered63
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $500,603
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberMULTI-CONTRACTS
Policy instance 20
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered88
Insurance policy start date2013-04-01
Insurance policy end date2014-03-31
Total amount of commissions paid to insurance brokerUSD $1,769
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $12,357
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $644
Insurance broker namePROFESSIONAL PENSIONS INC
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number10-36239-15
Policy instance 21
Insurance contract or identification number10-36239-15
Number of Individuals Covered14
Insurance policy start date2013-08-01
Insurance policy end date2014-07-31
Total amount of commissions paid to insurance brokerUSD $889
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $11,410
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $807
Insurance broker namePROFESSIONAL PENSIONS INC
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number10-39530
Policy instance 22
Insurance contract or identification number10-39530
Number of Individuals Covered48
Insurance policy start date2013-02-01
Insurance policy end date2014-01-31
Total amount of commissions paid to insurance brokerUSD $959
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,364
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $647
Insurance broker namePROFESSIONAL PENSIONS INC
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberMULTI-CONTRACTS
Policy instance 23
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered429
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $13,969
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $271,457
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,488
Insurance broker nameGALLAGHER BENEFIT SERVICES(ITASCA,I
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberMULTI-CONTRACTS
Policy instance 24
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered64
Insurance policy start date2013-07-01
Insurance policy end date2014-06-30
Total amount of commissions paid to insurance brokerUSD $2,390
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $30,392
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,770
Insurance broker nameRAYMOND CONGELOSI
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number10-36509
Policy instance 25
Insurance contract or identification number10-36509
Number of Individuals Covered19
Insurance policy start date3013-06-01
Insurance policy end date2014-05-31
Total amount of commissions paid to insurance brokerUSD $840
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,771
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $816
Insurance broker namePROFESSIONAL PENSIONS INC
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number10-25738
Policy instance 26
Insurance contract or identification number10-25738
Number of Individuals Covered35
Insurance policy start date2013-03-01
Insurance policy end date2014-02-28
Total amount of commissions paid to insurance brokerUSD $1,964
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $16,354
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,213
Insurance broker namePROFESSIONAL PENSIONS INC
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberMULTI-CONTRACTS
Policy instance 27
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered37
Insurance policy start date2013-05-01
Insurance policy end date2014-04-30
Total amount of commissions paid to insurance brokerUSD $3,639
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $47,010
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,170
Insurance broker nameSECURITY FIRST INSURANCE GROUP(WATE
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number26-201589
Policy instance 28
Insurance contract or identification number26-201589
Number of Individuals Covered290
Insurance policy start date2013-11-01
Insurance policy end date2014-10-31
Total amount of commissions paid to insurance brokerUSD $1,253
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $9,819
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $909
Insurance broker namePROFESSIONAL PENSIONS INC
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberMULTI-CONTRACTS
Policy instance 29
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered187
Insurance policy start date2013-10-01
Insurance policy end date2014-09-30
Total amount of commissions paid to insurance brokerUSD $5,621
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $127,148
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,259
Insurance broker nameROSE AND KIERNAN, INC
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberMULTI-CONTRACTS
Policy instance 30
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered545
Insurance policy start date2013-09-01
Insurance policy end date2014-08-30
Total amount of commissions paid to insurance brokerUSD $13,571
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $193,567
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,337
Insurance broker nameMERCER (FORMERLY MARSH/SEABURY& SMI
ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 )
Policy contract numberMULTI-CONTRACTS
Policy instance 31
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1926
Insurance policy start date2013-04-01
Insurance policy end date2014-03-31
Total amount of commissions paid to insurance brokerUSD $11,433
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,024,906
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,433
Insurance broker namePIERSON & SMITH INC
ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 )
Policy contract number054791
Policy instance 32
Insurance contract or identification number054791
Number of Individuals Covered54
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,310,322
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 )
Policy contract numberMULTI-CONTRACTS
Policy instance 33
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered506
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $1,714
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $37,158
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $302
Insurance broker namePAYCHEX INSURANCE AGENCY, INC.
BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 )
Policy contract numberMULTI-CONTRACTS
Policy instance 34
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered3839
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $9,314,661
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 35
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered399
Insurance policy start date2013-04-01
Insurance policy end date2014-03-31
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,136,935
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 36
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered685
Insurance policy start date2013-12-01
Insurance policy end date2014-11-30
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,580,700
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberMULTI-CONTRACTS
Policy instance 37
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1286
Insurance policy start date2013-02-01
Insurance policy end date2014-01-31
Total amount of commissions paid to insurance brokerUSD $7,645
Total amount of fees paid to insurance companyUSD $429
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,387,333
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,873
Amount paid for insurance broker fees429
Insurance broker nameLOCKTON COMPANIES LLC
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract numberMULTI-CONTRACTS
Policy instance 38
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered7692
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $8,540
Total amount of fees paid to insurance companyUSD $35,131
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $21,101,699
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,109
Amount paid for insurance broker fees35131
Insurance broker namePROFESSIONAL PENSIONS INC
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 40
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered396
Insurance policy start date2013-06-01
Insurance policy end date2014-05-31
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,369,606
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 39
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1002
Insurance policy start date2013-07-01
Insurance policy end date2014-06-30
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,393,137
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 41
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered808
Insurance policy start date2013-03-01
Insurance policy end date2014-02-28
Total amount of commissions paid to insurance brokerUSD $1,335
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,129,588
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $766
Insurance broker nameBRYAN ERDHEIM
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 42
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1605
Insurance policy start date2013-05-01
Insurance policy end date2014-04-01
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,647,603
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 43
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1193
Insurance policy start date2013-11-01
Insurance policy end date2014-10-31
Total amount of commissions paid to insurance brokerUSD $4,610
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $123,094
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,610
Insurance broker namePROFESSIONAL PENSIONS INC
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 44
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1709
Insurance policy start date2013-10-01
Insurance policy end date2014-09-30
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $166,282
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 45
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1932
Insurance policy start date2013-09-01
Insurance policy end date2014-08-31
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,579,782
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONNECTICARE, INC. (National Association of Insurance Commissioners NAIC id number: 95675 )
Policy contract number007249
Policy instance 46
Insurance contract or identification number007249
Number of Individuals Covered36
Insurance policy start date2013-12-01
Insurance policy end date2014-11-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $363,126
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
Policy contract numberMULTI-CONTRACTS
Policy instance 47
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered172
Insurance policy start date2013-03-01
Insurance policy end date2014-02-28
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $121,386
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract number9844176
Policy instance 48
Insurance contract or identification number9844176
Number of Individuals Covered171
Insurance policy start date2013-04-01
Insurance policy end date2014-03-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $21,619
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract numberMULTI-CONTRACTS
Policy instance 49
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered236
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $32,446
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract number9851346
Policy instance 50
Insurance contract or identification number9851346
Number of Individuals Covered103
Insurance policy start date2013-07-01
Insurance policy end date2014-06-30
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,898
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract number9721507
Policy instance 51
Insurance contract or identification number9721507
Number of Individuals Covered11
Insurance policy start date2013-06-01
Insurance policy end date2014-05-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,270
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract numberMULTI-CONTRACTS
Policy instance 52
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered311
Insurance policy start date2013-03-01
Insurance policy end date2014-02-28
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $27,196
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract numberMULTI-CONTRACTS
Policy instance 53
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered213
Insurance policy start date2013-05-01
Insurance policy end date2014-04-30
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $19,699
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract numberMULTI-CONTRACTS
Policy instance 54
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered453
Insurance policy start date3013-10-01
Insurance policy end date2014-09-30
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $28,274
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract number9826181
Policy instance 55
Insurance contract or identification number9826181
Number of Individuals Covered304
Insurance policy start date2013-09-01
Insurance policy end date2014-08-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $58,161
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 numberF012582
Policy instance 56
Insurance contract or identification numberF012582
Number of Individuals Covered106
Insurance policy start date2013-08-01
Insurance policy end date2014-07-31
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $13,077
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 numberF018626
Policy instance 57
Insurance contract or identification numberF018626
Number of Individuals Covered128
Insurance policy start date2013-11-01
Insurance policy end date2014-10-31
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $13,945
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 numberF018610
Policy instance 58
Insurance contract or identification numberF018610
Number of Individuals Covered54
Insurance policy start date2013-09-01
Insurance policy end date2014-08-01
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,040
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 )
Policy contract number468F1G281
Policy instance 59
Insurance contract or identification number468F1G281
Number of Individuals Covered28
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,656
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 )
Policy contract numberMULTI-CONTRACTS
Policy instance 60
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered329
Insurance policy start date2013-06-01
Insurance policy end date2014-05-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,495,041
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 )
Policy contract numberMULTI-CONTRACTS
Policy instance 61
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered85
Insurance policy start date2013-10-01
Insurance policy end date2014-09-30
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $375,398
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 )
Policy contract numberMULTI-CONTRACTS
Policy instance 62
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered331
Insurance policy start date2013-09-01
Insurance policy end date2014-08-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,737,865
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 63
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1303
Insurance policy start date2013-04-01
Insurance policy end date2014-03-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $287,539
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 64
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2531
Insurance policy start date2013-08-01
Insurance policy end date2014-07-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $260,468
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 65
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered716
Insurance policy start date2013-12-01
Insurance policy end date2014-11-30
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $261,467
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 66
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered428
Insurance policy start date2013-02-01
Insurance policy end date2014-01-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $72,210
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 67
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered3723
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,501,456
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 68
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered3834
Insurance policy start date2013-07-01
Insurance policy end date2014-06-30
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $713,643
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 69
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered425
Insurance policy start date2013-06-01
Insurance policy end date2014-05-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $69,658
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 71
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2479
Insurance policy start date2013-05-01
Insurance policy end date2014-04-30
Total amount of commissions paid to insurance brokerUSD $84
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $427,006
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $84
Insurance broker namePROFESSIONAL PENSIONS INC
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 70
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1460
Insurance policy start date2013-03-01
Insurance policy end date2014-02-28
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $358,932
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 72
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered817
Insurance policy start date2013-11-01
Insurance policy end date2014-10-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $353,428
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00403012
Policy instance 73
Insurance contract or identification number00403012
Number of Individuals Covered213
Insurance policy start date2013-10-01
Insurance policy end date2014-09-30
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $24,661
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 74
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered4651
Insurance policy start date2013-09-01
Insurance policy end date2014-08-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,036,906
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HIP HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number1084063000
Policy instance 75
Insurance contract or identification number1084063000
Number of Individuals Covered13
Insurance policy start date2013-06-01
Insurance policy end date2014-05-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $63,005
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberSR-83114532
Policy instance 76
Insurance contract or identification numberSR-83114532
Number of Individuals Covered351
Insurance policy start date2013-12-01
Insurance policy end date2014-11-30
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $19,518
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 77
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered157
Insurance policy start date2013-07-01
Insurance policy end date2014-06-30
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $33,215
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 78
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered467
Insurance policy start date2013-04-01
Insurance policy end date2014-03-31
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $65,724
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010162255
Policy instance 79
Insurance contract or identification number000010162255
Number of Individuals Covered128
Insurance policy start date2013-08-01
Insurance policy end date2014-07-31
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,292
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 80
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered88
Insurance policy start date2013-12-01
Insurance policy end date2014-11-30
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $12,518
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number01-0139064
Policy instance 81
Insurance contract or identification number01-0139064
Number of Individuals Covered118
Insurance policy start date2013-02-28
Insurance policy end date2014-01-31
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,363
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 82
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered11096
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $148
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $911,002
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $148
Insurance broker namePROFESSIONAL PENSIONS INC
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 83
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered176
Insurance policy start date2013-07-01
Insurance policy end date2014-06-30
Total amount of commissions paid to insurance brokerUSD $542
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $11,127
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $542
Insurance broker nameDARREN J WALSH
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number01-0159948
Policy instance 84
Insurance contract or identification number01-0159948
Number of Individuals Covered18
Insurance policy start date2013-06-01
Insurance policy end date2014-05-31
Total amount of commissions paid to insurance brokerUSD $206
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,700
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $206
Insurance broker namePROFESSIONAL PENSIONS INC
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 85
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered430
Insurance policy start date2013-03-01
Insurance policy end date2014-02-28
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $28,966
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 86
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1890
Insurance policy start date2013-05-01
Insurance policy end date2014-04-30
Total amount of commissions paid to insurance brokerUSD $1,438
Total amount of fees paid to insurance companyUSD $479
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $160,820
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,438
Amount paid for insurance broker fees479
Insurance broker namePROFESSIONAL PENSIONS INC
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 87
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered339
Insurance policy start date2013-11-01
Insurance policy end date2014-10-31
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $42,205
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 88
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered271
Insurance policy start date2013-10-01
Insurance policy end date2014-09-30
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedCRITACAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $46,737
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 89
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2878
Insurance policy start date2013-09-01
Insurance policy end date2014-08-31
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $533,015
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberMULTI-CONTRACTS
Policy instance 90
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered666
Insurance policy start date2013-12-01
Insurance policy end date2014-11-30
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $36,960
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5333776
Policy instance 91
Insurance contract or identification number5333776
Number of Individuals Covered6488
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $2,993
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,281,117
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,993
Insurance broker nameEMERSON REID & COMPANY, INC. (LEADE
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5595669
Policy instance 92
Insurance contract or identification number5595669
Number of Individuals Covered157
Insurance policy start date2013-07-01
Insurance policy end date2014-06-30
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $121,296
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberMULTI-CONTRACTS
Policy instance 93
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered122
Insurance policy start date2013-03-01
Insurance policy end date2014-02-28
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $76,552
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number383202
Policy instance 94
Insurance contract or identification number383202
Number of Individuals Covered42
Insurance policy start date2013-10-01
Insurance policy end date2014-09-30
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,080
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5568741
Policy instance 95
Insurance contract or identification number5568741
Number of Individuals Covered32
Insurance policy start date2013-09-01
Insurance policy end date2014-08-31
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,254
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberG000AP7Y
Policy instance 96
Insurance contract or identification numberG000AP7Y
Number of Individuals Covered192
Insurance policy start date2013-04-01
Insurance policy end date2014-03-31
Total amount of commissions paid to insurance brokerUSD $3,304
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $16,740
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,503
Insurance broker nameCORPORATE CONSULTING SERVICES LIMIT
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberGOOOAGPG
Policy instance 97
Insurance contract or identification numberGOOOAGPG
Number of Individuals Covered234
Insurance policy start date2013-08-01
Insurance policy end date2014-07-31
Total amount of commissions paid to insurance brokerUSD $1,744
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $8,823
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $882
Insurance broker namePROFESSIONAL PENSIONS INC
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 98
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered686
Insurance policy start date2013-12-01
Insurance policy end date2014-11-30
Total amount of commissions paid to insurance brokerUSD $13,706
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $71,154
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,454
Insurance broker nameNFP CORPORATE SERVICES
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 99
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2980
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $67,826
Total amount of fees paid to insurance companyUSD $3,284
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $328,868
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $28,867
Amount paid for insurance broker fees3284
Insurance broker namePILOT BENEFITS GROUP, LLC
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 100
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered158
Insurance policy start date2013-07-01
Insurance policy end date2014-06-30
Total amount of commissions paid to insurance brokerUSD $4,483
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $21,946
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,795
Insurance broker nameTHE HEALTH CONSULTANTS GROUP LLC
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 102
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered187
Insurance policy start date2013-03-01
Insurance policy end date2014-02-28
Total amount of commissions paid to insurance brokerUSD $9,897
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $47,725
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
Insurance broker nameBENEFITS CONSULTING GROUP
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 101
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered718
Insurance policy start date2013-06-01
Insurance policy end date2014-05-31
Total amount of commissions paid to insurance brokerUSD $12,283
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $45,593
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,322
Insurance broker namePETERMAN BENEFITS
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberMULTI-CONTRACTS
Policy instance 103
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered320
Insurance policy start date2013-09-01
Insurance policy end date2014-08-31
Total amount of commissions paid to insurance brokerUSD $2,352
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $13,160
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,173
Insurance broker nameSINGER NELSON CHARLMERS, INC.
