EMPLOYEE BENEFIT PLAN OF PHIPPS HOUSES 401k Plan overview

Plan Name	EMPLOYEE BENEFIT PLAN OF PHIPPS HOUSES
Plan identification number	501

EMPLOYEE BENEFIT PLAN OF PHIPPS HOUSES Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Temporary disability (accident and sickness) Long-term disability cover Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

PHIPPS HOUSES has sponsored the creation of one or more 401k plans.

Company Name:	PHIPPS HOUSES
Employer identification number (EIN):	111187480
NAIC Classification:	531390
NAIC Description:	Other Activities Related to Real Estate

Additional information about PHIPPS HOUSES

Jurisdiction of Incorporation:	New York Department of State
Incorporation Date:	1905-01-01
Company Identification Number:	91
Legal Registered Office Address:	80 STATE STREET New York ALBANY United States of America (USA) 122072543

More information about PHIPPS HOUSES

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EMPLOYEE BENEFIT PLAN OF PHIPPS HOUSES

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2022-01-01
501	2021-01-01
501	2020-01-01
501	2020-01-01
501	2019-01-01
501	2019-01-01
501	2018-01-01
501	2017-01-01	BRIAN BRICKER		BRIAN BRICKER	2018-09-27
501	2016-01-01	BRIAN BRICKER
501	2015-01-01	BRIAN BRICKER
501	2014-01-01	BRIAN BRICKER
501	2013-01-01	BRIAN BRICKER
501	2012-01-01	BRIAN BRICKER
501	2011-01-01	BRIAN BRICKER
501	2009-01-01	BRIAN BRICKER

Plan Statistics for EMPLOYEE BENEFIT PLAN OF PHIPPS HOUSES

401k plan membership statisitcs for EMPLOYEE BENEFIT PLAN OF PHIPPS HOUSES

Measure	Date	Value
2022: EMPLOYEE BENEFIT PLAN OF PHIPPS HOUSES 2022 401k membership
Total participants, beginning-of-year	2022-01-01	584
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	586
Number of retired or separated participants receiving benefits	2022-01-01	21
Total of all active and inactive participants	2022-01-01	607
Total participants	2022-01-01	607
2021: EMPLOYEE BENEFIT PLAN OF PHIPPS HOUSES 2021 401k membership
Total participants, beginning-of-year	2021-01-01	584
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	521
Number of retired or separated participants receiving benefits	2021-01-01	21
Total of all active and inactive participants	2021-01-01	542
Total participants	2021-01-01	542
2020: EMPLOYEE BENEFIT PLAN OF PHIPPS HOUSES 2020 401k membership
Total participants, beginning-of-year	2020-01-01	598
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	750
Number of retired or separated participants receiving benefits	2020-01-01	24
Total of all active and inactive participants	2020-01-01	774
Total participants	2020-01-01	774
2019: EMPLOYEE BENEFIT PLAN OF PHIPPS HOUSES 2019 401k membership
Total participants, beginning-of-year	2019-01-01	611
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	571
Number of retired or separated participants receiving benefits	2019-01-01	27
Total of all active and inactive participants	2019-01-01	598
Total participants	2019-01-01	598
2018: EMPLOYEE BENEFIT PLAN OF PHIPPS HOUSES 2018 401k membership
Total participants, beginning-of-year	2018-01-01	645
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	661
Total of all active and inactive participants	2018-01-01	661
Total participants	2018-01-01	661
2017: EMPLOYEE BENEFIT PLAN OF PHIPPS HOUSES 2017 401k membership
Total participants, beginning-of-year	2017-01-01	631
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	608
Number of retired or separated participants receiving benefits	2017-01-01	37
Total of all active and inactive participants	2017-01-01	645
Total participants	2017-01-01	645
2016: EMPLOYEE BENEFIT PLAN OF PHIPPS HOUSES 2016 401k membership
Total participants, beginning-of-year	2016-01-01	685
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	596
Number of retired or separated participants receiving benefits	2016-01-01	35
Total of all active and inactive participants	2016-01-01	631
Total participants	2016-01-01	631
2015: EMPLOYEE BENEFIT PLAN OF PHIPPS HOUSES 2015 401k membership
Total participants, beginning-of-year	2015-01-01	614
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	653
Number of retired or separated participants receiving benefits	2015-01-01	32
Total of all active and inactive participants	2015-01-01	685
Total participants	2015-01-01	685
2014: EMPLOYEE BENEFIT PLAN OF PHIPPS HOUSES 2014 401k membership
Total participants, beginning-of-year	2014-01-01	560
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	584
Number of retired or separated participants receiving benefits	2014-01-01	30
Total of all active and inactive participants	2014-01-01	614
Total participants	2014-01-01	614
2013: EMPLOYEE BENEFIT PLAN OF PHIPPS HOUSES 2013 401k membership
Total participants, beginning-of-year	2013-01-01	606
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	533
Number of retired or separated participants receiving benefits	2013-01-01	27
Total of all active and inactive participants	2013-01-01	560
Total participants	2013-01-01	560
2012: EMPLOYEE BENEFIT PLAN OF PHIPPS HOUSES 2012 401k membership
Total participants, beginning-of-year	2012-01-01	373
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	582
Number of retired or separated participants receiving benefits	2012-01-01	24
Total of all active and inactive participants	2012-01-01	606
Total participants	2012-01-01	606
2011: EMPLOYEE BENEFIT PLAN OF PHIPPS HOUSES 2011 401k membership
Total participants, beginning-of-year	2011-01-01	423
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	327
Number of retired or separated participants receiving benefits	2011-01-01	46
Total of all active and inactive participants	2011-01-01	373
Total participants	2011-01-01	373
2009: EMPLOYEE BENEFIT PLAN OF PHIPPS HOUSES 2009 401k membership
Total participants, beginning-of-year	2009-01-01	407
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	393