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberGOOOAE9U
Policy instance 104
Insurance contract or identification numberGOOOAE9U
Number of Individuals Covered79
Insurance policy start date2013-11-01
Insurance policy end date2014-10-31
Total amount of commissions paid to insurance brokerUSD $2,084
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $8,838
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,235
Insurance broker namePROFESSIONAL PENSIONS INC
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberMULTI-CONTRACTS
Policy instance 105
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered550
Insurance policy start date2013-10-01
Insurance policy end date2014-09-30
Total amount of commissions paid to insurance brokerUSD $7,889
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $42,553
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,262
Insurance broker namePILOT BENEFITS
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberMULTI-CONTRACTS
Policy instance 106
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered990
Insurance policy start date2013-09-01
Insurance policy end date2014-08-31
Total amount of commissions paid to insurance brokerUSD $23,445
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $135,743
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,662
Insurance broker nameWHARTON LYON & LYON
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 107
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered38
Insurance policy start date2013-12-01
Insurance policy end date2014-11-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $587,227
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMUTLI-CONTRACTS
Policy instance 108
Insurance contract or identification numberMUTLI-CONTRACTS
Number of Individuals Covered149
Insurance policy start date2013-02-01
Insurance policy end date2014-01-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,537,630
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 109
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered253
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,398,710
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 110
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered202
Insurance policy start date2013-07-01
Insurance policy end date2014-06-30
Total amount of commissions paid to insurance brokerUSD $9,750
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,430,761
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,750
Insurance broker namePROFESSIONAL PENSIONS INC
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 111
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered57
Insurance policy start date2013-06-01
Insurance policy end date2014-05-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $613,434
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 112
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered192
Insurance policy start date2013-03-01
Insurance policy end date2014-02-28
Total amount of commissions paid to insurance brokerUSD $5,142
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,048,878
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,142
Insurance broker namePROFESSIONAL PENSIONS INC
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberEG1123
Policy instance 113
Insurance contract or identification numberEG1123
Number of Individuals Covered77
Insurance policy start date2013-05-01
Insurance policy end date2014-04-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $852,019
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberLR8085
Policy instance 114
Insurance contract or identification numberLR8085
Number of Individuals Covered98
Insurance policy start date2013-11-01
Insurance policy end date2014-10-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,198,945
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 115
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered246
Insurance policy start date2013-10-01
Insurance policy end date2014-09-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,551,496
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 116
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered187
Insurance policy start date2013-09-01
Insurance policy end date2014-08-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,534,504
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberMULTI-CONTRACTS
Policy instance 117
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered42
Insurance policy start date2013-12-01
Insurance policy end date2014-11-30
Total amount of commissions paid to insurance brokerUSD $97
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $34,319
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $97
Insurance broker namePROFESSIONAL PENSIONS INC
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberMULTI-CONTRACTS
Policy instance 118
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered225
Insurance policy start date2013-02-01
Insurance policy end date2014-01-31
Total amount of commissions paid to insurance brokerUSD $10,234
Total amount of fees paid to insurance companyUSD $3,070
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $121,244
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,234
Amount paid for insurance broker fees3070
Insurance broker namePROFESSIONAL PENSIONS INC
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberH43785-1
Policy instance 119
Insurance contract or identification numberH43785-1
Number of Individuals Covered5
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,407
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberMULTI-CONTRACTS
Policy instance 120
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered75
Insurance policy start date2013-07-01
Insurance policy end date2014-06-30
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $8,688
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberH65245-1
Policy instance 121
Insurance contract or identification numberH65245-1
Number of Individuals Covered23
Insurance policy start date2013-06-01
Insurance policy end date2014-05-31
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,996
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberMUTLI-CONTRACTS
Policy instance 122
Insurance contract or identification numberMUTLI-CONTRACTS
Number of Individuals Covered95
Insurance policy start date2013-11-01
Insurance policy end date2014-10-31
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $42,794
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberMULTI-CONTRACTS
Policy instance 123
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered38
Insurance policy start date2013-10-01
Insurance policy end date2014-09-30
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $8,331
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberH69494-1
Policy instance 124
Insurance contract or identification numberH69494-1
Number of Individuals Covered58
Insurance policy start date2013-09-01
Insurance policy end date2014-08-01
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,443
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number89993
Policy instance 125
Insurance contract or identification number89993
Number of Individuals Covered112
Insurance policy start date2013-04-01
Insurance policy end date2014-03-31
Total amount of commissions paid to insurance brokerUSD $998
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $14,049
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $998
Insurance broker namePROFESSIONAL PENSIONS INC
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number23492
Policy instance 126
Insurance contract or identification number23492
Number of Individuals Covered132
Insurance policy start date2013-12-01
Insurance policy end date2014-11-30
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $9,241
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract numberMULTI-CONTRACTS
Policy instance 127
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered724
Insurance policy start date2013-08-01
Insurance policy end date2014-07-31
Total amount of commissions paid to insurance brokerUSD $34,889
Total amount of fees paid to insurance companyUSD $10
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $107,528
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $21,285
Amount paid for insurance broker fees10
Insurance broker nameAXA ASSISTANCE, USA
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract numberMULTI-CONTRACTS
Policy instance 128
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered620
Insurance policy start date2013-02-01
Insurance policy end date2014-01-31
Total amount of commissions paid to insurance brokerUSD $8,692
Total amount of fees paid to insurance companyUSD $63
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $36,237
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,130
Amount paid for insurance broker fees63
Insurance broker nameAXA ASSISTANCE, USA
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract numberMULTI-CONTRACTS
Policy instance 129
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered3530
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $13,573
Total amount of fees paid to insurance companyUSD $69
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $442,101
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,451
Amount paid for insurance broker fees69
Insurance broker nameAXA ASSISTANCE, USA
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number89935
Policy instance 130
Insurance contract or identification number89935
Number of Individuals Covered103
Insurance policy start date2013-08-01
Insurance policy end date2014-06-30
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $8,029
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract numberMULTI-CONTRACTS
Policy instance 132
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered269
Insurance policy start date2013-03-01
Insurance policy end date2014-02-28
Total amount of commissions paid to insurance brokerUSD $1,074
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $64,039
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,074
Insurance broker nameERICH G STRUNK
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract numberMULT-CONTRACTS
Policy instance 131
Insurance contract or identification numberMULT-CONTRACTS
Number of Individuals Covered185
Insurance policy start date2013-06-01
Insurance policy end date2014-05-31
Total amount of commissions paid to insurance brokerUSD $818
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,364
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $507
Insurance broker nameEMERSON REID & COMPANY, INC. (LEADE
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number89957
Policy instance 133
Insurance contract or identification number89957
Number of Individuals Covered243
Insurance policy start date2013-05-01
Insurance policy end date2014-04-30
Total amount of commissions paid to insurance brokerUSD $15,336
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $83,212
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,336
Insurance broker namePROFESSIONAL PENSIONS INC
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract numberMULTI-CONTRACTS
Policy instance 134
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered160
Insurance policy start date2013-11-01
Insurance policy end date2014-10-31
Total amount of commissions paid to insurance brokerUSD $7,978
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $24,362
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,354
Insurance broker nameCOMPAIN AMDERSON AZAR, LTD
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract numberMULTI-CONTRACTS
Policy instance 135
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered96
Insurance policy start date2013-10-01
Insurance policy end date2014-09-30
Total amount of commissions paid to insurance brokerUSD $1,801
Total amount of fees paid to insurance companyUSD $2,382
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $8,004
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,201
Amount paid for insurance broker fees2382
Insurance broker namePROFESSIONAL PENSIONS INC
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract numberMULTI-CONTRACTS
Policy instance 136
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1358
Insurance policy start date2013-09-01
Insurance policy end date2014-08-31
Total amount of commissions paid to insurance brokerUSD $12,563
Total amount of fees paid to insurance companyUSD $180
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $111,433
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,807
Amount paid for insurance broker fees180
Insurance broker nameAXA ASSISTANCE, USA
THE STANDARD LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 89009 )
Policy contract number154539
Policy instance 137
Insurance contract or identification number154539
Number of Individuals Covered63
Insurance policy start date2013-04-01
Insurance policy end date2014-03-31
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $11,665
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number153691
Policy instance 138
Insurance contract or identification number153691
Number of Individuals Covered591
Insurance policy start date2013-08-01
Insurance policy end date2014-07-31
Total amount of commissions paid to insurance brokerUSD $25,930
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $245,489
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,656
Insurance broker namePROFESSIONAL PENSIONS INC
THE STANDARD LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 89009 )
Policy contract number155938
Policy instance 139
Insurance contract or identification number155938
Number of Individuals Covered452
Insurance policy start date2013-02-01
Insurance policy end date2014-01-31
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $71,762
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE STANDARD LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 89009 )
Policy contract number442045
Policy instance 140
Insurance contract or identification number442045
Number of Individuals Covered103
Insurance policy start date2013-03-01
Insurance policy end date2014-02-28
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,564
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE STANDARD LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 89009 )
Policy contract number430690
Policy instance 141
Insurance contract or identification number430690
Number of Individuals Covered873
Insurance policy start date2013-09-01
Insurance policy end date2014-08-31
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $705,034
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number222323
Policy instance 142
Insurance contract or identification number222323
Number of Individuals Covered152
Insurance policy start date2013-04-01
Insurance policy end date2014-03-31
Total amount of commissions paid to insurance brokerUSD $13,759
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $66,673
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,656
Insurance broker namePROFESSIONAL PENSIONS INC
SUN LIFE INSURANCE AND ANNUITY COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract numberMULTI-CONTRACTS
Policy instance 143
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered794
Insurance policy start date2013-08-01
Insurance policy end date2014-07-01
Total amount of commissions paid to insurance brokerUSD $11,889
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $135,015
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,617
Insurance broker nameRUDOLF ASSOCIATES INC
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract numberMULTI-CONTRACTS
Policy instance 144
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered97
Insurance policy start date2013-12-01
Insurance policy end date2014-11-30
Total amount of commissions paid to insurance brokerUSD $4,264
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $64,651
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,895
Insurance broker nameSECURITY FIRST
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract numberMULTI-CONTRACTS
Policy instance 145
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered168
Insurance policy start date2013-02-01
Insurance policy end date2014-01-31
Total amount of commissions paid to insurance brokerUSD $6,077
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $57,084
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,343
Insurance broker nameTHE HEALTH CONSULTANTS GROUP LLC
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract numberMULTI-CONTRACTS
Policy instance 146
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2146
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $16,123
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $119,262
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,701
Insurance broker namePILOT BENEFITS GROUP INC
SUN LIFE INSURANCE AND ANNUITY COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract numberMULTI-CONTRACTS
Policy instance 147
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1769
Insurance policy start date2013-07-01
Insurance policy end date2014-06-30
Total amount of commissions paid to insurance brokerUSD $29,071
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $237,541
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,253
Insurance broker namePIERSON & SMITH INC
SUN LIFE INSURANCE AND ANNUITY COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract numberMULTI-CONTRACTS
Policy instance 148
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered584
Insurance policy start date2013-06-01
Insurance policy end date2014-05-31
Total amount of commissions paid to insurance brokerUSD $7,525
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $37,550
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,501
Insurance broker nameROSE & KIERNAN INC
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract numberMULTI-CONTRACTS
Policy instance 149
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered235
Insurance policy start date2013-03-01
Insurance policy end date2014-02-28
Total amount of commissions paid to insurance brokerUSD $1,422
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $17,745
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $627
Insurance broker nameKOHLER THOMAS
SUN LIFE INSURANCE AND ANNUITY COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract number811423
Policy instance 150
Insurance contract or identification number811423
Number of Individuals Covered181
Insurance policy start date2013-05-01
Insurance policy end date2014-04-30
Total amount of commissions paid to insurance brokerUSD $2,376
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $11,354
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $673
Insurance broker nameCORPORATE CONSULING SERVICES LTD
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract numberMULTI-CONTRACTS
Policy instance 151
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1784
Insurance policy start date2013-11-01
Insurance policy end date2014-10-31
Total amount of commissions paid to insurance brokerUSD $4,583
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $82,962
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,377
Insurance broker nameMARSH & MCLENNAN AGENCY LLC
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract numberMULTI-CONTRACTS
Policy instance 152
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered252
Insurance policy start date2013-10-01
Insurance policy end date2014-09-30
Total amount of commissions paid to insurance brokerUSD $1,240
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $60,406
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $809
Insurance broker namePROFESSIONAL PENSIONS INC
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number217906-001
Policy instance 153
Insurance contract or identification number217906-001
Number of Individuals Covered51
Insurance policy start date2013-04-01
Insurance policy end date2014-03-31
Total amount of commissions paid to insurance brokerUSD $515
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,714
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $384
Insurance broker namePROFESSIONAL PENSIONS INC
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract numberMULTI-CONTRACTS
Policy instance 154
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1414
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $7,916
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $71,680
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,147
Insurance broker namePROFESSIONAL PENSIONS INC
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number217552
Policy instance 155
Insurance contract or identification number217552
Number of Individuals Covered42
Insurance policy start date2013-03-01
Insurance policy end date2014-02-28
Total amount of commissions paid to insurance brokerUSD $515
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,848
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $294
Insurance broker namePROFESSIONAL PENSIONS INC
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract number028-3316-00
Policy instance 156
Insurance contract or identification number028-3316-00
Number of Individuals Covered39
Insurance policy start date2013-10-01
Insurance policy end date2014-09-30
Total amount of commissions paid to insurance brokerUSD $1,215
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,668
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $911
Insurance broker namePROFESSIONAL PENSIONS INC
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 157
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered175
Insurance policy start date2013-12-01
Insurance policy end date2014-11-30
Total amount of commissions paid to insurance brokerUSD $46,148
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $853,506
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $34,110
Insurance broker namePROFESSIONAL PENSIONS INC
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 158
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1443
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $132,488
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,345,890
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $58,934
Insurance broker namePROFESSIONAL PENSIONS INC
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACT
Policy instance 159
Insurance contract or identification numberMULTI-CONTRACT
Number of Individuals Covered47
Insurance policy start date2013-06-01
Insurance policy end date2014-05-31
Total amount of commissions paid to insurance brokerUSD $153
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,113
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $153
Insurance broker namePROFESSIONAL PENSIONS INC
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 160
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered329
Insurance policy start date2013-03-01
Insurance policy end date2014-02-28
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $60,932
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 161
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered268
Insurance policy start date2013-05-01
Insurance policy end date2014-04-30
Total amount of commissions paid to insurance brokerUSD $61,323
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,232,314
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $43,149
Insurance broker namePROFESSIONAL PENSIONS INC
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number07P3689
Policy instance 162
Insurance contract or identification number07P3689
Number of Individuals Covered25
Insurance policy start date2013-10-01
Insurance policy end date2014-09-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,924
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 163
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered605
Insurance policy start date2013-09-01
Insurance policy end date2014-08-31
Total amount of commissions paid to insurance brokerUSD $360
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,330,635
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $360
Insurance broker namePROFESSIONAL PENSIONS INC
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 164
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered860
Insurance policy start date2013-04-01
Insurance policy end date2014-03-31
Total amount of commissions paid to insurance brokerUSD $16,188
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $71,578
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,261
Insurance broker nameTM BURROWS ASSOC, LLC(WATERFORD,CT)
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 165
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered135
Insurance policy start date2013-08-01
Insurance policy end date2014-07-31
Total amount of commissions paid to insurance brokerUSD $6,504
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $23,851
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,318
Insurance broker nameHUB INTERNATIONAL NE (WOODBURY)
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 166
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered451
Insurance policy start date2013-12-01
Insurance policy end date2014-11-30
Total amount of commissions paid to insurance brokerUSD $19,814
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $79,815
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,592
Insurance broker nameMAY-BONEE & COMPANY, INC.
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 167
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered599
Insurance policy start date2013-02-01
Insurance policy end date2014-01-31
Total amount of commissions paid to insurance brokerUSD $20,650
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $81,364
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,547
Insurance broker nameDARREN J WALSH
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 168
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered5667
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $127,995
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $764,531
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $57,971
Insurance broker nameRICHARD R DAMICO, LUTCF
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 169
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered668
Insurance policy start date2013-07-01
Insurance policy end date2014-06-30
Total amount of commissions paid to insurance brokerUSD $11,316
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $36,988
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,496
Insurance broker nameTHE TARPEY GROUP, LLC
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 170
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered204
Insurance policy start date2013-06-01
Insurance policy end date2014-05-31
Total amount of commissions paid to insurance brokerUSD $4,115
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $16,363
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,164
Insurance broker nameTM BURROWS ASSOC, LLC(WATERFORD,CT)
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 171
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered253
Insurance policy start date2013-03-01
Insurance policy end date2014-02-28
Total amount of commissions paid to insurance brokerUSD $8,465
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $41,218
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,250
Insurance broker namePROFESSIONAL PENSIONS INC
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 172
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1271
Insurance policy start date2013-05-01
Insurance policy end date2014-04-30
Total amount of commissions paid to insurance brokerUSD $27,127
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $112,607
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,752
Insurance broker nameWILLIAM P. MCCARTHY
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 173
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered185
Insurance policy start date1201-01-17
Insurance policy end date2014-10-31
Total amount of commissions paid to insurance brokerUSD $7,972
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $30,913
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,607
Insurance broker nameRICHARD R DAMICO, LUTCF
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 174
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1090
Insurance policy start date2013-10-01
Insurance policy end date2014-09-30
Total amount of commissions paid to insurance brokerUSD $33,100
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $145,263
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,386
Insurance broker nameWILLIS OF CT
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 175
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1371
Insurance policy start date2013-09-01
Insurance policy end date2014-08-30
Total amount of commissions paid to insurance brokerUSD $33,999
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $169,165
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,825
Insurance broker nameRAYMOND CONGELOSI
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract numberMULTI-CONTRACTS
Policy instance 176
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered733
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $91,700
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract numberMULTI-CONTRACTS
Policy instance 177
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered324
Insurance policy start date2013-07-01
Insurance policy end date2014-06-30
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $47,632
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract number30033212
Policy instance 178
Insurance contract or identification number30033212
Number of Individuals Covered85
Insurance policy start date2013-06-01
Insurance policy end date2014-05-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $9,096
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract numberMULTI-CONTRACTS
Policy instance 179
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered300
Insurance policy start date2013-03-01
Insurance policy end date2014-02-28
Total amount of commissions paid to insurance brokerUSD $1,322
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $40,245
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,322
Insurance broker nameGALLAGHER BENEFIT SERVICES INC
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract numberMULTI-CONTRACTS
Policy instance 180
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered160
Insurance policy start date2013-10-01
Insurance policy end date2014-09-30
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $16,445
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 1
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered9923
Insurance policy start date2013-01-01
Insurance policy end date2013-12-01
Total amount of commissions paid to insurance brokerUSD $683,932
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,815,012
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $261,286
Insurance broker nameSCOTT FINANCIAL SERVICES INC.
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number696715
Policy instance 2
Insurance contract or identification number696715
Number of Individuals Covered754
Insurance policy start date2012-09-01
Insurance policy end date2013-08-31
Total amount of commissions paid to insurance brokerUSD $33,685
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $541,769
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $33,685
Insurance broker nameEMERSON REID & COMPANY, INC. (LEADE
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 3
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered602
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $1,238
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $9,196
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $431
Insurance broker nameFRENKEL BENEFITS, LLC
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number617383
Policy instance 4
Insurance contract or identification number617383
Number of Individuals Covered8300
Insurance policy start date2012-07-01
Insurance policy end date2013-06-30
Total amount of commissions paid to insurance brokerUSD $55,495
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $682,296
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,462
Insurance broker nameTHE MELTZER GROUP
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 5
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered221
Insurance policy start date2012-04-01
Insurance policy end date2013-03-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,229,762
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 6
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered187
Insurance policy start date2012-08-01
Insurance policy end date2013-07-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,954,714
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract numberMULTI-CONTRACTS
Policy instance 7
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered188
Insurance policy start date2012-02-01
Insurance policy end date2013-01-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,358,058
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract numberMULTI-CONTRACTS
Policy instance 8
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1372
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $12,631,510
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract numberMULTI-CONTRACTS
Policy instance 9
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered163
Insurance policy start date2012-07-01
Insurance policy end date2013-06-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,931,051
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract numberMULTI-CONTRACTS
Policy instance 10
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered177
Insurance policy start date2012-06-01
Insurance policy end date2013-05-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,383,663
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract numberMULTI-CONTRACTS
Policy instance 11
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered356
Insurance policy start date2012-03-01
Insurance policy end date2013-02-28
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,610,438
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 12
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered189
Insurance policy start date2012-05-01
Insurance policy end date2013-04-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,580,783
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number477517
Policy instance 13
Insurance contract or identification number477517
Number of Individuals Covered77
Insurance policy start date2012-11-01
Insurance policy end date2013-10-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $932,079
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number477488
Policy instance 14
Insurance contract or identification number477488
Number of Individuals Covered57
Insurance policy start date2012-10-01
Insurance policy end date2013-09-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $782,969
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract numberMULTI-CONTRACTS
Policy instance 15
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered409
Insurance policy start date2012-09-01
Insurance policy end date2013-08-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,285,392
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract numberMULTI-CONTRACTS
Policy instance 16
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered166
Insurance policy start date2012-04-01
Insurance policy end date2013-03-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,570,093
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number431283
Policy instance 17
Insurance contract or identification number431283
Number of Individuals Covered158
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,814,956
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract numberMULTI-CONTRACTS
Policy instance 18
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered113
Insurance policy start date2012-03-01
Insurance policy end date2013-02-28
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $492,082
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number387883
Policy instance 19
Insurance contract or identification number387883
Number of Individuals Covered82
Insurance policy start date2012-05-01
Insurance policy end date2013-04-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $772,947
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number444762
Policy instance 20
Insurance contract or identification number444762
Number of Individuals Covered25
Insurance policy start date2012-11-01
Insurance policy end date2013-10-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $163,369
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number10-33637
Policy instance 21
Insurance contract or identification number10-33637
Number of Individuals Covered26
Insurance policy start date2012-04-01
Insurance policy end date2013-03-31
Total amount of commissions paid to insurance brokerUSD $1,182
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,781
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $604
Insurance broker nameRUDOLF ASSOCIATES, INC
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberMULTI-CONTRACTS
Policy instance 22
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered66
Insurance policy start date2012-08-01
Insurance policy end date2013-07-31
Total amount of commissions paid to insurance brokerUSD $1,670
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $30,418
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,670
Insurance broker namePROFESSIONAL PENSIONS INC
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number26-201528
Policy instance 23
Insurance contract or identification number26-201528
Number of Individuals Covered45
Insurance policy start date2012-12-01
Insurance policy end date2013-11-30
Total amount of commissions paid to insurance brokerUSD $2,847
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,540
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,172
Insurance broker nameCORPORATE SYNERGIES GROUP, LLC
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberMULTI-CONTRACTS
Policy instance 24
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered818
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $27,172
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $383,158
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,849
Insurance broker nameGALLAGHER BENEFIT SERVICES, INC. NY
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberMULTI-CONTRACTS
Policy instance 25
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered40
Insurance policy start date2012-07-01
Insurance policy end date2013-06-30
Total amount of commissions paid to insurance brokerUSD $2,133
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $25,261
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,395
Insurance broker namePROFESSIONAL PENSIONS INC
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number10-36509
Policy instance 26
Insurance contract or identification number10-36509
Number of Individuals Covered22
Insurance policy start date2012-06-01
Insurance policy end date2013-05-31
Total amount of commissions paid to insurance brokerUSD $246
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,173
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $246
Insurance broker namePROFESSIONAL PENSIONS INC
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract numberMULTI-CONTRACTS
Policy instance 27
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered176
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $23,839
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberMULTI-CONTRACTS
Policy instance 28
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered45
Insurance policy start date2012-03-01
Insurance policy end date2013-02-28
Total amount of commissions paid to insurance brokerUSD $4,827
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $29,400
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,423
Insurance broker nameSTRATFORD FINANCIAL GROUP, INC.
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number26-201589
Policy instance 29
Insurance contract or identification number26-201589
Number of Individuals Covered281
Insurance policy start date2012-11-01
Insurance policy end date2013-10-31
Total amount of commissions paid to insurance brokerUSD $3,762
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $35,253
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,983
Insurance broker namePROFESSIONAL PENSIONS INC
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number26-201515
Policy instance 30
Insurance contract or identification number26-201515
Number of Individuals Covered24
Insurance policy start date2012-10-01
Insurance policy end date2013-09-30
Total amount of commissions paid to insurance brokerUSD $674
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,694
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $305
Insurance broker nameCAPACITY BENEFITS & FINANCIAL SERVI
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberMULTI-CONTRACTS
Policy instance 31
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered106
Insurance policy start date2012-09-01
Insurance policy end date2013-08-31
Total amount of commissions paid to insurance brokerUSD $6,874
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $50,093
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,337
Insurance broker nameSECURITY FIRST INSURANCE GROUP(WATE
ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 )
Policy contract numberMULTI-CONTRACTS
Policy instance 32
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1845
Insurance policy start date2012-04-01
Insurance policy end date2013-03-31
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $874,213
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 )
Policy contract numberMULTI-CONTRACTS
Policy instance 33
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered117
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,059,305
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNION SECURITY LIFE INSURANCE COMPANY OF NEW YORK 4D DENTAL (National Association of Insurance Commissioners NAIC id number: 81477 )
Policy contract number5461895
Policy instance 34
Insurance contract or identification number5461895
Number of Individuals Covered720
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $182,822
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 )
Policy contract numberMULTI-CONTRACTS
Policy instance 35
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered485
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $2,051
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $35,601
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $487
Insurance broker nameMARK D DZIALO
BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 )
Policy contract number90562
Policy instance 36
Insurance contract or identification number90562
Number of Individuals Covered2539
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Health Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,942,656
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 37
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered289
Insurance policy start date2012-04-01
Insurance policy end date2013-03-31
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $873,950
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract number3336152
Policy instance 38
Insurance contract or identification number3336152
Number of Individuals Covered61
Insurance policy start date2012-08-01
Insurance policy end date2013-07-31
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $468,761
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 40
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered514
Insurance policy start date2012-02-01
Insurance policy end date2013-01-31
Total amount of commissions paid to insurance brokerUSD $251
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $39,376
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $251
Insurance broker namePROFESSIONAL PENSIONS INC
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 39
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered257
Insurance policy start date2012-12-01
Insurance policy end date2013-11-01
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $824,028
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 41
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered5627
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $4,132
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $16,318,438
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,745
Insurance broker nameTHE HEALTH CONSULTANTS GROUP LLC
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract number9844176
Policy instance 42
Insurance contract or identification number9844176
Number of Individuals Covered152
Insurance policy start date2012-04-01
Insurance policy end date2013-03-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $19,107
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 43
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered946
Insurance policy start date2012-07-01
Insurance policy end date2013-06-30
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,988,207
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 44
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered442
Insurance policy start date2012-06-01
Insurance policy end date2013-05-31
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,168,801
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 45
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered654
Insurance policy start date2012-03-01
Insurance policy end date2013-02-28
Total amount of commissions paid to insurance brokerUSD $1,036
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,125,713
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,036
Insurance broker namePROFESSIONAL PENSIONS INC
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 46
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1050
Insurance policy start date2012-05-01
Insurance policy end date2013-04-30
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,387,320
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 47
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1136
Insurance policy start date2012-11-01
Insurance policy end date2013-10-31
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $158,868
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 48
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered798
Insurance policy start date2012-10-01
Insurance policy end date2013-09-30
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,166,070
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 49
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered132
Insurance policy start date2012-09-01
Insurance policy end date2013-08-31
Total amount of commissions paid to insurance brokerUSD $1,909
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $507,073
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,909
Insurance broker namePROFESSIONAL PENSIONS INC
CONNECTICARE, INC. (National Association of Insurance Commissioners NAIC id number: 95675 )
Policy contract number007175
Policy instance 50
Insurance contract or identification number007175
Number of Individuals Covered150
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $741
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $766,532
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $741
Insurance broker namePROFESSIONAL PENSIONS INC
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
Policy contract number0576
Policy instance 51
Insurance contract or identification number0576
Number of Individuals Covered72
Insurance policy start date2012-08-01
Insurance policy end date2013-07-31
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $53,715
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
Policy contract number9410
Policy instance 52
Insurance contract or identification number9410
Number of Individuals Covered141
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $174,214
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
Policy contract numberMULTI-CONTRACTS
Policy instance 53
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered145
Insurance policy start date2012-03-01
Insurance policy end date2013-02-28
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $133,120
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract number9851346
Policy instance 54
Insurance contract or identification number9851346
Number of Individuals Covered43
Insurance policy start date2012-07-01
Insurance policy end date2013-06-30
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,140
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract number9721507
Policy instance 55
Insurance contract or identification number9721507
Number of Individuals Covered9
Insurance policy start date2012-06-01
Insurance policy end date2013-05-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,798
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract number9813544
Policy instance 56
Insurance contract or identification number9813544
Number of Individuals Covered78
Insurance policy start date2012-03-01
Insurance policy end date2013-02-28
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $9,680
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract number9816570
Policy instance 57
Insurance contract or identification number9816570
Number of Individuals Covered198
Insurance policy start date2012-05-01
Insurance policy end date2013-04-30
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $17,334
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract numberMULTI-CONTRACTS
Policy instance 58
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered148
Insurance policy start date2012-10-01
Insurance policy end date2013-09-30
Total amount of commissions paid to insurance brokerUSD $73
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $21,846
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $73
Insurance broker namePROFESSIONAL PENSIONS INC
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract number9826181
Policy instance 59
Insurance contract or identification number9826181
Number of Individuals Covered298
Insurance policy start date2012-09-01
Insurance policy end date2013-08-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $53,487
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
WELLCHOICE HMO OF NEW JERSEY (National Association of Insurance Commissioners NAIC id number: 95433 )
Policy contract number598914D2
Policy instance 60
Insurance contract or identification number598914D2
Number of Individuals Covered22
Insurance policy start date2012-09-01
Insurance policy end date2013-08-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $953
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 numberFO18626
Policy instance 62
Insurance contract or identification numberFO18626
Number of Individuals Covered124
Insurance policy start date2012-11-01
Insurance policy end date2013-10-31
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $12,276
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 numberF1D1608-0001
Policy instance 61
Insurance contract or identification numberF1D1608-0001
Number of Individuals Covered249
Insurance policy start date2012-04-01
Insurance policy end date2013-03-31
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $9,787
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 numberFO18610
Policy instance 63
Insurance contract or identification numberFO18610
Number of Individuals Covered66
Insurance policy start date2012-09-01
Insurance policy end date2013-08-31
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,551
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract number217906-001
Policy instance 64
Insurance contract or identification number217906-001
Number of Individuals Covered51
Insurance policy start date2012-04-01
Insurance policy end date2013-03-31
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,407
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract numberMULTI-CONTRACTS
Policy instance 65
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1285
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $8,252
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedEAP
Welfare Benefit Premiums Paid to CarrierUSD $144,292
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,056
Insurance broker namePROFESSIONAL PENSIONS INC
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number217552
Policy instance 66
Insurance contract or identification number217552
Number of Individuals Covered44
Insurance policy start date2012-03-01
Insurance policy end date2013-02-28
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,122
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract number028-3316-00
Policy instance 67
Insurance contract or identification number028-3316-00
Number of Individuals Covered43
Insurance policy start date2012-10-01
Insurance policy end date2013-09-30
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,812
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 )
Policy contract numberMULTI-CONTRACTS
Policy instance 68
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered58
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $4
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $712,382
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4
Insurance broker namePROFESSIONAL PENSIONS INC
EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 )
Policy contract numberMULTI-CONTRACTS
Policy instance 69
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered341
Insurance policy start date2012-06-01
Insurance policy end date2013-05-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $732,284
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 )
Policy contract number8188B1GF97
Policy instance 70
Insurance contract or identification number8188B1GF97
Number of Individuals Covered42
Insurance policy start date2012-10-01
Insurance policy end date2013-09-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $337,794
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 )
Policy contract number468F1GL38
Policy instance 71
Insurance contract or identification number468F1GL38
Number of Individuals Covered80
Insurance policy start date2012-09-01
Insurance policy end date2013-08-31
Total amount of commissions paid to insurance brokerUSD $45,718
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,241,370
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $45,718
Insurance broker nameGALLAGHER BENEFIT SERVICES
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 72
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered446
Insurance policy start date2012-04-01
Insurance policy end date2013-03-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $157,921
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 73
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1691
Insurance policy start date2012-08-01
Insurance policy end date2013-07-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $210,114
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 74
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered442
Insurance policy start date2012-02-01
Insurance policy end date2013-01-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $71,364
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 75
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered3396
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,113,416
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 76
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2136
Insurance policy start date2012-07-01
Insurance policy end date2013-06-30
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $619,969
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 77
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered293
Insurance policy start date2012-06-01
Insurance policy end date2013-05-31
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $35,117
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 78
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered197
Insurance policy start date2012-12-01
Insurance policy end date2013-11-30
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $71,418
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 79
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered6899
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $104
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $381,676
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $104
Insurance broker namePROFESSIONAL PENSIONS INC
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 80
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1220
Insurance policy start date2012-03-01
Insurance policy end date2013-02-28
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $226,457
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 81
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2404
Insurance policy start date2012-05-01
Insurance policy end date2013-04-30
Total amount of commissions paid to insurance brokerUSD $142
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $612,107
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $142
Insurance broker namePROFESSIONAL PENSIONS INC
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 82
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered740
Insurance policy start date2012-11-01
Insurance policy end date2013-10-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $289,459
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 83
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered966
Insurance policy start date2012-10-01
Insurance policy end date2013-09-30
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $81,774
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 84
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered4266
Insurance policy start date2012-09-01
Insurance policy end date2013-08-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $961,607
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 )
Policy contract numberMULTI-CONTRACTS
Policy instance 85
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered69
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $522,190
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberSR-83114532
Policy instance 86
Insurance contract or identification numberSR-83114532
Number of Individuals Covered354
Insurance policy start date2012-12-01
Insurance policy end date2013-11-30
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $18,462
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 87
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered313
Insurance policy start date2012-04-01
Insurance policy end date2013-03-31
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $28,484
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 88
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered276
Insurance policy start date2012-08-01
Insurance policy end date2013-07-31
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $17,601
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 )
Policy contract numberMULTI-CONTRACTS
Policy instance 89
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered438
Insurance policy start date2012-07-01
Insurance policy end date2013-06-30
Total amount of commissions paid to insurance brokerUSD $824
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $49,921
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $824
Insurance broker nameDARREN J WALSH
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number01-0159948
Policy instance 90
Insurance contract or identification number01-0159948
Number of Individuals Covered32
Insurance policy start date2012-06-01
Insurance policy end date2013-05-31
Total amount of commissions paid to insurance brokerUSD $134
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,460
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $134
Insurance broker namePROFESSIONAL PENSIONS INC
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number00010155957
Policy instance 91
Insurance contract or identification number00010155957
Number of Individuals Covered154
Insurance policy start date2012-03-01
Insurance policy end date2013-02-28
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,320
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 92
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2300
Insurance policy start date2012-05-01
Insurance policy end date2013-04-30
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $170,823
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 93
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered413
Insurance policy start date2012-11-01
Insurance policy end date2013-10-31
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $60,974
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number01-0083742
Policy instance 94
Insurance contract or identification number01-0083742
Number of Individuals Covered292
Insurance policy start date2012-10-01
Insurance policy end date2013-09-30
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,564
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 95
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2666
Insurance policy start date2012-09-01
Insurance policy end date2013-08-31
Total amount of commissions paid to insurance brokerUSD $111
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $215,814
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $111
Insurance broker namePROFESSIONAL PENSIONS INC
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5725412
Policy instance 96
Insurance contract or identification number5725412
Number of Individuals Covered1
Insurance policy start date2012-04-01
Insurance policy end date2013-03-31
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $356
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5333776
Policy instance 97
Insurance contract or identification number5333776
Number of Individuals Covered3953
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $2,744
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,921,179
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,744
Insurance broker nameEMERSON REID & COMPANY, INC. (LEADE
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberMULTI-CONTRACTS
Policy instance 98
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered215
Insurance policy start date2012-07-01
Insurance policy end date2013-06-30
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $183,683
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberMULTI-CONTRACTS
Policy instance 99
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered379
Insurance policy start date2012-09-01
Insurance policy end date2013-08-31
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $271,363
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 100
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered661
Insurance policy start date2012-08-01
Insurance policy end date2013-07-31
Total amount of commissions paid to insurance brokerUSD $23,577
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $105,413
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,225
Insurance broker nameHUB INTERNATIONAL NE (WOODBURY)
MUTUAL OF OMAHA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 101
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered721
Insurance policy start date2012-12-01
Insurance policy end date2013-11-30
Total amount of commissions paid to insurance brokerUSD $14,608
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $66,679
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,835
Insurance broker nameBRYAN ERDHEIM
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberMULTI-CONTRACTS
Policy instance 102
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1567
Insurance policy start date2012-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $4,568
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $93,278
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,568
Insurance broker namePROFESSIONAL PENSIONS INC
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 103
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered3135
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $66,799
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $305,827
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $30,511
Insurance broker nameBT BENEFITS & CONSULTING LLC
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 104
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered302
Insurance policy start date2012-07-01
Insurance policy end date2013-06-30
Total amount of commissions paid to insurance brokerUSD $4,512
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $21,809
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,266
Insurance broker nameWILLIS OF NEW JERSEY
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 105
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered349
Insurance policy start date2012-06-01
Insurance policy end date2013-05-31
Total amount of commissions paid to insurance brokerUSD $9,365
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $38,580
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,756
Insurance broker nameWILLIS OF NEW JERSEY
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberMUTLI-CONTRACTS
Policy instance 106
Insurance contract or identification numberMUTLI-CONTRACTS
Number of Individuals Covered370
Insurance policy start date2012-03-01
Insurance policy end date2013-02-28
Total amount of commissions paid to insurance brokerUSD $7,370
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $34,246
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,530
Insurance broker nameSINGER NELSON CHARLMERS, INC.