Number of retired or separated participants receiving benefits	2009-01-01	41
Total of all active and inactive participants	2009-01-01	434
Total participants	2009-01-01	434

Form 5500 Responses for EMPLOYEE BENEFIT PLAN OF PHIPPS HOUSES

2022: EMPLOYEE BENEFIT PLAN OF PHIPPS HOUSES 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Submission has been amended	No
2022-01-01	This submission is the final filing	No
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-01-01	Plan is a collectively bargained plan	No
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2021: EMPLOYEE BENEFIT PLAN OF PHIPPS HOUSES 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2020: EMPLOYEE BENEFIT PLAN OF PHIPPS HOUSES 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2019: EMPLOYEE BENEFIT PLAN OF PHIPPS HOUSES 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	Yes
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2018: EMPLOYEE BENEFIT PLAN OF PHIPPS HOUSES 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2017: EMPLOYEE BENEFIT PLAN OF PHIPPS HOUSES 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2016: EMPLOYEE BENEFIT PLAN OF PHIPPS HOUSES 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2015: EMPLOYEE BENEFIT PLAN OF PHIPPS HOUSES 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2014: EMPLOYEE BENEFIT PLAN OF PHIPPS HOUSES 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2013: EMPLOYEE BENEFIT PLAN OF PHIPPS HOUSES 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2012: EMPLOYEE BENEFIT PLAN OF PHIPPS HOUSES 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2011: EMPLOYEE BENEFIT PLAN OF PHIPPS HOUSES 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	First time form 5500 has been submitted	Yes
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2009: EMPLOYEE BENEFIT PLAN OF PHIPPS HOUSES 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number	713851D
Policy instance	6
Insurance contract or identification number 713851D Number of Individuals Covered 594 Insurance policy start date 2022-01-01 Insurance policy end date 2022-12-31 Total amount of commissions paid to insurance broker USD $4,716 Total amount of fees paid to insurance company USD $1,124 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 plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit Yes Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided PAID FAMILY LEAVE Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $18,124 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $4,716 Insurance broker organization code? 3 Amount paid for insurance broker fees 1124 Additional information about fees paid to insurance broker BONUS
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract number	000000411385
Policy instance	5
Insurance contract or identification number 000000411385 Number of Individuals Covered 91 Insurance policy start date 2022-01-01 Insurance policy end date 2023-01-01 Total amount of commissions paid to insurance broker USD $2,578 Total amount of fees paid to insurance company USD $1,557 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 plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit Yes Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $51,553 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $2,578 Amount paid for insurance broker fees 1557 Additional information about fees paid to insurance broker ADDITIONAL COMPENSATION Insurance broker organization code? 3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number	893040G
Policy instance	4
Insurance contract or identification number 893040G Number of Individuals Covered 516 Insurance policy start date 2022-01-01 Insurance policy end date 2022-12-31 Total amount of commissions paid to insurance broker USD $19,885 Total amount of fees paid to insurance company USD $2,541 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 plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit Yes Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided ADD - BAS Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $131,321 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $19,885 Amount paid for insurance broker fees 2541 Additional information about fees paid to insurance broker FEES AND COMMISSIONS PAID Insurance broker organization code? 3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	5967133
Policy instance	3
Insurance contract or identification number 5967133 Number of Individuals Covered 732 Insurance policy start date 2022-01-01 Insurance policy end date 2022-12-31 Total amount of commissions paid to insurance broker USD $8,883 Total amount of fees paid to insurance company USD $3,584 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 plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $222,081 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $8,883 Amount paid for insurance broker fees 3584 Additional information about fees paid to insurance broker SUPPLEMENTARY AND NONMONETARY COMPENSATION AS WELL AS MARKETING FEES Insurance broker organization code? 3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47029 )
Policy contract number	12082796
Policy instance	2
Insurance contract or identification number 12082796 Number of Individuals Covered 349 Insurance policy start date 2022-01-01 Insurance policy end date 2022-12-31 Total amount of fees paid to insurance company USD $1,365 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 plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit Yes Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $27,083 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Amount paid for insurance broker fees 1365 Additional information about fees paid to insurance broker FEES AND COMMISSIONS PAID Insurance broker organization code? 3
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number	00623821