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberMULTI-CONTRACT
Policy instance 107
Insurance contract or identification numberMULTI-CONTRACT
Number of Individuals Covered264
Insurance policy start date2012-05-01
Insurance policy end date2013-04-30
Total amount of commissions paid to insurance brokerUSD $822
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,503
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $450
Insurance broker namePROFESSIONAL PENSIONS INC
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberGOOOAE9U
Policy instance 108
Insurance contract or identification numberGOOOAE9U
Number of Individuals Covered70
Insurance policy start date2012-11-01
Insurance policy end date2013-10-31
Total amount of commissions paid to insurance brokerUSD $2,733
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,966
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,769
Insurance broker nameTHE HEALTH CONSULTANTS GROUP LLC
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberMULTI-CONTRACTS
Policy instance 109
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered160
Insurance policy start date2012-10-01
Insurance policy end date2013-09-30
Total amount of commissions paid to insurance brokerUSD $1,878
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,409
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,093
Insurance broker nameRUDOLF ASSOCIATES, INC
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberMULTI-CONTRACTS
Policy instance 110
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2259
Insurance policy start date2012-09-01
Insurance policy end date2013-08-31
Total amount of commissions paid to insurance brokerUSD $27,326
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $154,301
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,426
Insurance broker nameGALLAGHER BENEFIT SERVICES(ITASCA,I
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 111
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered37
Insurance policy start date2012-12-01
Insurance policy end date2013-11-30
Total amount of commissions paid to insurance brokerUSD $1,968
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $325,069
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,968
Insurance broker namePROFESSIONAL PENSIONS INC
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberRP15275
Policy instance 112
Insurance contract or identification numberRP15275
Number of Individuals Covered13
Insurance policy start date2012-02-01
Insurance policy end date2013-01-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $238,513
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 113
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered186
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $4,462
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,018,957
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,462
Insurance broker namePROFESSIONAL PENSIONS INC
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 114
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered114
Insurance policy start date2012-07-01
Insurance policy end date2013-06-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $925,404
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 115
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered399
Insurance policy start date2012-03-01
Insurance policy end date2013-02-28
Total amount of commissions paid to insurance brokerUSD $19,583
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,045,938
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $19,583
Insurance broker namePROFESSIONAL PENSIONS INC
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 116
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered146
Insurance policy start date2012-05-01
Insurance policy end date2013-04-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,669,535
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberLR8085
Policy instance 117
Insurance contract or identification numberLR8085
Number of Individuals Covered102
Insurance policy start date2012-11-01
Insurance policy end date2013-10-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,263,852
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberWT6094
Policy instance 118
Insurance contract or identification numberWT6094
Number of Individuals Covered42
Insurance policy start date2012-10-01
Insurance policy end date2013-09-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $485,732
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMS33129
Policy instance 119
Insurance contract or identification numberMS33129
Number of Individuals Covered38
Insurance policy start date2012-09-01
Insurance policy end date2013-08-31
Total amount of commissions paid to insurance brokerUSD $5,474
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $382,699
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,474
Insurance broker namePROFESSIONAL PENSIONS INC
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberH64709-1
Policy instance 120
Insurance contract or identification numberH64709-1
Number of Individuals Covered4
Insurance policy start date2012-08-01
Insurance policy end date2013-07-31
Total amount of commissions paid to insurance brokerUSD $67
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,390
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $67
Insurance broker namePROFESSIONAL PENSIONS INC
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberMULTI-CONTRACTS
Policy instance 121
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered66
Insurance policy start date2012-12-01
Insurance policy end date2013-11-30
Total amount of commissions paid to insurance brokerUSD $94
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $35,281
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $94
Insurance broker namePROFESSIONAL PENSIONS INC
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberMULTI-CONTRACTS
Policy instance 122
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered353
Insurance policy start date2012-02-01
Insurance policy end date2013-01-31
Total amount of commissions paid to insurance brokerUSD $11,808
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $100,936
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,083
Insurance broker namePROFESSIONAL PENSIONS INC
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberMULTI-CONTRACTS
Policy instance 123
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered183
Insurance policy start date2012-07-01
Insurance policy end date2013-06-30
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $14,027
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberH65245-1
Policy instance 124
Insurance contract or identification numberH65245-1
Number of Individuals Covered19
Insurance policy start date2012-06-01
Insurance policy end date2013-05-31
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,706
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberH7204-1
Policy instance 125
Insurance contract or identification numberH7204-1
Number of Individuals Covered71
Insurance policy start date2012-03-01
Insurance policy end date2013-02-28
Total amount of commissions paid to insurance brokerUSD $2,533
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $16,099
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,267
Insurance broker nameH.D. SEGUR
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number810744
Policy instance 126
Insurance contract or identification number810744
Number of Individuals Covered343
Insurance policy start date2012-11-01
Insurance policy end date2013-10-31
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $28,233
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberMULTI-CONTRACTS
Policy instance 127
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered422
Insurance policy start date2012-11-01
Insurance policy end date2013-10-31
Total amount of commissions paid to insurance brokerUSD $1,549
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $94,942
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $795
Insurance broker nameCAPACITY BENEFITS & FINANCIAL SERVI
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberMULTI-CONTRACTS
Policy instance 128
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered32
Insurance policy start date2012-10-01
Insurance policy end date2013-09-30
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,816
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberH69494-1
Policy instance 129
Insurance contract or identification numberH69494-1
Number of Individuals Covered54
Insurance policy start date2012-09-01
Insurance policy end date2013-08-31
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,883
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract numberMULTI-CONTRACTS
Policy instance 130
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered4128
Insurance policy start date2012-08-01
Insurance policy end date2013-07-31
Total amount of commissions paid to insurance brokerUSD $41,762
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedEAP
Welfare Benefit Premiums Paid to CarrierUSD $258,961
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,035
Insurance broker nameEMERSON REID & COMPANY, INC. (LEADE
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract numberMULTI-CONTRACTS
Policy instance 131
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered739
Insurance policy start date2012-10-01
Insurance policy end date2013-09-30
Total amount of commissions paid to insurance brokerUSD $1,222
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $30,561
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $813
Insurance broker namePROFESSIONAL PENSIONS INC
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number89933
Policy instance 132
Insurance contract or identification number89933
Number of Individuals Covered45
Insurance policy start date2012-12-01
Insurance policy end date2013-11-30
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,591
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract numberMULTI-CONTRACTS
Policy instance 133
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1086
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $3,869
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedEAP
Welfare Benefit Premiums Paid to CarrierUSD $61,128
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,288
Insurance broker nameTHAMES BENEFIT CONSULTING, INC.
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract numberMULTI-CONTRACTS
Policy instance 134
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered219
Insurance policy start date2012-07-01
Insurance policy end date2013-06-30
Total amount of commissions paid to insurance brokerUSD $11
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $9,740
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11
Insurance broker namePROFESSIONAL PENSIONS INC
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract numberMULTI-CONTRACTS
Policy instance 135
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered425
Insurance policy start date2012-06-01
Insurance policy end date2013-05-31
Total amount of commissions paid to insurance brokerUSD $201
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,513
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $191
Insurance broker nameEMERSON REID & COMPANY, INC. (LEADE
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract numberMULTI-CONTRACTS
Policy instance 136
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered547
Insurance policy start date2012-05-01
Insurance policy end date2013-04-30
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $95,323
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract numberMULTI-CONTRACTS
Policy instance 137
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered316
Insurance policy start date2012-11-01
Insurance policy end date2013-10-31
Total amount of commissions paid to insurance brokerUSD $1,317
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $19,201
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $837
Insurance broker nameDARREN J WALSH
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract numberMULTI-CONTRACTS
Policy instance 138
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered123
Insurance policy start date2012-10-01
Insurance policy end date2013-09-30
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $11,167
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number89946
Policy instance 139
Insurance contract or identification number89946
Number of Individuals Covered196
Insurance policy start date2012-09-01
Insurance policy end date2013-08-31
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $16,396
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE STANDARD LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 89009 )
Policy contract numberMULTI-CONTRACTS
Policy instance 140
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered272
Insurance policy start date2012-04-01
Insurance policy end date2013-03-31
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $48,312
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number153691
Policy instance 141
Insurance contract or identification number153691
Number of Individuals Covered1082
Insurance policy start date2012-08-01
Insurance policy end date2013-07-31
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $217,473
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE STANDARD LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 89009 )
Policy contract number648306
Policy instance 142
Insurance contract or identification number648306
Number of Individuals Covered76
Insurance policy start date2012-12-01
Insurance policy end date2013-11-30
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $11,552
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE STANDARD LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 89009 )
Policy contract numberMULTI-CONTRACTS
Policy instance 143
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered230
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,729
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE STANDARD LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 89009 )
Policy contract number442045
Policy instance 144
Insurance contract or identification number442045
Number of Individuals Covered246
Insurance policy start date2012-03-01
Insurance policy end date2013-02-28
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $24,419
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
STANDARD INS CO 117 151361 (National Association of Insurance Commissioners NAIC id number: 89009 )
Policy contract number430690
Policy instance 145
Insurance contract or identification number430690
Number of Individuals Covered801
Insurance policy start date2012-09-01
Insurance policy end date2013-08-31
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $583,371
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number222323
Policy instance 146
Insurance contract or identification number222323
Number of Individuals Covered140
Insurance policy start date2012-04-01
Insurance policy end date2013-03-31
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $47,998
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract numberMULTI-CONTRACTS
Policy instance 147
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered771
Insurance policy start date2012-08-01
Insurance policy end date2013-07-31
Total amount of commissions paid to insurance brokerUSD $13,767
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $141,987
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,987
Insurance broker nameRUDOLF ASSOCIATES INC
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number221096
Policy instance 148
Insurance contract or identification number221096
Number of Individuals Covered24
Insurance policy start date2012-12-01
Insurance policy end date2013-11-30
Total amount of commissions paid to insurance brokerUSD $506
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,046
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $336
Insurance broker namePROFESSIONAL PENSIONS INC
SUN LIFE INSURANCE AND ANNUITY COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract numberMULTI-CONTRACTS
Policy instance 149
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2163
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $36,753
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $253,173
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,602
Insurance broker namePILOT BENEFITS GROUP LLC
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract numberMULTI-CONTRACTS
Policy instance 150
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered295
Insurance policy start date2012-07-01
Insurance policy end date2013-06-30
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $34,033
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract numberMULTI-CONTRACTS
Policy instance 151
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered390
Insurance policy start date2012-06-01
Insurance policy end date2013-05-31
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $50,335
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract numberMULTI-CONTRACTS
Policy instance 152
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered291
Insurance policy start date2012-03-01
Insurance policy end date2013-02-28
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,227
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract numberMULTI-CONTRACTS
Policy instance 153
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered93
Insurance policy start date2012-05-01
Insurance policy end date2013-04-30
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $8,898
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 52411 )
Policy contract numberMULTI-CONTRACTS
Policy instance 154
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered504
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $143,005
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,082,750
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $68,671
Insurance broker namePROFESSIONAL PENSIONS INC
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number00210422
Policy instance 155
Insurance contract or identification number00210422
Number of Individuals Covered120
Insurance policy start date2012-07-01
Insurance policy end date2013-06-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $943,228
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number03H4501
Policy instance 156
Insurance contract or identification number03H4501
Number of Individuals Covered34
Insurance policy start date2012-06-01
Insurance policy end date2013-05-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,682
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number0742939
Policy instance 157
Insurance contract or identification number0742939
Number of Individuals Covered320
Insurance policy start date2012-03-01
Insurance policy end date2013-02-28
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $58,242
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 158
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered285
Insurance policy start date2012-05-01
Insurance policy end date2013-04-30
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,271,545
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 52411 )
Policy contract numberMULTI-CONTRACTS
Policy instance 159
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered33
Insurance policy start date2012-10-01
Insurance policy end date2013-09-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $361,651
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 160
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1416
Insurance policy start date2012-09-01
Insurance policy end date2013-08-31
Total amount of commissions paid to insurance brokerUSD $185,838
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,440,365
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $162,789
Insurance broker namePROFESSIONAL PENSIONS INC
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 161
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1349
Insurance policy start date2012-04-01
Insurance policy end date2013-03-31
Total amount of commissions paid to insurance brokerUSD $16,422
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $60,954
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,569
Insurance broker nameTM BURROWS ASSOC, LLC(WATERFORD,CT)
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 162
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered281
Insurance policy start date2012-08-01
Insurance policy end date2013-07-31
Total amount of commissions paid to insurance brokerUSD $9,673
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $34,299
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,483
Insurance broker nameHUB INTERNATIONAL NE (WOODBURY)
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 163
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered208
Insurance policy start date2012-12-01
Insurance policy end date2013-11-30
Total amount of commissions paid to insurance brokerUSD $4,896
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $13,387
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,308
Insurance broker nameRAYMOND CONGELOSI
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 164
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered479
Insurance policy start date2012-02-01
Insurance policy end date2013-01-31
Total amount of commissions paid to insurance brokerUSD $16,697
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $63,078
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,189
Insurance broker nameSTRATFORD FINANCIAL GROUP, INC.
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 165
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered7667
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $135,149
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $618,908
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $64,568
Insurance broker nameWENTWORTH, DEANGELIS & KAUFMAN(FARM
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 166
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered473
Insurance policy start date2012-07-01
Insurance policy end date2013-06-30
Total amount of commissions paid to insurance brokerUSD $7,363
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $25,765
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,966
Insurance broker nameSECURITY FIRST INSURANCE GROUP(WATE
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 167
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered207
Insurance policy start date2012-06-01
Insurance policy end date2013-05-31
Total amount of commissions paid to insurance brokerUSD $3,714
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $19,395
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,028
Insurance broker nameTM BURROWS ASSOC, LLC(WATERFORD,CT)
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 168
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered300
Insurance policy start date2012-03-01
Insurance policy end date2013-02-28
Total amount of commissions paid to insurance brokerUSD $11,906
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $46,395
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,082
Insurance broker nameBROWN & KNAPP GROUP BENEFITS, LLC
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 169
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1290
Insurance policy start date2012-05-01
Insurance policy end date2013-04-30
Total amount of commissions paid to insurance brokerUSD $28,025
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $112,565
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,624
Insurance broker nameWILLIAM P. MCCARTHY
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 170
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1245
Insurance policy start date2012-11-01
Insurance policy end date2013-10-31
Total amount of commissions paid to insurance brokerUSD $9,137
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $41,463
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,448
Insurance broker nameLINDQUIST INSURANCE ASSOCIATES, INC
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 171
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered881
Insurance policy start date2012-10-01
Insurance policy end date2013-09-30
Total amount of commissions paid to insurance brokerUSD $11,212
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $74,619
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,979
Insurance broker nameWILLIS OF CT
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 172
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1412
Insurance policy start date2012-09-01
Insurance policy end date2013-08-30
Total amount of commissions paid to insurance brokerUSD $37,304
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $179,581
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17,943
Insurance broker nameTHE HEALTH CONSULTANTS GROUP LLC
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract numberMULTI-CONTRACTS
Policy instance 173
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered672
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $88,667
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract number30000109
Policy instance 174
Insurance contract or identification number30000109
Number of Individuals Covered144
Insurance policy start date2012-07-01
Insurance policy end date2013-06-30
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $20,381
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract number30033212
Policy instance 175
Insurance contract or identification number30033212
Number of Individuals Covered90
Insurance policy start date2012-06-01
Insurance policy end date2013-05-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $9,144
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract number30012913
Policy instance 176
Insurance contract or identification number30012913
Number of Individuals Covered27
Insurance policy start date2012-03-01
Insurance policy end date2013-02-28
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,288
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract number30035853
Policy instance 177
Insurance contract or identification number30035853
Number of Individuals Covered136
Insurance policy start date2012-10-01
Insurance policy end date2013-09-30
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $12,738
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 1
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered295
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
Total amount of commissions paid to insurance brokerUSD $35,713
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $901,275
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $26,454
Insurance broker namePROFESSIONAL PENSIONS INC
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 2
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered191
Insurance policy start date2011-08-01
Insurance policy end date2012-07-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,792,335
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number477204
Policy instance 3
Insurance contract or identification number477204
Number of Individuals Covered36
Insurance policy start date2011-02-01
Insurance policy end date2012-01-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $373,813
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract numberMULTI-CONTRACTS
Policy instance 4
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered705
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,938,896
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract numberMULTI-CONTRACTS
Policy instance 5
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered147
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,643,007
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number861323
Policy instance 6
Insurance contract or identification number861323
Number of Individuals Covered228
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $715
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,967
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $715
Insurance broker nameLEFF COMPANY, INC., THE
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract numberMULTI-CONTRACTS
Policy instance 7
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered84
Insurance policy start date2011-06-01
Insurance policy end date2012-05-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $710,663
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number477231
Policy instance 8
Insurance contract or identification number477231
Number of Individuals Covered244
Insurance policy start date2011-03-01
Insurance policy end date2012-02-28
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,864,394
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract numberMULTI-CONTRACTS
Policy instance 9
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered206
Insurance policy start date2011-05-01
Insurance policy end date2012-04-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,720,679
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 10
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered164
Insurance policy start date2011-11-01
Insurance policy end date2012-10-31
Total amount of commissions paid to insurance brokerUSD $21,912
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $854,841
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,862
Insurance broker nameCAPACITY BENEFITS AND FINANCIAL SER
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number477488
Policy instance 11
Insurance contract or identification number477488
Number of Individuals Covered61
Insurance policy start date2011-10-01
Insurance policy end date2012-09-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $749,888
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number472982
Policy instance 12
Insurance contract or identification number472982
Number of Individuals Covered183
Insurance policy start date2011-09-01
Insurance policy end date2012-08-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,139,949
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract numberMULTI-CONTRACTS
Policy instance 13
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered168
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $932,186
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number417480
Policy instance 14
Insurance contract or identification number417480
Number of Individuals Covered41
Insurance policy start date2011-02-01
Insurance policy end date2012-01-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $466,350
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract numberMULTI-CONTRACTS
Policy instance 15
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered280
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,932,378
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract numberMULTI-CONTRACTS
Policy instance 16
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered130
Insurance policy start date2011-06-01
Insurance policy end date2012-05-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,507,766
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract numberMULTI-CONTRACTS
Policy instance 17
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered100
Insurance policy start date2011-03-01
Insurance policy end date2012-02-28
Total amount of commissions paid to insurance brokerUSD $539
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $972,796
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $539
Insurance broker namePROFESSIONAL PENSIONS INC
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract numberMULTI-CONTRACTS
Policy instance 18
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered241
Insurance policy start date2011-05-01
Insurance policy end date2012-04-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,940,361
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number410000
Policy instance 19
Insurance contract or identification number410000
Number of Individuals Covered50
Insurance policy start date2011-09-01
Insurance policy end date2012-08-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,546
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 20
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered23877
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $501,532
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,991,575
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $262,696
Insurance broker nameJEFFREY W STOLER
AETNA INC. 20 696715 (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number696715
Policy instance 21
Insurance contract or identification number696715
Number of Individuals Covered652
Insurance policy start date2011-09-01
Insurance policy end date2012-08-31
Total amount of commissions paid to insurance brokerUSD $23,123
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $449,113
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $23,123
Insurance broker nameEMERSON REID & COMPANY, INC. (LEADE
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 22
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1251
Insurance policy start date2011-08-01
Insurance policy end date2012-07-31
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $174,894
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number617383
Policy instance 23
Insurance contract or identification number617383
Number of Individuals Covered6680
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
Total amount of commissions paid to insurance brokerUSD $66,192
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $514,777
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,098
Insurance broker nameMDG ASSOCIATES OF CT, LLC
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberMULTI-CONTRACTS
Policy instance 24
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered81
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
Total amount of commissions paid to insurance brokerUSD $3,628
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $20,910
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16
Insurance broker namePROFESSIONAL PENSIONS INC
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number10-26634
Policy instance 25
Insurance contract or identification number10-26634
Number of Individuals Covered53
Insurance policy start date2011-08-01
Insurance policy end date2012-07-31
Total amount of commissions paid to insurance brokerUSD $1,245
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $17,136
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,245
Insurance broker namePROFESSIONAL PENSIONS INC
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number26-201528
Policy instance 26
Insurance contract or identification number26-201528
Number of Individuals Covered39
Insurance policy start date2011-12-01
Insurance policy end date2012-11-30
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,425
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberMULTI-CONTRACTS
Policy instance 27
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered370
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $21,466
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $261,751
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,763
Insurance broker namePEOPLES UNITED INSURANCE AGENCY(BRI
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 28
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered285
Insurance policy start date2011-12-01
Insurance policy end date2012-11-30
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $110,609
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number10-36509
Policy instance 29
Insurance contract or identification number10-36509
Number of Individuals Covered43
Insurance policy start date2011-06-01
Insurance policy end date2012-05-31
Total amount of commissions paid to insurance brokerUSD $249
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,451
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $249
Insurance broker namePROFESSIONAL PENSIONS INC
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberMULTI-CONTRACTS
Policy instance 30
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered54
Insurance policy start date2011-03-01
Insurance policy end date2012-02-28
Total amount of commissions paid to insurance brokerUSD $4,930
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $30,792
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,443
Insurance broker nameSTRATFORD FINANCIAL GROUP, INC.