Policy instance	1
Insurance contract or identification number 00623821 Number of Individuals Covered 326 Insurance policy start date 2022-01-01 Insurance policy end date 2022-12-31 Total amount of fees paid to insurance company USD $80,808 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 plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit Yes Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $2,937,969 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Amount paid for insurance broker fees 80808 Additional information about fees paid to insurance broker BENEFIT ADVISOR FE Insurance broker organization code? 3
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number	00623821
Policy instance	1
Insurance contract or identification number 00623821 Number of Individuals Covered 333 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 Total amount of fees paid to insurance company USD $106,964 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 plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit Yes Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $3,310,022 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Amount paid for insurance broker fees 106964 Additional information about fees paid to insurance broker BENEFIT ADVISOR FEES Insurance broker organization code? 3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47029 )
Policy contract number	12082796
Policy instance	2
Insurance contract or identification number 12082796 Number of Individuals Covered 317 Insurance policy start date 2020-12-01 Insurance policy end date 2021-11-30 Total amount of fees paid to insurance company USD $1,316 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 plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit Yes Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $26,992 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Amount paid for insurance broker fees 1316 Additional information about fees paid to insurance broker FEES AND COMMISSIONS PAID Insurance broker organization code? 3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	TM05967133
Policy instance	3
Insurance contract or identification number TM05967133 Number of Individuals Covered 730 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 Total amount of commissions paid to insurance broker USD $9,951 Total amount of fees paid to insurance company USD $372 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 plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $229,074 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $9,951 Amount paid for insurance broker fees 372 Additional information about fees paid to insurance broker SUPPLEMENTARY AND NONMONETARY COMPENSATION, AS WELL AS MARKETING FEES Insurance broker organization code? 3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number	893040G
Policy instance	4
Insurance contract or identification number 893040G Number of Individuals Covered 327 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 Total amount of commissions paid to insurance broker USD $18,095 Total amount of fees paid to insurance company USD $2,745 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 plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit Yes Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit Yes Unemployment Insurance Welfare Benefit No Other welfare benefits provided ADD - BAS Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $110,316 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Amount paid for insurance broker fees 2745 Additional information about fees paid to insurance broker BONUS Insurance broker organization code? 3 Commission paid to Insurance Broker USD $18,095
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract number	000000411385
Policy instance	5
Insurance contract or identification number 000000411385 Number of Individuals Covered 96 Insurance policy start date 2021-01-01 Insurance policy end date 2022-01-01 Total amount of commissions paid to insurance broker USD $2,516 Total amount of fees paid to insurance company USD $782 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 plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit Yes Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $50,325 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $2,516 Amount paid for insurance broker fees 782 Additional information about fees paid to insurance broker ADDITIONAL COMPENSATION Insurance broker organization code? 3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number	713851D
Policy instance	6
Insurance contract or identification number 504910-01 Number of Individuals Covered 7 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 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 plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? Yes Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Total amount of commissions paid to insurance broker USD $4,833 Total amount of fees paid to insurance company USD $1,596 Other welfare benefits provided PAID FAMILY LEAVE Welfare Benefit Premiums Paid to Carrier USD $192,855 Amount paid for insurance broker fees 1596 Additional information about fees paid to insurance broker BONUS Insurance broker organization code? 3 Commission paid to Insurance Broker USD $4,833
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract number	R0632141
Policy instance	7
Insurance contract or identification number R0632141 Number of Individuals Covered 125 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 Total amount of commissions paid to insurance broker USD $4,249 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 plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided ACCIDENT HOSPITAL, CRITICAL ILLNESS AND VSTD Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $25,973 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $4,249 Amount paid for insurance broker fees 316 Additional information about fees paid to insurance broker ADDITIONAL COMPENSATION