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberMULTI-CONTRACTS
Policy instance 32
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered77
Insurance policy start date2011-09-01
Insurance policy end date2012-08-31
Total amount of commissions paid to insurance brokerUSD $3,873
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $26,092
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,014
Insurance broker namePAYCHEX INSURANCE AGENCY, INC.
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberMULTI-CONTRACTS
Policy instance 31
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered104
Insurance policy start date2011-10-01
Insurance policy end date2012-09-30
Total amount of commissions paid to insurance brokerUSD $1,378
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $21,012
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $995
Insurance broker nameTM BURROWS ASSOC, LLC(WATERFORD,CT)
ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 )
Policy contract number610042
Policy instance 33
Insurance contract or identification number610042
Number of Individuals Covered246
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $80,329
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 )
Policy contract numberMULTI-CONTRACTS
Policy instance 34
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered136
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,023,685
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 )
Policy contract numberMULTI-CONTRACTS
Policy instance 35
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered571
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $1,439
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $33,620
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $475
Insurance broker nameMARK D DZIALO
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 36
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered139
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $82,989
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 37
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered555
Insurance policy start date2011-02-01
Insurance policy end date2012-01-31
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $35,808
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 38
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered3326
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $4,842
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $10,355,419
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,717
Insurance broker namePROFESSIONAL PENSIONS INC
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract number3333536
Policy instance 39
Insurance contract or identification number3333536
Number of Individuals Covered233
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,643,389
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 40
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered279
Insurance policy start date2011-06-01
Insurance policy end date2012-05-31
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $422,733
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 41
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered511
Insurance policy start date2011-03-01
Insurance policy end date2012-02-28
Total amount of commissions paid to insurance brokerUSD $224
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $485,512
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $224
Insurance broker namePROFESSIONAL PENSIONS INC
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 42
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered923
Insurance policy start date2011-05-01
Insurance policy end date2012-04-30
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,170,149
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 44
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered389
Insurance policy start date2011-10-01
Insurance policy end date2012-09-30
Total amount of commissions paid to insurance brokerUSD $6
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $86,365
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6
Insurance broker namePROFESSIONAL PENSIONS INC
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 43
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered156
Insurance policy start date2011-11-01
Insurance policy end date2012-10-31
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $81,553
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 45
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered279
Insurance policy start date2011-09-01
Insurance policy end date2012-08-31
Total amount of commissions paid to insurance brokerUSD $656
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $740,854
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $656
Insurance broker namePROFESSIONAL PENSIONS INC
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
Policy contract number0576
Policy instance 46
Insurance contract or identification number0576
Number of Individuals Covered71
Insurance policy start date2011-08-01
Insurance policy end date2012-07-31
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $44,210
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
Policy contract numberMULTI-CONTRACTS
Policy instance 47
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered95
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $723
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
Policy contract numberMULTI-CONTRACTS
Policy instance 48
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered134
Insurance policy start date2011-03-01
Insurance policy end date2012-02-28
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $124,997
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract number9835083
Policy instance 49
Insurance contract or identification number9835083
Number of Individuals Covered93
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $13,823
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract number9721507
Policy instance 50
Insurance contract or identification number9721507
Number of Individuals Covered18
Insurance policy start date2011-06-01
Insurance policy end date2012-05-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,461
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract number9813544
Policy instance 51
Insurance contract or identification number9813544
Number of Individuals Covered69
Insurance policy start date2011-03-01
Insurance policy end date2012-02-28
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,571
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract number9827106
Policy instance 52
Insurance contract or identification number9827106
Number of Individuals Covered97
Insurance policy start date2011-10-01
Insurance policy end date2012-09-30
Total amount of commissions paid to insurance brokerUSD $192
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $10,834
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $192
Insurance broker namePROFESSIONAL PENSIONS INC
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract number9826181
Policy instance 53
Insurance contract or identification number9826181
Number of Individuals Covered252
Insurance policy start date2011-09-01
Insurance policy end date2012-08-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $48,688
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
WELLCHOICE HMO OF NEW JERSEY (National Association of Insurance Commissioners NAIC id number: 95433 )
Policy contract number598914D2
Policy instance 54
Insurance contract or identification number598914D2
Number of Individuals Covered56
Insurance policy start date2011-09-01
Insurance policy end date2012-08-31
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $171,885
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 numberF1D1608-0001
Policy instance 55
Insurance contract or identification numberF1D1608-0001
Number of Individuals Covered35
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,289
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 )
Policy contract number468F1G281
Policy instance 56
Insurance contract or identification number468F1G281
Number of Individuals Covered53
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $616,250
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 )
Policy contract numberMULTI-CONTRACTS
Policy instance 57
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered210
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,610,797
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 )
Policy contract numberMULTI-CONTRACTS
Policy instance 58
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered351
Insurance policy start date2011-06-01
Insurance policy end date2012-05-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,811,346
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 )
Policy contract numberMULTI-CONTRACTS
Policy instance 59
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered46
Insurance policy start date2011-10-01
Insurance policy end date2012-09-30
Total amount of commissions paid to insurance brokerUSD $13,013
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $325,323
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,013
Insurance broker nameCORPORATE CONSULTING SERVICES, LTD
EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 )
Policy contract number468F1GL38
Policy instance 60
Insurance contract or identification number468F1GL38
Number of Individuals Covered84
Insurance policy start date2011-09-01
Insurance policy end date2012-08-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $251,430
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 62
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered202
Insurance policy start date2011-02-01
Insurance policy end date2012-01-31
Total amount of commissions paid to insurance brokerUSD $46
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $77,758
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $46
Insurance broker namePROFESSIONAL PENSIONS INC
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 61
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered423
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $147,597
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 63
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered3158
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $329
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $870,684
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $329
Insurance broker namePROFESSIONAL PENSIONS INC
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 64
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1898
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $469,244
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 65
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered632
Insurance policy start date2011-06-01
Insurance policy end date2012-05-31
Total amount of commissions paid to insurance brokerUSD $2,857
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $154,337
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,023
Insurance broker namePROFESSIONAL PENSIONS INC
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 66
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered750
Insurance policy start date2011-03-01
Insurance policy end date2012-02-28
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $193,930
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 67
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered405
Insurance policy start date2011-05-01
Insurance policy end date2012-04-30
Total amount of commissions paid to insurance brokerUSD $125
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $235,481
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $125
Insurance broker namePROFESSIONAL PENSIONS INC
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 68
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered601
Insurance policy start date2011-11-01
Insurance policy end date2012-10-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $265,140
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 69
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered938
Insurance policy start date2011-10-01
Insurance policy end date2012-09-30
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $139,240
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 70
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered3484
Insurance policy start date2011-09-01
Insurance policy end date2012-08-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $687,870
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 )
Policy contract numberMULTI-CONTRACTS
Policy instance 71
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered72
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $616,461
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberSR-83114532
Policy instance 72
Insurance contract or identification numberSR-83114532
Number of Individuals Covered351
Insurance policy start date2011-12-01
Insurance policy end date2012-11-30
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $16,091
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 73
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1159
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $25,185
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 74
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered6472
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $100
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $360,360
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $100
Insurance broker namePROFESSIONAL PENSIONS INC
LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 )
Policy contract numberMULTI-CONTRACTS
Policy instance 75
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered185
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $34,564
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 76
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1217
Insurance policy start date2011-05-01
Insurance policy end date2012-04-30
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $66,080
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 77
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered443
Insurance policy start date2011-11-01
Insurance policy end date2012-10-31
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $65,335
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number01-0083742
Policy instance 78
Insurance contract or identification number01-0083742
Number of Individuals Covered312
Insurance policy start date2011-10-01
Insurance policy end date2012-09-30
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,461
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 79
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1953
Insurance policy start date2011-09-01
Insurance policy end date2012-08-31
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $204,400
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 80
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered255
Insurance policy start date2011-12-01
Insurance policy end date2012-11-30
Total amount of commissions paid to insurance brokerUSD $4,755
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $28,525
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,864
Insurance broker nameRAYMOND CONGELOSI
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5725412
Policy instance 81
Insurance contract or identification number5725412
Number of Individuals Covered334
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
Total amount of commissions paid to insurance brokerUSD $14,712
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $199,553
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,126
Insurance broker namePIERSON & SMITH INC
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberMULTI-CONTRACTS
Policy instance 83
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered238
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $204,985
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberMULT-CONTRACTS
Policy instance 84
Insurance contract or identification numberMULT-CONTRACTS
Number of Individuals Covered343
Insurance policy start date2011-09-01
Insurance policy end date2012-08-31
Total amount of commissions paid to insurance brokerUSD $741
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $229,817
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $278
Insurance broker namePROFESSIONAL PENSIONS INC
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 85
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered117
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
Total amount of commissions paid to insurance brokerUSD $1,009
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,867
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $606
Insurance broker nameBWD AGENCY INC.
MUTUAL OF OMAHA 85 GOOOAGPG (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 86
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered611
Insurance policy start date2011-08-01
Insurance policy end date2012-07-31
Total amount of commissions paid to insurance brokerUSD $19,709
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $92,722
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,861
Insurance broker nameTHE ROSS BENEFITS GROUP, LTD
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 87
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1410
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $28,707
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $172,571
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,878
Insurance broker nameMARTIN BERNARD
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberGOOOAJ9K
Policy instance 88
Insurance contract or identification numberGOOOAJ9K
Number of Individuals Covered214
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
Total amount of commissions paid to insurance brokerUSD $4,037
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $19,157
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,228
Insurance broker namePROFESSIONAL PENSIONS INC
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 89
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered580
Insurance policy start date2011-06-01
Insurance policy end date2012-05-31
Total amount of commissions paid to insurance brokerUSD $6,230
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $83,046
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,547
Insurance broker nameWILLIS OF NEW JERSEY
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberMULTI-CONTRACTS
Policy instance 90
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered208
Insurance policy start date2011-03-01
Insurance policy end date2012-02-28
Total amount of commissions paid to insurance brokerUSD $6,259
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $37,221
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,066
Insurance broker nameCORPORATE SYNERGIES GROUP, LLC
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberMULTI-CONTRACTS
Policy instance 92
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered301
Insurance policy start date2011-10-01
Insurance policy end date2012-09-30
Total amount of commissions paid to insurance brokerUSD $6,192
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $19,248
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,729
Insurance broker nameNEMCO BROKERAGE INC (KOLINSKY HILL)
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 91
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered543
Insurance policy start date2011-11-01
Insurance policy end date2012-10-31
Total amount of commissions paid to insurance brokerUSD $8,191
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $42,278
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,681
Insurance broker nameTHE HEALTH CONSULTANTS GROUP LLC
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberEC1773
Policy instance 94
Insurance contract or identification numberEC1773
Number of Individuals Covered47
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $349,641
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberMULTI-CONTRACTS
Policy instance 93
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1592
Insurance policy start date2011-09-01
Insurance policy end date2012-08-31
Total amount of commissions paid to insurance brokerUSD $21,399
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $90,681
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,303
Insurance broker nameGALLAGHER BENEFIT SERVICES(ITASCA,I
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberRR15841
Policy instance 95
Insurance contract or identification numberRR15841
Number of Individuals Covered23
Insurance policy start date2011-12-01
Insurance policy end date2012-11-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $293,957
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberRP15275
Policy instance 96
Insurance contract or identification numberRP15275
Number of Individuals Covered14
Insurance policy start date2011-02-01
Insurance policy end date2012-01-31
Total amount of commissions paid to insurance brokerUSD $2,204
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $260,644
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,204
Insurance broker namePROFESSIONAL PENSIONS INC
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 97
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered291
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $1,672
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,898,038
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,672
Insurance broker namePROFESSIONAL PENSIONS INC
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberOT4288
Policy instance 98
Insurance contract or identification numberOT4288
Number of Individuals Covered78
Insurance policy start date2011-06-01
Insurance policy end date2012-05-31
Total amount of commissions paid to insurance brokerUSD $6,630
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,325,989
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,630
Insurance broker nameCONSUASOR, INC.
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberEG1123
Policy instance 99
Insurance contract or identification numberEG1123
Number of Individuals Covered98
Insurance policy start date2011-05-01
Insurance policy end date2012-04-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $921,674
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 100
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered62
Insurance policy start date2011-03-01
Insurance policy end date2012-02-28
Total amount of commissions paid to insurance brokerUSD $2,575
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $346,352
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,575
Insurance broker namePROFESSIONAL PENSIONS INC
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberLR8085
Policy instance 101
Insurance contract or identification numberLR8085
Number of Individuals Covered96
Insurance policy start date2011-11-01
Insurance policy end date2012-10-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,294,837
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 102
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered148
Insurance policy start date2011-10-01
Insurance policy end date2012-09-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $586,546
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 103
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered94
Insurance policy start date2011-09-30
Insurance policy end date2012-08-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,016,241
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberH63030-1
Policy instance 104
Insurance contract or identification numberH63030-1
Number of Individuals Covered24
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $32,768
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberMULTI-CONTRACTS
Policy instance 105
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered69
Insurance policy start date2011-08-01
Insurance policy end date2012-07-31
Total amount of commissions paid to insurance brokerUSD $534
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $18,183
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $534
Insurance broker namePROFESSIONAL PENSIONS INC
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberMULT-CONTRACTS
Policy instance 106
Insurance contract or identification numberMULT-CONTRACTS
Number of Individuals Covered107
Insurance policy start date2011-12-01
Insurance policy end date2012-11-30
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $35,340
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberMULTI-CONTRACTS
Policy instance 107
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered187
Insurance policy start date2011-02-01
Insurance policy end date2012-01-31
Total amount of commissions paid to insurance brokerUSD $15,092
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $126,685
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,609
Insurance broker namePROFESSIONAL PENSIONS INC
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberMULTI-CONTRACTS
Policy instance 108
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1901
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $9,271
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $211,823
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,320
Insurance broker nameROGERS BENEFIT GROUP INC
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberH65245-1
Policy instance 110
Insurance contract or identification numberH65245-1
Number of Individuals Covered19
Insurance policy start date2011-06-01
Insurance policy end date2012-05-31
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,060
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberMULTI-CONTRACTS
Policy instance 109
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered225
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $63,099
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberH7204-1
Policy instance 111
Insurance contract or identification numberH7204-1
Number of Individuals Covered68
Insurance policy start date2011-03-01
Insurance policy end date2012-02-28
Total amount of commissions paid to insurance brokerUSD $2,495
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $15,818
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,249
Insurance broker namePROFESSIONAL PENSIONS INC
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberMULTI-CONTRACTS
Policy instance 112
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered187
Insurance policy start date2011-11-01
Insurance policy end date2012-10-31
Total amount of commissions paid to insurance brokerUSD $178
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $132,125
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $178
Insurance broker namePROFESSIONAL PENSIONS INC
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberMULTI-CONTRACTS
Policy instance 113
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered304
Insurance policy start date2011-10-01
Insurance policy end date2012-09-30
Total amount of commissions paid to insurance brokerUSD $3,898
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $41,728
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $178
Insurance broker nameCAPACITY BENEFITS AND FINANCIAL SER
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberH69494-1
Policy instance 114
Insurance contract or identification numberH69494-1
Number of Individuals Covered54
Insurance policy start date2011-09-01
Insurance policy end date2012-08-31
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,705
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number21329
Policy instance 115
Insurance contract or identification number21329
Number of Individuals Covered7352
Insurance policy start date2011-08-01
Insurance policy end date2012-07-31
Total amount of commissions paid to insurance brokerUSD $40,785
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $533,706
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $36,163
Insurance broker nameEMERSON REID & COMPANY, INC. (LEADE
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number21329N
Policy instance 116
Insurance contract or identification number21329N
Number of Individuals Covered314
Insurance policy start date2011-05-01
Insurance policy end date2012-04-30
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $106,934
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
STANDARD INS CO 117 151361 (National Association of Insurance Commissioners NAIC id number: 89009 )
Policy contract number151361
Policy instance 117
Insurance contract or identification number151361
Number of Individuals Covered103
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $10,427
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract numberMULTI-CONTRACTS
Policy instance 118
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered591
Insurance policy start date2011-08-01
Insurance policy end date2012-07-31
Total amount of commissions paid to insurance brokerUSD $28,348
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $164,189
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17,791
Insurance broker namePROFESSIONAL PENSIONS INC
THE STANDARD LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 89009 )
Policy contract number648306
Policy instance 119
Insurance contract or identification number648306
Number of Individuals Covered88
Insurance policy start date2011-12-01
Insurance policy end date2012-11-30
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $11,347
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE STANDARD LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 89009 )
Policy contract number442045
Policy instance 121
Insurance contract or identification number442045
Number of Individuals Covered243
Insurance policy start date2011-03-01
Insurance policy end date2012-02-28
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $23,112
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE STANDARD LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 89009 )
Policy contract numberMULTI-CONTRACTS
Policy instance 120
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered350
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $5,745
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $45,583
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,768
Insurance broker namePROFESSIONAL PENSIONS INC
THE STANDARD LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 89009 )
Policy contract numberMULTI-CONTRACTS
Policy instance 122
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered822
Insurance policy start date2011-09-01
Insurance policy end date2012-08-31
Total amount of commissions paid to insurance brokerUSD $4,071
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $396,138
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,363
Insurance broker namePROFESSIONAL PENSIONS INC
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract numberMULTI-CONTRACTS
Policy instance 123
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered59
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,204
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number221096
Policy instance 124
Insurance contract or identification number221096
Number of Individuals Covered32
Insurance policy start date2011-12-01
Insurance policy end date2012-11-30
Total amount of commissions paid to insurance brokerUSD $420
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,626
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $292
Insurance broker namePROFESSIONAL PENSIONS INC
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract number454-4327-00
Policy instance 125
Insurance contract or identification number454-4327-00
Number of Individuals Covered72
Insurance policy start date2011-02-01
Insurance policy end date2012-01-31
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $298
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE INSURANCE AND ANNUITY COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract numberMULTI-CONTRACTS
Policy instance 126
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered3620
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $31,579
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $535,891
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,845
Insurance broker namePIERSON & SMITH INC
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number218643
Policy instance 127
Insurance contract or identification number218643
Number of Individuals Covered111
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $28,127
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract numberMULTI-CONTRACTS
Policy instance 128
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered878
Insurance policy start date2011-06-01
Insurance policy end date2012-05-31
Total amount of commissions paid to insurance brokerUSD $6,860
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $99,936
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,543
Insurance broker namePROFESSIONAL PENSIONS INC
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract numberMULTI-CONTRACTS
Policy instance 129
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered84
Insurance policy start date2011-03-01
Insurance policy end date2012-02-28
Total amount of commissions paid to insurance brokerUSD $816
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $15,675
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $521
Insurance broker nameRAYMOND CONGELOSI
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number810315
Policy instance 130
Insurance contract or identification number810315
Number of Individuals Covered39
Insurance policy start date2011-05-01
Insurance policy end date2012-04-30
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,094
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number810744
Policy instance 131
Insurance contract or identification number810744
Number of Individuals Covered303
Insurance policy start date2011-11-01
Insurance policy end date2012-10-31
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $24,850
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract number028-3316-00
Policy instance 132
Insurance contract or identification number028-3316-00
Number of Individuals Covered26
Insurance policy start date2011-10-01
Insurance policy end date2012-09-30
Total amount of commissions paid to insurance brokerUSD $198
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,063
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $198
Insurance broker namePROFESSIONAL PENSIONS INC
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number0716380
Policy instance 133
Insurance contract or identification number0716380
Number of Individuals Covered322
Insurance policy start date2011-12-01
Insurance policy end date2012-11-30
Total amount of commissions paid to insurance brokerUSD $30,430
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,591,607
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $30,430
Insurance broker nameGROUP INSURANCE ASSOCIATES
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 134
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered682
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $90,250
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,398,999
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $67,687
Insurance broker namePROFESSIONAL PENSIONS INC
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number00210422
Policy instance 135
Insurance contract or identification number00210422
Number of Individuals Covered218
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
Total amount of commissions paid to insurance brokerUSD $43,217
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $796,237
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $34,577
Insurance broker namePROFESSIONAL PENSIONS INC
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number03H4501
Policy instance 136
Insurance contract or identification number03H4501
Number of Individuals Covered37
Insurance policy start date2011-06-01
Insurance policy end date2012-05-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $47,032
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 137
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered240
Insurance policy start date2011-05-01
Insurance policy end date2012-04-30
Total amount of commissions paid to insurance brokerUSD $234
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,112,836
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $234
Insurance broker namePROFESSIONAL PENSIONS INC
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 139
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1242
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
Total amount of commissions paid to insurance brokerUSD $17,063
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $70,476
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,690
Insurance broker nameMORIN ASSOCIATES, LLC
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 138
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered849
Insurance policy start date2011-09-01
Insurance policy end date2012-08-31
Total amount of commissions paid to insurance brokerUSD $186,336
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,130,264
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $149,775
Insurance broker namePROFESSIONAL PENSIONS INC
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 140
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered282
Insurance policy start date2011-08-01
Insurance policy end date2012-07-31
Total amount of commissions paid to insurance brokerUSD $14,514
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $64,093
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,619
Insurance broker nameHUB INTERNATIONAL NE (WOODBURY)
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 141
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered134
Insurance policy start date2011-12-01
Insurance policy end date2012-11-30
Total amount of commissions paid to insurance brokerUSD $4,560
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $19,707
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,764
Insurance broker nameRAYMOND CONGELOSI
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 142
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered696
Insurance policy start date2011-02-01
Insurance policy end date2012-01-31
Total amount of commissions paid to insurance brokerUSD $19,313
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $63,674
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,878
Insurance broker nameCAPACITY BENEFITS & FINANCIAL SERVI
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 143
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered4000
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $57,659
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $395,776
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $37,774
Insurance broker nameGREENBERG & RAPP FINANCIAL GROUP IN
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 144
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered278
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
Total amount of commissions paid to insurance brokerUSD $3,760
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $11,967
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,433
Insurance broker nameLILIAN DE SOUZA
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 145
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered237
Insurance policy start date2011-06-01
Insurance policy end date2012-05-31
Total amount of commissions paid to insurance brokerUSD $5,103
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $22,450
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,451
Insurance broker nameROSE AND KIERNAN, INC
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 146
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered317
Insurance policy start date2011-03-01
Insurance policy end date2012-02-28
Total amount of commissions paid to insurance brokerUSD $13,223
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $43,283
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,268
Insurance broker nameINSURANCE OFFICE OF AMERICA, INC.