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47029 )
Policy contract number	12082796
Policy instance	2
Insurance contract or identification number 12082796 Number of Individuals Covered 336 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 Total amount of fees paid to insurance company USD $1,205 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 plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit Yes Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $25,573 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Amount paid for insurance broker fees 1205 Additional information about fees paid to insurance broker FFES AND COMMISSIONS PAID
FIRST UNUM LIFE LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract number	411383
Policy instance	3
Insurance contract or identification number 411383 Number of Individuals Covered 364 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 Total amount of commissions paid to insurance broker USD $8,026 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 plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit Yes Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $129,657 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $8,026 Amount paid for insurance broker fees 2354 Additional information about fees paid to insurance broker ADDITIONAL COMPENSATION PAID
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	TM05967133
Policy instance	4
Insurance contract or identification number TM05967133 Number of Individuals Covered 730 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 Total amount of commissions paid to insurance broker USD $6,847 Total amount of fees paid to insurance company USD $877 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 plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $209,203 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $6,847 Amount paid for insurance broker fees 877 Additional information about fees paid to insurance broker SUPPLEMENTAL AND NON-MONETARY COMPENSATION PAID
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number	7133851D
Policy instance	5
Insurance contract or identification number 7133851D Number of Individuals Covered 750 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 Total amount of commissions paid to insurance broker USD $3,289 Total amount of fees paid to insurance company USD $0 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 plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit Yes Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $89,455 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $3,289
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract number	411385
Policy instance	6
Insurance contract or identification number 411385 Number of Individuals Covered 99 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 Total amount of commissions paid to insurance broker USD $2,291 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 plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided SUPPLEMENTAL LIFE Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $45,824 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $2,291 Amount paid for insurance broker fees 802 Additional information about fees paid to insurance broker ADDITIONAL COMPENSATION PAID
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	TM05967133
Policy instance	2
Insurance contract or identification number TM05967133 Number of Individuals Covered 730 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 Total amount of commissions paid to insurance broker USD $6,847 Total amount of fees paid to insurance company USD $877 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 plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $209,203 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $6,847 Amount paid for insurance broker fees 877 Additional information about fees paid to insurance broker SUPPLEMENTAL AND NON-MONETARY COMPENSATION PAID
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number	00623821
Policy instance	1
Insurance contract or identification number 00623821 Number of Individuals Covered 353 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $80,019 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 plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit Yes Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $2,914,391 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Amount paid for insurance broker fees 80019 Additional information about fees paid to insurance broker INCENTIVE COMPENSATION PAYMENTS BASED ON MEMBERSHIP IN YOUR PLAN OR LUMP SUM AMOUNT
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number	7133851D
Policy instance	7
Insurance contract or identification number 7133851D Number of Individuals Covered 750 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 Total amount of commissions paid to insurance broker USD $3,289 Total amount of fees paid to insurance company USD $0 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 plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit Yes Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $89,455 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $3,289
FIRST UNUM LIFE LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract number	411383
Policy instance	6
Insurance contract or identification number 411383 Number of Individuals Covered 364 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 Total amount of commissions paid to insurance broker USD $8,026 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 plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit Yes Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $129,657 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $8,026 Amount paid for insurance broker fees 2354 Additional information about fees paid to insurance broker ADDITIONAL COMPENSATION PAID