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 147
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1577
Insurance policy start date2011-05-01
Insurance policy end date2012-04-30
Total amount of commissions paid to insurance brokerUSD $40,966
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $147,163
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $20,750
Insurance broker nameWENTWORTH, DEANGELIS & KAUFMAN(FARM
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 148
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1200
Insurance policy start date2011-11-01
Insurance policy end date2012-10-31
Total amount of commissions paid to insurance brokerUSD $7,628
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $43,838
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,912
Insurance broker nameRICHARD R DAMICO, LUTCF
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 149
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered715
Insurance policy start date2011-10-01
Insurance policy end date2012-09-30
Total amount of commissions paid to insurance brokerUSD $8,308
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $38,236
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,913
Insurance broker nameGREENBERG & RAPP FINANCIAL GROUP IN
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 150
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1312
Insurance policy start date2011-09-01
Insurance policy end date2012-08-31
Total amount of commissions paid to insurance brokerUSD $33,422
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $158,340
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $18,845
Insurance broker nameTHE HEALTH CONSULTANTS GROUP LLC
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract number300007027
Policy instance 151
Insurance contract or identification number300007027
Number of Individuals Covered133
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,804
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract numberMULTI-CONTRACTS
Policy instance 152
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered475
Insurance policy start date2012-01-01
Insurance policy end date2012-12-01
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $58,469
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract number30000109
Policy instance 153
Insurance contract or identification number30000109
Number of Individuals Covered167
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $23,752
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI CONTRACTS
Policy instance 1
Insurance contract or identification numberMULTI CONTRACTS
Number of Individuals Covered237
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
Total amount of commissions paid to insurance brokerUSD $35,713
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $901,275
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number472495
Policy instance 2
Insurance contract or identification number472495
Number of Individuals Covered132
Insurance policy start date2010-08-01
Insurance policy end date2011-07-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,114,850
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number477204
Policy instance 3
Insurance contract or identification number477204
Number of Individuals Covered36
Insurance policy start date2011-02-01
Insurance policy end date2012-01-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $373,813
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract numberMULTI-CONTRACTS
Policy instance 4
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered594
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,725,650
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract numberMULTI-CONTRACTS
Policy instance 5
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered249
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,625,506
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract numberMULTI-CONTRACTS
Policy instance 6
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered84
Insurance policy start date2011-06-01
Insurance policy end date2012-05-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $710,663
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number472276
Policy instance 7
Insurance contract or identification number472276
Number of Individuals Covered29
Insurance policy start date2010-11-01
Insurance policy end date2011-10-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $362,589
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number477281
Policy instance 8
Insurance contract or identification number477281
Number of Individuals Covered195
Insurance policy start date2011-05-01
Insurance policy end date2012-04-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,632,249
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number472982
Policy instance 9
Insurance contract or identification number472982
Number of Individuals Covered164
Insurance policy start date2010-09-01
Insurance policy end date2011-08-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $837,820
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract numberMULTI-CONTRACTS
Policy instance 10
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered60
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $591,234
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number387196
Policy instance 11
Insurance contract or identification number387196
Number of Individuals Covered46
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $340,951
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number477231
Policy instance 12
Insurance contract or identification number477231
Number of Individuals Covered244
Insurance policy start date2011-03-01
Insurance policy end date2012-02-29
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,864,394
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number417480
Policy instance 13
Insurance contract or identification number417480
Number of Individuals Covered41
Insurance policy start date2011-02-01
Insurance policy end date2012-01-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $466,350
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract numberMULTI-CONTRACTS
Policy instance 14
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered270
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,736,512
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number293509
Policy instance 15
Insurance contract or identification number293509
Number of Individuals Covered1
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $804
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract numberMULTI-CONTRACTS
Policy instance 16
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered130
Insurance policy start date2011-06-01
Insurance policy end date2012-05-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,507,766
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract numberMULTI-CONTRACTS
Policy instance 17
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered100
Insurance policy start date2011-03-01
Insurance policy end date2012-02-29
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $972,796
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract numberMULTI-CONTRACTS
Policy instance 18
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered216
Insurance policy start date2011-05-01
Insurance policy end date2012-04-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,940,361
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number410000
Policy instance 19
Insurance contract or identification number410000
Number of Individuals Covered108
Insurance policy start date2010-09-01
Insurance policy end date2011-08-31
Total amount of commissions paid to insurance brokerUSD $46,408
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $586,343
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number472757
Policy instance 20
Insurance contract or identification number472757
Number of Individuals Covered449
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
Total amount of commissions paid to insurance brokerUSD $32,230
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $256,237
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract numberMULTI-CONTRACTS
Policy instance 21
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered3736
Insurance policy start date2010-08-01
Insurance policy end date2011-07-31
Total amount of commissions paid to insurance brokerUSD $378,597
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,628,837
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 22
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered7208
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $486,129
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,356,433
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number617383
Policy instance 23
Insurance contract or identification number617383
Number of Individuals Covered5147
Insurance policy start date2011-06-01
Insurance policy end date2012-05-31
Total amount of commissions paid to insurance brokerUSD $66,443
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $511,063
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 24
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1241
Insurance policy start date2010-09-01
Insurance policy end date2011-08-31
Total amount of commissions paid to insurance brokerUSD $53,271
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $567,517
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberMULTI-CONTRACTS
Policy instance 25
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered40
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
Total amount of commissions paid to insurance brokerUSD $3,628
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $20,910
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberMULTI-CONTRACTS
Policy instance 26
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered198
Insurance policy start date2010-10-01
Insurance policy end date2011-09-30
Total amount of commissions paid to insurance brokerUSD $5,279
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $117,113
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberMULTI-CONTRACTS
Policy instance 27
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered591
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $33,810
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $324,500
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberMULTI-CONTRACTS
Policy instance 28
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered54
Insurance policy start date2011-03-01
Insurance policy end date2012-02-29
Total amount of commissions paid to insurance brokerUSD $4,930
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $30,792
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number26201455
Policy instance 29
Insurance contract or identification number26201455
Number of Individuals Covered18
Insurance policy start date2010-09-01
Insurance policy end date2011-08-31
Total amount of commissions paid to insurance brokerUSD $8,217
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $21,054
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberMULTI-CONTRACTS
Policy instance 30
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered28
Insurance policy start date2011-06-01
Insurance policy end date2012-05-31
Total amount of commissions paid to insurance brokerUSD $1,806
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,451
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 )
Policy contract numberMULTI-CONTRACTS
Policy instance 31
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered440
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $2,098
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $33,513
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 32
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered126
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $82,989
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 33
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered859
Insurance policy start date2011-02-01
Insurance policy end date2012-01-31
Total amount of commissions paid to insurance brokerUSD $224
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $47,442
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract number3333621
Policy instance 34
Insurance contract or identification number3333621
Number of Individuals Covered445
Insurance policy start date2010-12-01
Insurance policy end date2011-11-30
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,666,753
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 35
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2157
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $6,669
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,134,896
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract number3333536
Policy instance 36
Insurance contract or identification number3333536
Number of Individuals Covered233
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,643,389
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 37
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered154
Insurance policy start date2011-06-01
Insurance policy end date2012-05-31
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $422,733
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract number3333115
Policy instance 38
Insurance contract or identification number3333115
Number of Individuals Covered211
Insurance policy start date2011-03-01
Insurance policy end date2012-02-29
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $472,839
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA 3333556 (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 39
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered923
Insurance policy start date2011-05-01
Insurance policy end date2012-04-30
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,170,149
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 40
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered162
Insurance policy start date2010-11-01
Insurance policy end date2011-10-31
Total amount of commissions paid to insurance brokerUSD $240
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $39,537
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 41
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered322
Insurance policy start date2010-10-01
Insurance policy end date2011-09-30
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $592,419
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract number3333197
Policy instance 42
Insurance contract or identification number3333197
Number of Individuals Covered61
Insurance policy start date2010-09-01
Insurance policy end date2011-08-31
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $10,741
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 )
Policy contract number610042
Policy instance 43
Insurance contract or identification number610042
Number of Individuals Covered246
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $80,329
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONNECTICARE, INC. (National Association of Insurance Commissioners NAIC id number: 95675 )
Policy contract number006513
Policy instance 44
Insurance contract or identification number006513
Number of Individuals Covered29
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $231,581
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
Policy contract numberMULTI-CONTRACTS
Policy instance 45
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered173
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $321
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $13,232
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
Policy contract numberMULTI-CONTRACTS
Policy instance 46
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered134
Insurance policy start date2011-03-01
Insurance policy end date2012-02-29
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $124,997
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract number9721507
Policy instance 47
Insurance contract or identification number9721507
Number of Individuals Covered18
Insurance policy start date2011-06-01
Insurance policy end date2012-05-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,461
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract number9813544
Policy instance 48
Insurance contract or identification number9813544
Number of Individuals Covered69
Insurance policy start date2011-03-01
Insurance policy end date2012-02-29
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,571
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract number9795402
Policy instance 49
Insurance contract or identification number9795402
Number of Individuals Covered89
Insurance policy start date2010-10-01
Insurance policy end date2011-09-30
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,800
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
WELLCHOICE HMO OF NEW JERSEY (National Association of Insurance Commissioners NAIC id number: 95433 )
Policy contract numberMULTI-CONTRACTS
Policy instance 50
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered59
Insurance policy start date2010-09-01
Insurance policy end date2011-08-31
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $494,559
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 numberF1D1608-001
Policy instance 51
Insurance contract or identification numberF1D1608-001
Number of Individuals Covered35
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,289
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract numberMULTI-CONTRACTS
Policy instance 52
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered59
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,204
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract number4544327-00
Policy instance 53
Insurance contract or identification number4544327-00
Number of Individuals Covered5
Insurance policy start date2011-02-01
Insurance policy end date2012-01-31
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $298
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract numberMULTI-CONTRACTS
Policy instance 54
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1608
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $13,043
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedOTHER SPECIFY
Welfare Benefit Premiums Paid to CarrierUSD $176,321
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract numberMULTI-CONTRACTS
Policy instance 55
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered177
Insurance policy start date2011-03-01
Insurance policy end date2012-02-29
Total amount of commissions paid to insurance brokerUSD $2,748
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedOTHER SPECIFY
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE INSURANCE AND ANNUITY COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract number028-3316-00
Policy instance 56
Insurance contract or identification number028-3316-00
Number of Individuals Covered30
Insurance policy start date2010-10-01
Insurance policy end date2011-09-30
Total amount of commissions paid to insurance brokerUSD $934
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,679
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 )
Policy contract numberMULTI-CONTRACTS
Policy instance 57
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2
Insurance policy start date2010-12-01
Insurance policy end date2011-11-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $16,073
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 )
Policy contract numberMULTI-CONTRACTS
Policy instance 58
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered54
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $594,060
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 )
Policy contract numberMULTI-C0NTRACTS
Policy instance 59
Insurance contract or identification numberMULTI-C0NTRACTS
Number of Individuals Covered150
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,610,797
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 )
Policy contract numberMULTI-CONTRACTS
Policy instance 60
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered244
Insurance policy start date2011-06-01
Insurance policy end date2012-05-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,816,735
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 )
Policy contract numberMULTI-CONTRACTS
Policy instance 61
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered110
Insurance policy start date2010-10-01
Insurance policy end date2011-09-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $789,216
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 )
Policy contract numberMULTI-CONTRACTS
Policy instance 62
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered101
Insurance policy start date2010-09-01
Insurance policy end date2011-08-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,123,089
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 63
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered488
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
Total amount of commissions paid to insurance brokerUSD $46
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $212,194
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 64
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered90
Insurance policy start date2010-08-01
Insurance policy end date2011-07-31
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $40,291
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00452358
Policy instance 65
Insurance contract or identification number00452358
Number of Individuals Covered161
Insurance policy start date2010-12-01
Insurance policy end date2011-11-30
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $70,643
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 66
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered286
Insurance policy start date2011-02-01
Insurance policy end date2012-01-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $99,743
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 67
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered4046
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $135
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,113,158
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 68
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2538
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $508,991
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 69
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1178
Insurance policy start date2011-06-01
Insurance policy end date2012-05-31
Total amount of commissions paid to insurance brokerUSD $2,857
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $282,585
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
GUARDIAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 70
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered595
Insurance policy start date2011-03-01
Insurance policy end date2012-02-29
Total amount of commissions paid to insurance brokerUSD $161
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $196,395
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 71
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered316
Insurance policy start date2011-05-01
Insurance policy end date2012-04-30
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $177,671
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 )
Policy contract numberMULTI-CONTRACTS
Policy instance 72
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered79
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $629,749
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
GUARDIAN 00461561 452466 00452187 00398575 00314375 (National Association of Insurance Commissioners NAIC id number: )
Policy contract numberMULTICONTRACTS
Policy instance 73
Insurance contract or identification numberMULTICONTRACTS
Number of Individuals Covered715
Insurance policy start date2010-11-01
Insurance policy end date2011-10-31
Total amount of commissions paid to insurance brokerUSD $76
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $250,782
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 74
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered332
Insurance policy start date2010-10-01
Insurance policy end date2011-09-30
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $112,289
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 75
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered509
Insurance policy start date2010-09-01
Insurance policy end date2011-08-31
Total amount of commissions paid to insurance brokerUSD $972
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $143,969
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HEALTH NET INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 43893 )
Policy contract number339041
Policy instance 76
Insurance contract or identification number339041
Number of Individuals Covered7
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,284
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HEALTH NET INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 43893 )
Policy contract number420599
Policy instance 77
Insurance contract or identification number420599
Number of Individuals Covered2
Insurance policy start date2010-12-01
Insurance policy end date2011-11-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $365
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HEALTH NET INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 43893 )
Policy contract numberOB9293
Policy instance 78
Insurance contract or identification numberOB9293
Number of Individuals Covered1
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,436
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HEALTH NET INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 43893 )
Policy contract number4811P
Policy instance 79
Insurance contract or identification number4811P
Number of Individuals Covered1
Insurance policy start date2010-10-01
Insurance policy end date2011-09-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $530
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberSR-83114532
Policy instance 80
Insurance contract or identification numberSR-83114532
Number of Individuals Covered118
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $731
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 )
Policy contract number01-0140755
Policy instance 81
Insurance contract or identification number01-0140755
Number of Individuals Covered56
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,579
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 )
Policy contract numberMULTI-CONTRACTS
Policy instance 82
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered738
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $607
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $68,555
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 )
Policy contract numberMULTI-CONTRACTS
Policy instance 83
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered185
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $34,564
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 84
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1103
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $21,606
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LINCOLN NATIONAL LIFE INSURANCE CO (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 85
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered592
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $76,733
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 86
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered901
Insurance policy start date2011-05-01
Insurance policy end date2012-04-30
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $66,080
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberMULTI-CONTRACTS
Policy instance 87
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered298
Insurance policy start date2010-10-01
Insurance policy end date2011-09-30
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $440
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER OF NORTH CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 60053 )
Policy contract number7880
Policy instance 88
Insurance contract or identification number7880
Number of Individuals Covered35
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $247,099
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberTM05725412
Policy instance 89
Insurance contract or identification numberTM05725412
Number of Individuals Covered334
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
Total amount of commissions paid to insurance brokerUSD $7,923
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $199,553
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberMULTI-CONTRACTS
Policy instance 90
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1727
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $2,521
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $736,721
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberMULTI-CONTRACTS
Policy instance 91
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered238
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $204,985
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5568741
Policy instance 92
Insurance contract or identification number5568741
Number of Individuals Covered52
Insurance policy start date2010-09-01
Insurance policy end date2011-08-31
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,284
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5612233
Policy instance 93
Insurance contract or identification number5612233
Number of Individuals Covered81
Insurance policy start date2010-10-01
Insurance policy end date2011-09-30
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $66,069
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 94
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered49
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
Total amount of commissions paid to insurance brokerUSD $1,009
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,867
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberGOOOADPB
Policy instance 95
Insurance contract or identification numberGOOOADPB
Number of Individuals Covered381
Insurance policy start date2010-08-01
Insurance policy end date2011-07-31
Total amount of commissions paid to insurance brokerUSD $21,586
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $86,829
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 96
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered149
Insurance policy start date2010-12-01
Insurance policy end date2011-11-30
Total amount of commissions paid to insurance brokerUSD $1,250
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,001
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 97
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered5971