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract number	R0632141
Policy instance	5
Insurance contract or identification number R0632141 Number of Individuals Covered 125 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 Total amount of commissions paid to insurance broker USD $4,249 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 plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided ACCIDENT HOSPITAL, CRITICAL ILLNESS AND VSTD Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $25,973 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $4,249 Amount paid for insurance broker fees 316 Additional information about fees paid to insurance broker ADDITIONAL COMPENSATION
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract number	411385
Policy instance	4
Insurance contract or identification number 411385 Number of Individuals Covered 99 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 Total amount of commissions paid to insurance broker USD $2,291 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 plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided SUPPLEMENTAL LIFE Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $45,824 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $2,291 Amount paid for insurance broker fees 802 Additional information about fees paid to insurance broker ADDITIONAL COMPENSATION PAID
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47029 )
Policy contract number	12082796
Policy instance	3
Insurance contract or identification number 12082796 Number of Individuals Covered 336 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 Total amount of fees paid to insurance company USD $1,205 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 plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit Yes Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $25,573 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Amount paid for insurance broker fees 1205 Additional information about fees paid to insurance broker FFES AND COMMISSIONS PAID
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract number	471078
Policy instance	6
Insurance contract or identification number 471078 Number of Individuals Covered 571 Insurance policy start date 2019-01-01 Insurance policy end date 2020-01-01 Total amount of commissions paid to insurance broker USD $8,090 Total amount of fees paid to insurance company USD $1,538 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 plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit Yes Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $81,801 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $8,090 Amount paid for insurance broker fees 1538 Additional information about fees paid to insurance broker ADDITIONAL COMPENSATION
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	00545965
Policy instance	5
Insurance contract or identification number 00545965 Number of Individuals Covered 275 Insurance policy start date 2019-01-01 Insurance policy end date 2019-12-31 Total amount of commissions paid to insurance broker USD $6,089 Total amount of fees paid to insurance company USD $7,782 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 plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $271,498 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $6,089 Amount paid for insurance broker fees 7782 Additional information about fees paid to insurance broker ADVISOR FEES
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract number	411385
Policy instance	4
Insurance contract or identification number 411385 Number of Individuals Covered 97 Insurance policy start date 2019-01-01 Insurance policy end date 2020-01-01 Total amount of commissions paid to insurance broker USD $2,481 Total amount of fees paid to insurance company USD $868 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 plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit Yes Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $50,489 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $2,481 Amount paid for insurance broker fees 868 Additional information about fees paid to insurance broker ADDITIONAL COMPENSATION
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract number	411383
Policy instance	3
Insurance contract or identification number 411383 Number of Individuals Covered 389 Insurance policy start date 2019-01-01 Insurance policy end date 2020-01-01 Total amount of commissions paid to insurance broker USD $8,882 Total amount of fees paid to insurance company USD $3,162 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 plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit Yes Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit Yes Unemployment Insurance Welfare Benefit No Other welfare benefits provided ACCIDENTAL DEATH AND DISMEMBERMENT Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $162,529 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $8,882 Amount paid for insurance broker fees 3162 Additional information about fees paid to insurance broker ADDITIONAL COMPENSATION
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47029 )
Policy contract number	12082796
Policy instance	2
Insurance contract or identification number 12082796 Number of Individuals Covered 353 Insurance policy start date 2019-01-01 Insurance policy end date 2019-12-31 Total amount of commissions paid to insurance broker USD $1,363 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 plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit Yes Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $29,405 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $1,362
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number	00623821
Policy instance	1
Insurance contract or identification number 00623821 Number of Individuals Covered 354 Insurance policy start date 2019-01-01 Insurance policy end date 2019-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $89,711 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 plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit Yes Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $2,988,972 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Amount paid for insurance broker fees 89711 Additional information about fees paid to insurance broker BENEFIT ADVISOR FEES AND INCENTIVE COMPENSATION PAYMENT FUNDED BY THE INSURER OF $5,928
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	00545965
Policy instance	2
Insurance contract or identification number 00545965 Number of Individuals Covered 275 Insurance policy start date 2019-01-01 Insurance policy end date 2019-12-31 Total amount of commissions paid to insurance broker USD $6,089 Total amount of fees paid to insurance company USD $7,782 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 plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $271,498 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $6,089 Amount paid for insurance broker fees 7782 Additional information about fees paid to insurance broker ADVISOR FEES
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47029 )
Policy contract number	12082796
Policy instance	3
Insurance contract or identification number 12082796 Number of Individuals Covered 353 Insurance policy start date 2019-01-01 Insurance policy end date 2019-12-31 Total amount of commissions paid to insurance broker USD $1,363 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 plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit Yes Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $29,405 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $1,362
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract number	R0632141
Policy instance	4
Insurance contract or identification number R0632141 Number of Individuals Covered 134 Insurance policy start date 2019-01-01 Insurance policy end date 2020-01-01 Total amount of commissions paid to insurance broker USD $4,196 Total amount of fees paid to insurance company USD $340 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 plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided ACCIDENT HOSPITAL, CRITICAL ILLNESS AND VSTD Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $30,311 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $4,196 Amount paid for insurance broker fees 340 Additional information about fees paid to insurance broker ADDITIONAL COMPENSATION
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract number	411385
Policy instance	5
Insurance contract or identification number 411385 Number of Individuals Covered 97 Insurance policy start date 2019-01-01 Insurance policy end date 2020-01-01 Total amount of commissions paid to insurance broker USD $2,481 Total amount of fees paid to insurance company USD $868 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 plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit Yes Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $50,489 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $2,481 Amount paid for insurance broker fees 868 Additional information about fees paid to insurance broker ADDITIONAL COMPENSATION
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract number	411383
Policy instance	6
Insurance contract or identification number 411383 Number of Individuals Covered 389 Insurance policy start date 2019-01-01 Insurance policy end date 2020-01-01 Total amount of commissions paid to insurance broker USD $8,882 Total amount of fees paid to insurance company USD $3,162 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 plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit Yes Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit Yes Unemployment Insurance Welfare Benefit No Other welfare benefits provided ACCIDENTAL DEATH AND DISMEMBERMENT Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $162,529 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $8,882 Amount paid for insurance broker fees 3162 Additional information about fees paid to insurance broker ADDITIONAL COMPENSATION
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract number	471078
Policy instance	7
Insurance contract or identification number 471078 Number of Individuals Covered 571 Insurance policy start date 2019-01-01 Insurance policy end date 2020-01-01 Total amount of commissions paid to insurance broker USD $8,090 Total amount of fees paid to insurance company USD $1,538 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 plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit Yes Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $81,801 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $8,090 Amount paid for insurance broker fees 1538 Additional information about fees paid to insurance broker ADDITIONAL COMPENSATION
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract number	R0632141
Policy instance	7
Insurance contract or identification number R0632141 Number of Individuals Covered 134 Insurance policy start date 2019-01-01 Insurance policy end date 2020-01-01 Total amount of commissions paid to insurance broker USD $4,196 Total amount of fees paid to insurance company USD $340 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 plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided ACCIDENT HOSPITAL, CRITICAL ILLNESS AND VSTD Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $30,311 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $4,196 Amount paid for insurance broker fees 340 Additional information about fees paid to insurance broker ADDITIONAL COMPENSATION