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $56,188
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $387,080
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 98
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered237
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
Total amount of commissions paid to insurance brokerUSD $5,441
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $25,941
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 99
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered580
Insurance policy start date2011-06-01
Insurance policy end date2012-05-31
Total amount of commissions paid to insurance brokerUSD $6,230
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $83,046
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberMULTI-CONTRACTS
Policy instance 100
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered208
Insurance policy start date2011-03-01
Insurance policy end date2012-02-29
Total amount of commissions paid to insurance brokerUSD $4,570
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $37,221
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 101
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered278
Insurance policy start date2010-11-01
Insurance policy end date2011-10-31
Total amount of commissions paid to insurance brokerUSD $5,446
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $22,386
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 102
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered363
Insurance policy start date2010-10-01
Insurance policy end date2011-09-30
Total amount of commissions paid to insurance brokerUSD $6,944
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $27,643
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberMULTI-CONTRACTS
Policy instance 103
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered875
Insurance policy start date2010-09-01
Insurance policy end date2011-08-31
Total amount of commissions paid to insurance brokerUSD $20,383
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $81,344
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberEC17773
Policy instance 104
Insurance contract or identification numberEC17773
Number of Individuals Covered47
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $349,641
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberTN2679
Policy instance 105
Insurance contract or identification numberTN2679
Number of Individuals Covered7
Insurance policy start date2010-08-01
Insurance policy end date2011-07-31
Total amount of commissions paid to insurance brokerUSD $1,889
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $51,736
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberRR15841
Policy instance 106
Insurance contract or identification numberRR15841
Number of Individuals Covered31
Insurance policy start date2010-12-01
Insurance policy end date2011-11-30
Total amount of commissions paid to insurance brokerUSD $644
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $268,267
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberRP15275
Policy instance 107
Insurance contract or identification numberRP15275
Number of Individuals Covered14
Insurance policy start date2011-02-01
Insurance policy end date2012-01-31
Total amount of commissions paid to insurance brokerUSD $2,204
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $260,644
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 108
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered258
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $6,328
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,247,282
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberWT6094
Policy instance 109
Insurance contract or identification numberWT6094
Number of Individuals Covered40
Insurance policy start date2010-10-01
Insurance policy end date2011-09-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $411,070
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 110
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered79
Insurance policy start date2011-06-01
Insurance policy end date2012-05-31
Total amount of commissions paid to insurance brokerUSD $6,630
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,326,476
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 111
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered34
Insurance policy start date2011-03-01
Insurance policy end date2012-02-29
Total amount of commissions paid to insurance brokerUSD $2,575
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $346,352
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberEG1123
Policy instance 112
Insurance contract or identification numberEG1123
Number of Individuals Covered98
Insurance policy start date2011-05-01
Insurance policy end date2012-04-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $921,674
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 113
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered129
Insurance policy start date2010-09-01
Insurance policy end date2011-08-31
Total amount of commissions paid to insurance brokerUSD $504
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $907,662
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberH63030-1
Policy instance 114
Insurance contract or identification numberH63030-1
Number of Individuals Covered24
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $32,768
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberMULTI-CONTRACTS
Policy instance 115
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered250
Insurance policy start date2010-08-01
Insurance policy end date2011-07-31
Total amount of commissions paid to insurance brokerUSD $798
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $53,156
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberMULTI-CONTRACTS
Policy instance 116
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered252
Insurance policy start date2010-12-01
Insurance policy end date2011-11-30
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $82,876
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberMULTI-CONTRACTS
Policy instance 117
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered187
Insurance policy start date2011-02-01
Insurance policy end date2012-01-31
Total amount of commissions paid to insurance brokerUSD $15,092
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $126,685
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberMULTI-CONTRACTS
Policy instance 118
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1163
Insurance policy start date2011-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $1,716
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $55,067
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberMULTI-CONTRACTS
Policy instance 119
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered225
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $63,099
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberH65245-1
Policy instance 120
Insurance contract or identification numberH65245-1
Number of Individuals Covered19
Insurance policy start date2011-06-01
Insurance policy end date2012-05-31
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,060
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberH7204-1
Policy instance 121
Insurance contract or identification numberH7204-1
Number of Individuals Covered68
Insurance policy start date2011-03-01
Insurance policy end date2012-02-29
Total amount of commissions paid to insurance brokerUSD $2,495
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $15,818
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberMULTI-CONTRACTS
Policy instance 122
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered539
Insurance policy start date2010-11-01
Insurance policy end date2011-10-31
Total amount of commissions paid to insurance brokerUSD $806
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $168,815
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberMULTI-CONTRACTS
Policy instance 123
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered387
Insurance policy start date2010-10-01
Insurance policy end date2011-09-30
Total amount of commissions paid to insurance brokerUSD $20,598
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $321,459
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberMULTI-CONTRACTS
Policy instance 124
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered120
Insurance policy start date2010-09-01
Insurance policy end date2011-08-31
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $25,557
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number21329
Policy instance 125
Insurance contract or identification number21329
Number of Individuals Covered7898
Insurance policy start date2010-08-01
Insurance policy end date2011-07-31
Total amount of commissions paid to insurance brokerUSD $164,045
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedOTHER SPECIFY
Welfare Benefit Premiums Paid to CarrierUSD $723,121
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number21329N
Policy instance 126
Insurance contract or identification number21329N
Number of Individuals Covered309
Insurance policy start date2011-05-01
Insurance policy end date2012-04-30
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $106,934
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE STANDARD LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 89009 )
Policy contract numberMULTI-CONTRACTS
Policy instance 127
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered179
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $54,362
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE STANDARD LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 89009 )
Policy contract numberMULTI-CONTRACTS
Policy instance 128
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered79
Insurance policy start date2010-08-01
Insurance policy end date2011-07-31
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $75,508
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE STANDARD LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 89009 )
Policy contract number648306
Policy instance 129
Insurance contract or identification number648306
Number of Individuals Covered88
Insurance policy start date2010-12-01
Insurance policy end date2011-11-30
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $11,587
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract numberMULTI-CONTRACTS
Policy instance 130
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered423
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $4,794
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $69,026
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE STANDARD LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 89009 )
Policy contract number442045
Policy instance 131
Insurance contract or identification number442045
Number of Individuals Covered243
Insurance policy start date2011-03-01
Insurance policy end date2012-02-29
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $23,112
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE STANDARD LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 89009 )
Policy contract number148579
Policy instance 132
Insurance contract or identification number148579
Number of Individuals Covered27
Insurance policy start date2010-11-01
Insurance policy end date2011-10-31
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $11,933
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE INSURANCE AND ANNUITY COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract number218643
Policy instance 133
Insurance contract or identification number218643
Number of Individuals Covered111
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $28,127
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE INSURANCE AND ANNUITY COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract number810315
Policy instance 134
Insurance contract or identification number810315
Number of Individuals Covered39
Insurance policy start date2011-05-01
Insurance policy end date2012-04-30
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,278
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE INSURANCE AND ANNUITY COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract numberMULTI-CONTRACTS
Policy instance 135
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered862
Insurance policy start date2011-06-01
Insurance policy end date2012-05-31
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $95,892
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 136
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered26
Insurance policy start date2010-08-01
Insurance policy end date2011-07-31
Total amount of commissions paid to insurance brokerUSD $1,857
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $594,607
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number0716380
Policy instance 137
Insurance contract or identification number0716380
Number of Individuals Covered99
Insurance policy start date2010-12-01
Insurance policy end date2011-11-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $883,574
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number156263
Policy instance 138
Insurance contract or identification number156263
Number of Individuals Covered218
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
Total amount of commissions paid to insurance brokerUSD $43,217
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $796,237
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 139
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered583
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $76,469
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,070,215
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number03H4501
Policy instance 140
Insurance contract or identification number03H4501
Number of Individuals Covered37
Insurance policy start date2011-06-01
Insurance policy end date2012-05-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,815
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI-CONTRACTS
Policy instance 141
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered240
Insurance policy start date2011-05-01
Insurance policy end date2012-04-30
Total amount of commissions paid to insurance brokerUSD $234
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,112,836
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number0715476
Policy instance 142
Insurance contract or identification number0715476
Number of Individuals Covered142
Insurance policy start date2010-09-01
Insurance policy end date2011-08-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $479,826
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 143
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1242
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
Total amount of commissions paid to insurance brokerUSD $17,063
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $70,476
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 144
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered258
Insurance policy start date2010-08-01
Insurance policy end date2011-07-31
Total amount of commissions paid to insurance brokerUSD $15,553
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $80,256
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 145
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered131
Insurance policy start date2010-12-01
Insurance policy end date2011-11-30
Total amount of commissions paid to insurance brokerUSD $5,783
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $16,551
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 146
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered696
Insurance policy start date2011-02-01
Insurance policy end date2012-01-31
Total amount of commissions paid to insurance brokerUSD $19,562
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $63,674
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 147
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered3281
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $99,289
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $450,190
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Are there contracts with allocated funds for individual policies?0
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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?Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 148
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered366
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
Total amount of commissions paid to insurance brokerUSD $5,883
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $22,357
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 149
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered263
Insurance policy start date2011-06-01
Insurance policy end date2012-05-31
Total amount of commissions paid to insurance brokerUSD $9,576
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $32,654
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 150
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered315
Insurance policy start date2011-03-01
Insurance policy end date2012-02-29
Total amount of commissions paid to insurance brokerUSD $13,223
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $43,283
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 151
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1540
Insurance policy start date2011-05-01
Insurance policy end date2012-04-30
Total amount of commissions paid to insurance brokerUSD $40,281
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $142,739
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 152
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1237
Insurance policy start date2010-11-01
Insurance policy end date2011-10-31
Total amount of commissions paid to insurance brokerUSD $14,469
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $51,174
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 153
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered665
Insurance policy start date2010-10-01
Insurance policy end date2011-09-30
Total amount of commissions paid to insurance brokerUSD $19,450
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $76,567
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 154
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1304
Insurance policy start date2010-09-01
Insurance policy end date2011-08-31
Total amount of commissions paid to insurance brokerUSD $36,492
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $156,700
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number822626
Policy instance 1
Insurance contract or identification number822626
Number of Individuals Covered63
Insurance policy start date2010-04-01
Insurance policy end date2011-03-31
Total amount of commissions paid to insurance brokerUSD $24,170
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $462,140
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number472495
Policy instance 2
Insurance contract or identification number472495
Number of Individuals Covered142
Insurance policy start date2009-08-01
Insurance policy end date2010-07-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,024,655
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract numberMULTI-CONTRACTS
Policy instance 3
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered182
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,462,992
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract numberMULTI-CONTRACTS
Policy instance 4
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered311
Insurance policy start date2010-07-01
Insurance policy end date2011-06-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,979,305
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number472276
Policy instance 5
Insurance contract or identification number472276
Number of Individuals Covered45
Insurance policy start date2009-11-01
Insurance policy end date2010-10-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $401,983
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number791834
Policy instance 6
Insurance contract or identification number791834
Number of Individuals Covered25
Insurance policy start date2009-10-01
Insurance policy end date2010-09-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $192,539
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract numberMULTI-CONTRACTS
Policy instance 7
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered50
Insurance policy start date2010-04-01
Insurance policy end date2011-03-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $319,128
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number417480
Policy instance 8
Insurance contract or identification number417480
Number of Individuals Covered43
Insurance policy start date2010-02-01
Insurance policy end date2011-01-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $413,649
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract numberMULTI-CONTRACTS
Policy instance 9
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered274
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,470,046
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract numberMULTI-CONTRACTS
Policy instance 10
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered114
Insurance policy start date2010-07-01
Insurance policy end date2011-06-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $847,420
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract numberMULTI-CONTRACTS
Policy instance 11
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered140
Insurance policy start date2010-06-01
Insurance policy end date2011-05-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,488,642
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract numberMULTI-CONTRACTS
Policy instance 12
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered296
Insurance policy start date2010-05-01
Insurance policy end date2011-04-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,563,586
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number410000
Policy instance 13
Insurance contract or identification number410000
Number of Individuals Covered49
Insurance policy start date2009-09-01
Insurance policy end date2010-08-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $512,977
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number810687
Policy instance 14
Insurance contract or identification number810687
Number of Individuals Covered1
Insurance policy start date2009-08-01
Insurance policy end date2010-07-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,435
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number472757
Policy instance 15
Insurance contract or identification number472757
Number of Individuals Covered363
Insurance policy start date2010-04-01
Insurance policy end date2011-03-31
Total amount of commissions paid to insurance brokerUSD $26,279
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $206,745
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 16
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered5304
Insurance policy start date2009-08-01
Insurance policy end date2010-07-31
Total amount of commissions paid to insurance brokerUSD $469,100
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,389,605
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 17
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered7485
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $481,871
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,483,294
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number617383
Policy instance 18
Insurance contract or identification number617383
Number of Individuals Covered10322
Insurance policy start date2010-06-01
Insurance policy end date2011-05-31
Total amount of commissions paid to insurance brokerUSD $100,551
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $729,484
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number696709
Policy instance 19
Insurance contract or identification number696709
Number of Individuals Covered798
Insurance policy start date2009-09-01
Insurance policy end date2010-08-31
Total amount of commissions paid to insurance brokerUSD $35,379
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $343,568
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberMULTI-CONTRACTS
Policy instance 20
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered107
Insurance policy start date2010-04-01
Insurance policy end date2011-03-31
Total amount of commissions paid to insurance brokerUSD $7,791
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $63,099
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number1032661
Policy instance 21
Insurance contract or identification number1032661
Number of Individuals Covered35
Insurance policy start date2009-12-01
Insurance policy end date2010-11-30
Total amount of commissions paid to insurance brokerUSD $3,648
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $28,369
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberMULTI-CONTRACTS
Policy instance 22
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered664
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $31,151
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $519,661
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberMULTI-CONTRACTS
Policy instance 23
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered59
Insurance policy start date2010-03-01
Insurance policy end date2011-02-28
Total amount of commissions paid to insurance brokerUSD $5,169
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $32,612
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number1034562
Policy instance 24
Insurance contract or identification number1034562
Number of Individuals Covered28
Insurance policy start date2009-11-01
Insurance policy end date2010-10-31
Total amount of commissions paid to insurance brokerUSD $4,163
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $21,794
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number26-201457
Policy instance 25
Insurance contract or identification number26-201457
Number of Individuals Covered96
Insurance policy start date2009-10-01
Insurance policy end date2010-09-30
Total amount of commissions paid to insurance brokerUSD $6,702
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $69,446
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberMULTI-CONTRACTS
Policy instance 26
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered38
Insurance policy start date2009-09-01
Insurance policy end date2010-08-31
Total amount of commissions paid to insurance brokerUSD $3,773
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $23,645
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 )
Policy contract numberMULTI-CONTRACTS
Policy instance 27
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered565
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $2,714
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $34,227
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract number3329288
Policy instance 28
Insurance contract or identification number3329288
Number of Individuals Covered124
Insurance policy start date2010-04-01
Insurance policy end date2011-03-31
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $79,601
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 29
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered565
Insurance policy start date2009-12-01
Insurance policy end date2010-11-30
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $40,911
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 30
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered231
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $48,138
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA 3333556 (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract number3333556
Policy instance 31
Insurance contract or identification number3333556
Number of Individuals Covered42
Insurance policy start date2010-07-01
Insurance policy end date2011-06-30
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $21,020
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 32
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered128
Insurance policy start date2010-06-01
Insurance policy end date2011-05-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $37,542
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract number3333115
Policy instance 33
Insurance contract or identification number3333115
Number of Individuals Covered93
Insurance policy start date2010-03-01
Insurance policy end date2011-02-28
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $40,826
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 34
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered596
Insurance policy start date2010-05-01
Insurance policy end date2011-04-30
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $157,876
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract number4001703
Policy instance 35
Insurance contract or identification number4001703
Number of Individuals Covered13
Insurance policy start date2010-04-01
Insurance policy end date2011-03-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $140,130
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract number3328183
Policy instance 36
Insurance contract or identification number3328183
Number of Individuals Covered12
Insurance policy start date2009-08-01
Insurance policy end date2010-07-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $196,498
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 37
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered214
Insurance policy start date2009-12-01
Insurance policy end date2010-11-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $527,148
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 38
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered268
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,018,833
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract number3333556
Policy instance 39
Insurance contract or identification number3333556
Number of Individuals Covered62
Insurance policy start date2010-07-01
Insurance policy end date2011-06-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $912,109
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 40
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered244
Insurance policy start date2010-06-01
Insurance policy end date2011-05-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,356,324
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract number3333115
Policy instance 41
Insurance contract or identification number3333115
Number of Individuals Covered44
Insurance policy start date2010-03-01
Insurance policy end date2011-02-28
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $452,566
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract numberMULTI-CONTRACTS
Policy instance 42
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered224
Insurance policy start date2010-05-01
Insurance policy end date2011-04-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,865,776
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract number3330016
Policy instance 43
Insurance contract or identification number3330016
Number of Individuals Covered91
Insurance policy start date2009-11-01
Insurance policy end date2010-10-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $125,821
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTHCARE OF CONNECTICUT, INC. (National Association of Insurance Commissioners NAIC id number: 95660 )
Policy contract number3328432
Policy instance 44
Insurance contract or identification number3328432
Number of Individuals Covered46
Insurance policy start date2009-09-01
Insurance policy end date2010-08-31
Total amount of commissions paid to insurance brokerUSD $45
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,265
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
Policy contract numberMULTI-CONTRACTS
Policy instance 45
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered133
Insurance policy start date2010-03-01
Insurance policy end date2011-02-28
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $20,722
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED/EYECARE PLAN 47 9835083 (National Association of Insurance Commissioners NAIC id number: 97055 )
Policy contract number9721507
Policy instance 46
Insurance contract or identification number9721507
Number of Individuals Covered18
Insurance policy start date2010-06-01
Insurance policy end date2011-05-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $765
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 numberF016294-0001
Policy instance 47
Insurance contract or identification numberF016294-0001
Number of Individuals Covered134
Insurance policy start date2010-03-01
Insurance policy end date2011-02-28
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,733
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract number041-6822-00
Policy instance 48
Insurance contract or identification number041-6822-00
Number of Individuals Covered10
Insurance policy start date2010-04-01
Insurance policy end date2011-03-31
Total amount of commissions paid to insurance brokerUSD $412
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,258
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract number454-4327-00
Policy instance 49
Insurance contract or identification number454-4327-00
Number of Individuals Covered74
Insurance policy start date2010-02-02
Insurance policy end date2011-01-31
Total amount of commissions paid to insurance brokerUSD $3,247
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $23,043
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract numberMULTI-CONTRACTS
Policy instance 50
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered875
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedEAP
Welfare Benefit Premiums Paid to CarrierUSD $54,447
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract number028-3316-00
Policy instance 51
Insurance contract or identification number028-3316-00
Number of Individuals Covered44
Insurance policy start date2009-10-01
Insurance policy end date2010-09-30
Total amount of commissions paid to insurance brokerUSD $1,195
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,205
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 )
Policy contract numberMULTI-CONTRACTS
Policy instance 52
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered48
Insurance policy start date2009-12-01
Insurance policy end date2010-11-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $402,114
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 )
Policy contract numberMULTI-CONTRACTS
Policy instance 53
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered202
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,475,851
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 )
Policy contract numberMULTI-CONTRACTS
Policy instance 54
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered229
Insurance policy start date2010-07-01
Insurance policy end date2011-06-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,235,138
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 )
Policy contract numberMULTI-CONTRACTS
Policy instance 55
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered70
Insurance policy start date2010-06-01
Insurance policy end date2011-05-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $541,224
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 )
Policy contract numberMULTI-CONTRACTS
Policy instance 56
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered62
Insurance policy start date2009-10-01
Insurance policy end date2010-09-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $472,457
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 )
Policy contract numberMULTI-CONTRACTS
Policy instance 57
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered214
Insurance policy start date2009-09-01
Insurance policy end date2010-08-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,070,013
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 58
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered349
Insurance policy start date2010-04-01
Insurance policy end date2011-03-31
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $103,654
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00452358
Policy instance 59
Insurance contract or identification number00452358
Number of Individuals Covered265
Insurance policy start date2009-12-01
Insurance policy end date2010-11-30
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $78,319
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00454253
Policy instance 60
Insurance contract or identification number00454253
Number of Individuals Covered44
Insurance policy start date2010-02-01
Insurance policy end date2011-01-31
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $30,386
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 61
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1327
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $11,461
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $395,194
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 62
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1324
Insurance policy start date2010-07-01
Insurance policy end date2011-06-30
Total amount of commissions paid to insurance brokerUSD $1,135
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $74,190
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 63
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1378
Insurance policy start date2010-06-01
Insurance policy end date2011-05-31
Total amount of commissions paid to insurance brokerUSD $137
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $231,894
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 64
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered557
Insurance policy start date2010-05-01
Insurance policy end date2011-04-30
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $155,044
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberMULTI-CONTRACTS
Policy instance 65
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered640
Insurance policy start date2009-11-01
Insurance policy end date2010-10-31
Total amount of commissions paid to insurance brokerUSD $105
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $171,635
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00451061
Policy instance 66
Insurance contract or identification number00451061
Number of Individuals Covered107
Insurance policy start date2009-10-01
Insurance policy end date2010-09-30
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $87,004
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
GUARDIAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number359933
Policy instance 67
Insurance contract or identification number359933
Number of Individuals Covered101
Insurance policy start date2009-09-30
Insurance policy end date2010-08-31
Total amount of commissions paid to insurance brokerUSD $566
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $62,302
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 )
Policy contract numberMULTI-CONTRACTS
Policy instance 68
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered79
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $600,355
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HEALTH NET INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 43893 )
Policy contract number339041
Policy instance 69
Insurance contract or identification number339041
Number of Individuals Covered75
Insurance policy start date2010-04-01
Insurance policy end date2011-03-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $510,281
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HEALTH NET INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 43893 )
Policy contract numberMULLTI-CONRACTS
Policy instance 70
Insurance contract or identification numberMULLTI-CONRACTS
Number of Individuals Covered22
Insurance policy start date2009-12-01
Insurance policy end date2010-11-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $162,173
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HEALTH NET INSURANCE OF CONNECTICUT (National Association of Insurance Commissioners NAIC id number: 10360 )
Policy contract numberMULTI-CONTRACTS
Policy instance 71
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered189
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $14,846
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $896,073
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HEALTH NET INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 43893 )
Policy contract numberMUTLI-CONTRACTS
Policy instance 72
Insurance contract or identification numberMUTLI-CONTRACTS
Number of Individuals Covered71
Insurance policy start date2010-06-30
Insurance policy end date2011-05-31
Total amount of commissions paid to insurance brokerUSD $21
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,198
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HEALTH NET INSURANCE OF CONNECTICUT (National Association of Insurance Commissioners NAIC id number: 10360 )
Policy contract numberMULTI-CONTRACTS
Policy instance 73
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered44
Insurance policy start date2009-10-01
Insurance policy end date2010-09-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $371,705
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HEALTH NET INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 43893 )
Policy contract numberMULTI-CONTRACTS
Policy instance 74
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered39
Insurance policy start date2009-09-01
Insurance policy end date2010-08-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $300,646
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 )
Policy contract number5965502
Policy instance 75
Insurance contract or identification number5965502
Number of Individuals Covered136
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,663
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 )
Policy contract numberMULTI-CONTRRACT
Policy instance 76
Insurance contract or identification numberMULTI-CONTRRACT
Number of Individuals Covered194
Insurance policy start date2010-07-01
Insurance policy end date2011-06-30
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,988
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5333776
Policy instance 77
Insurance contract or identification number5333776
Number of Individuals Covered373
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $67,842
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5595669
Policy instance 78
Insurance contract or identification number5595669
Number of Individuals Covered172
Insurance policy start date2010-07-01
Insurance policy end date2011-06-30
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $24,109
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number05333776
Policy instance 79
Insurance contract or identification number05333776
Number of Individuals Covered192
Insurance policy start date2010-03-01
Insurance policy end date2011-02-28
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $52,355
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberMULTI-CONTRACTS
Policy instance 80
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered150
Insurance policy start date2009-10-01
Insurance policy end date2010-09-30
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $68,108
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 81
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered123
Insurance policy start date2010-04-01
Insurance policy end date2011-03-31
Total amount of commissions paid to insurance brokerUSD $2,604
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,449
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberG000ADPB
Policy instance 82
Insurance contract or identification numberG000ADPB
Number of Individuals Covered363
Insurance policy start date2009-08-01
Insurance policy end date2010-07-31
Total amount of commissions paid to insurance brokerUSD $12,928
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $60,460
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 83
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered200
Insurance policy start date2009-12-01
Insurance policy end date2010-11-30
Total amount of commissions paid to insurance brokerUSD $1,390
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,226
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 84
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1014
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $13,026
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $69,640
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberG000AGPG
Policy instance 85
Insurance contract or identification numberG000AGPG
Number of Individuals Covered184
Insurance policy start date2010-07-01
Insurance policy end date2011-06-30
Total amount of commissions paid to insurance brokerUSD $1,030
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,960
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 86
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered241
Insurance policy start date2010-06-30
Insurance policy end date2011-05-31
Total amount of commissions paid to insurance brokerUSD $4,015
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $16,996
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberG00082R6
Policy instance 87
Insurance contract or identification numberG00082R6
Number of Individuals Covered20
Insurance policy start date2010-03-01
Insurance policy end date2011-02-28
Total amount of commissions paid to insurance brokerUSD $966
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,503
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberG000AE9U
Policy instance 88
Insurance contract or identification numberG000AE9U
Number of Individuals Covered62
Insurance policy start date2009-11-01
Insurance policy end date2010-10-31
Total amount of commissions paid to insurance brokerUSD $682
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,983
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberMULTI-CONTRACTS
Policy instance 89
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered507
Insurance policy start date2009-10-01
Insurance policy end date2010-09-30
Total amount of commissions paid to insurance brokerUSD $11,324
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $53,222
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberG000ADTT
Policy instance 90
Insurance contract or identification numberG000ADTT
Number of Individuals Covered124
Insurance policy start date2009-09-01
Insurance policy end date2010-08-31
Total amount of commissions paid to insurance brokerUSD $5,092
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $14,671
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberEC1773
Policy instance 91
Insurance contract or identification numberEC1773
Number of Individuals Covered39
Insurance policy start date2010-04-01
Insurance policy end date2011-03-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $304,348
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberTN2679
Policy instance 92
Insurance contract or identification numberTN2679
Number of Individuals Covered36
Insurance policy start date2009-08-01
Insurance policy end date2010-07-31
Total amount of commissions paid to insurance brokerUSD $3,298
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $451,651
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 93
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered22
Insurance policy start date2010-02-01
Insurance policy end date2011-01-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $171,016
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 94
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered35
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $271,928
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 95
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered73
Insurance policy start date2010-07-01
Insurance policy end date2011-06-30
Total amount of commissions paid to insurance brokerUSD $39
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $747,054
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 96
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered173
Insurance policy start date2010-06-01
Insurance policy end date2011-05-31
Total amount of commissions paid to insurance brokerUSD $7,582
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,877,071
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberMULTI-CONTRACTS
Policy instance 97
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered63
Insurance policy start date2010-03-01
Insurance policy end date2011-02-28
Total amount of commissions paid to insurance brokerUSD $2,473
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $726,210
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberEG1123
Policy instance 98
Insurance contract or identification numberEG1123
Number of Individuals Covered78
Insurance policy start date2010-05-01
Insurance policy end date2011-04-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $659,110
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberAP2736
Policy instance 99
Insurance contract or identification numberAP2736
Number of Individuals Covered5
Insurance policy start date2009-09-30
Insurance policy end date2010-08-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $66,986
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberMULTI-CONTRACTS
Policy instance 100
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered85
Insurance policy start date2010-04-01
Insurance policy end date2011-03-31
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $50,336
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberMULTI-CONTRACTS
Policy instance 101
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered398
Insurance policy start date2009-08-01
Insurance policy end date2010-07-31
Total amount of commissions paid to insurance brokerUSD $838
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $66,012
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberMULTI-CONTRACTS
Policy instance 102
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered281
Insurance policy start date2009-12-01
Insurance policy end date2010-11-30
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $90,628
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberMULTI-CONTRACTS
Policy instance 103
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered389
Insurance policy start date2010-02-01
Insurance policy end date2011-01-31
Total amount of commissions paid to insurance brokerUSD $18,267
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $158,175
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberMULTI-CONTRACTS
Policy instance 104
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered976
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $1,284
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $160,092
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberMULTI-CONTRACTS
Policy instance 105
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered541
Insurance policy start date2010-07-01
Insurance policy end date2011-06-30
Total amount of commissions paid to insurance brokerUSD $1,877
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $68,567
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberMULTI-CONTRACTS
Policy instance 106
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered117
Insurance policy start date2010-06-01
Insurance policy end date2011-05-31
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,931
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberMULTI-CONTRACTS
Policy instance 107
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered160
Insurance policy start date2010-03-01
Insurance policy end date2011-02-28
Total amount of commissions paid to insurance brokerUSD $2,285
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $41,836
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberMULTI-CONTRACTS
Policy instance 108
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered516
Insurance policy start date2009-11-01
Insurance policy end date2010-10-31
Total amount of commissions paid to insurance brokerUSD $1,245
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $121,660
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberMULTI-CONTRACTS
Policy instance 109
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered695
Insurance policy start date2009-10-01
Insurance policy end date2010-09-30
Total amount of commissions paid to insurance brokerUSD $17,112
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $487,578
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberH52022-1
Policy instance 110
Insurance contract or identification numberH52022-1
Number of Individuals Covered54
Insurance policy start date2009-09-01
Insurance policy end date2010-08-31
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $16,729
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number21329
Policy instance 111
Insurance contract or identification number21329
Number of Individuals Covered9314
Insurance policy start date2009-08-01
Insurance policy end date2010-07-31
Total amount of commissions paid to insurance brokerUSD $72,861
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $801,107
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number21329N
Policy instance 112
Insurance contract or identification number21329N
Number of Individuals Covered337
Insurance policy start date2010-05-01
Insurance policy end date2011-04-30
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $113,064
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE STANDARD LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 89009 )
Policy contract numberMULTI-CONTRACTS
Policy instance 113
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered169
Insurance policy start date2010-04-01
Insurance policy end date2011-03-31
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $49,536
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE STANDARD LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 89009 )
Policy contract numberMULTI-CONTRACTS
Policy instance 114
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered48
Insurance policy start date2009-08-01
Insurance policy end date2010-07-31
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $80,664
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE STANDARD LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 89009 )
Policy contract numberMULTI-CONTRACTS
Policy instance 115
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered176
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $30,620
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE STANDARD LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 89009 )
Policy contract number442045
Policy instance 116
Insurance contract or identification number442045
Number of Individuals Covered222
Insurance policy start date2010-03-01
Insurance policy end date2011-02-28
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $21,226
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE STANDARD LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 89009 )
Policy contract number148579
Policy instance 117
Insurance contract or identification number148579
Number of Individuals Covered23
Insurance policy start date2009-11-01
Insurance policy end date2010-10-31
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $9,804
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract numberMULTI CONTRACTS
Policy instance 118
Insurance contract or identification numberMULTI CONTRACTS
Number of Individuals Covered337
Insurance policy start date2009-08-01
Insurance policy end date2010-07-31
Total amount of commissions paid to insurance brokerUSD $64,134
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $929,308
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number0716380
Policy instance 119
Insurance contract or identification number0716380
Number of Individuals Covered139
Insurance policy start date2009-12-01
Insurance policy end date2010-11-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,060,540
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number713779
Policy instance 120
Insurance contract or identification number713779
Number of Individuals Covered231
Insurance policy start date2010-02-01
Insurance policy end date2011-01-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $935,222
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number02G5506
Policy instance 121
Insurance contract or identification number02G5506
Number of Individuals Covered81
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $778,483
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number03H4501
Policy instance 122
Insurance contract or identification number03H4501
Number of Individuals Covered27
Insurance policy start date2010-06-01
Insurance policy end date2011-05-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,626
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number7R8626
Policy instance 123
Insurance contract or identification number7R8626
Number of Individuals Covered69
Insurance policy start date2010-05-01
Insurance policy end date2011-04-30
Total amount of commissions paid to insurance brokerUSD $520
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $327,098
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 124
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1358
Insurance policy start date2010-04-01
Insurance policy end date2011-03-31
Total amount of commissions paid to insurance brokerUSD $10,351
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $75,386
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 125
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered489
Insurance policy start date2009-08-01
Insurance policy end date2010-07-31
Total amount of commissions paid to insurance brokerUSD $15,698
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $91,308
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNUMPROVIDENT 95664 133923 (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 126
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered165
Insurance policy start date2009-12-01
Insurance policy end date2010-11-30
Total amount of commissions paid to insurance brokerUSD $7,124
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $25,120
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 127
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered465
Insurance policy start date2010-02-01
Insurance policy end date2011-01-31
Total amount of commissions paid to insurance brokerUSD $9,846
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $30,989
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 128
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered2460
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $71,967
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $344,438
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 129
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered1516
Insurance policy start date2010-07-01
Insurance policy end date2011-06-30
Total amount of commissions paid to insurance brokerUSD $59,583
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $210,148
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 130
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered794
Insurance policy start date2010-06-01
Insurance policy end date2011-05-31
Total amount of commissions paid to insurance brokerUSD $17,172
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $70,607
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 131
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered197
Insurance policy start date2010-03-01
Insurance policy end date2011-02-28
Total amount of commissions paid to insurance brokerUSD $7,534
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $28,658
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 132
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered630
Insurance policy start date2010-05-01
Insurance policy end date2011-04-30
Total amount of commissions paid to insurance brokerUSD $7,760
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $35,419
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 133
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered798
Insurance policy start date2009-11-01
Insurance policy end date2010-10-31
Total amount of commissions paid to insurance brokerUSD $10,318
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $38,772
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberMULTI-CONTRACTS
Policy instance 134
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered519
Insurance policy start date2009-10-01
Insurance policy end date2010-09-30
Total amount of commissions paid to insurance brokerUSD $15,054
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $61,098
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract numberMULTI-CONTRACTS
Policy instance 135
Insurance contract or identification numberMULTI-CONTRACTS
Number of Individuals Covered470
Insurance policy start date2009-09-01
Insurance policy end date2010-08-31
Total amount of commissions paid to insurance brokerUSD $13,319
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $54,893
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract number30000109
Policy instance 136
Insurance contract or identification number30000109
Number of Individuals Covered152
Insurance policy start date2010-07-01
Insurance policy end date2011-06-30
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,445
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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