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	005455965
Policy instance	2
Insurance contract or identification number 005455965 Number of Individuals Covered 272 Insurance policy start date 2018-01-01 Insurance policy end date 2018-12-31 Total amount of commissions paid to insurance broker USD $4,954 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 plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $196,262 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $4,954
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number	0865728
Policy instance	1
Insurance contract or identification number 0865728 Number of Individuals Covered 464 Insurance policy start date 2018-01-01 Insurance policy end date 2018-12-31 Total amount of commissions paid to insurance broker USD $90,928 Total amount of fees paid to insurance company USD $11,525 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 plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit Yes Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $3,031,689 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $90,928 Amount paid for insurance broker fees 11525 Additional information about fees paid to insurance broker 2017 PPP ENGAGEMENT CREDIT MEDICAL RETENTION
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47029 )
Policy contract number	12082796
Policy instance	3
Insurance contract or identification number 12082796 Number of Individuals Covered 349 Insurance policy start date 2018-01-01 Insurance policy end date 2018-12-31 Total amount of commissions paid to insurance broker USD $1,331 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 plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit Yes Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $29,457 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $1,331
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract number	471078
Policy instance	4
Insurance contract or identification number 471078 Number of Individuals Covered 661 Insurance policy start date 2018-01-01 Insurance policy end date 2019-01-01 Total amount of commissions paid to insurance broker USD $7,219 Total amount of fees paid to insurance company USD $1,777 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 plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit Yes Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $76,155 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $7,219 Amount paid for insurance broker fees 1777 Additional information about fees paid to insurance broker ADDITIONAL COMPENSATION
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract number	411383
Policy instance	5
Insurance contract or identification number 411383 Number of Individuals Covered 372 Insurance policy start date 2018-01-01 Insurance policy end date 2019-01-01 Total amount of commissions paid to insurance broker USD $8,623 Total amount of fees paid to insurance company USD $2,929 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 plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit Yes Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit Yes Unemployment Insurance Welfare Benefit No Other welfare benefits provided ACCIDENTAL DEATH AND DISMEMBERMENT Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $131,427 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $8,623 Amount paid for insurance broker fees 2929 Additional information about fees paid to insurance broker ADDITIONAL COMPENSATION
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract number	411385
Policy instance	6
Insurance contract or identification number 411385 Number of Individuals Covered 117 Insurance policy start date 2018-01-01 Insurance policy end date 2019-01-01 Total amount of commissions paid to insurance broker USD $1,842 Total amount of fees paid to insurance company USD $629 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 plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided LIFESTYLE LIFE Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $41,109 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $1,842 Amount paid for insurance broker fees 629 Additional information about fees paid to insurance broker ADDITIONAL COMPENSATION
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract number	R0632141
Policy instance	7
Insurance contract or identification number R0632141 Number of Individuals Covered 143 Insurance policy start date 2018-01-01 Insurance policy end date 2019-01-01 Total amount of commissions paid to insurance broker USD $5,183 Total amount of fees paid to insurance company USD $545 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 plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided CRITICAL ILLNESS, CHILD PROTECTION, GROUP ACCIDENT Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $34,548 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $5,183 Amount paid for insurance broker fees 545 Additional information about fees paid to insurance broker ADDITIONAL COMPENSATION
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract number	411384
Policy instance	7
Insurance contract or identification number 411384 Number of Individuals Covered 9 Insurance policy start date 2017-01-01 Insurance policy end date 2018-01-01 Total amount of commissions paid to insurance broker USD $1,188 Total amount of fees paid to insurance company USD $117 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 plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided SELECT LONG TERM DISABILITY Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $7,577 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $1,188 Amount paid for insurance broker fees 117 Additional information about fees paid to insurance broker ADDITIONAL COMPENSATION Insurance broker name HUB INTERNATIONAL NORTHEAST LIMITED
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract number	411385
Policy instance	6
Insurance contract or identification number 411385 Number of Individuals Covered 116 Insurance policy start date 2017-01-01 Insurance policy end date 2018-01-01 Total amount of commissions paid to insurance broker USD $1,875 Total amount of fees paid to insurance company USD $551 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 plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided LIFESTYLE LIFE Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $39,138 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $1,875 Amount paid for insurance broker fees 551 Additional information about fees paid to insurance broker ADDITIONAL COMPENSATION Insurance broker name HUB INTERNATIONAL NORTHEAST LIMITED
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract number	411383
Policy instance	5
Insurance contract or identification number 411383 Number of Individuals Covered 359 Insurance policy start date 2017-01-01 Insurance policy end date 2018-01-01 Total amount of commissions paid to insurance broker USD $6,598 Total amount of fees paid to insurance company USD $1,389 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 plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit Yes Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit Yes Unemployment Insurance Welfare Benefit No Other welfare benefits provided ACCIDENTAL DEATH AND DISMEMBERMENT Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $100,859 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $6,598 Amount paid for insurance broker fees 1389 Additional information about fees paid to insurance broker ADDITIONAL COMPENSATION Insurance broker name HUB INTERNATIONAL NORTHEAST LIMITED
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract number	471078
Policy instance	4
Insurance contract or identification number 471078 Number of Individuals Covered 619 Insurance policy start date 2017-01-01 Insurance policy end date 2018-01-01 Total amount of commissions paid to insurance broker USD $3,998 Total amount of fees paid to insurance company USD $1,438 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 plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit Yes Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $39,333 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $3,998 Amount paid for insurance broker fees 1438 Additional information about fees paid to insurance broker ADDITIONAL COMPENSATION Insurance broker name HUB INTERNATIONAL NORTHEAST LIMITED
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47029 )
Policy contract number	12082796
Policy instance	3
Insurance contract or identification number 12082796 Number of Individuals Covered 362 Insurance policy start date 2017-01-01 Insurance policy end date 2017-12-31 Total amount of commissions paid to insurance broker USD $1,319 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 plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit Yes Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $26,945 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $1,319 Insurance broker name HUB INTERNATIONAL NORTHEAST LINITED
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	TM05913692
Policy instance	2
Insurance contract or identification number TM05913692 Number of Individuals Covered 393 Insurance policy start date 2017-01-01 Insurance policy end date 2017-12-31 Total amount of commissions paid to insurance broker USD $10,261 Total amount of fees paid to insurance company USD $7,966 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 plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $234,113 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $10,261 Amount paid for insurance broker fees 7996 Additional information about fees paid to insurance broker SUPPLEMENTAL COMPENSATION, NON-MONETARY COMPENSATION AND ADMINISTRATIVE FEES Insurance broker organization code? 3 Insurance broker name HUB INTERNATIONAL NORTHEAST LTD
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number	0865728
Policy instance	1
Insurance contract or identification number 0865728 Number of Individuals Covered 472 Insurance policy start date 2017-01-01 Insurance policy end date 2017-12-31 Total amount of commissions paid to insurance broker USD $91,020 Total amount of fees paid to insurance company USD $12,225 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 plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit Yes Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $3,091,629 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $91,020 Amount paid for insurance broker fees 12225 Additional information about fees paid to insurance broker 2016-2017 PPP INCENTIVE MEDICAL Insurance broker name HUB INTERNATIONAL NORTHEAST LIMITED
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract number	ABY007698
Policy instance	7
Insurance contract or identification number ABY007698 Number of Individuals Covered 361 Insurance policy start date 2015-06-24 Insurance policy end date 2016-06-24 Total amount of fees paid to insurance company USD $15 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided ACCIDENTAL DEATH Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Amount paid for insurance broker fees 15 Additional information about fees paid to insurance broker OVERRIDE Insurance broker organization code? 3 Insurance broker name HUB INTERNATIONAL NORTHEAST LIMITED
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract number	FLY960076
Policy instance	6
Insurance contract or identification number FLY960076 Number of Individuals Covered 391 Insurance policy start date 2015-01-01 Insurance policy end date 2015-12-31 Total amount of commissions paid to insurance broker USD $4,536 Total amount of fees paid to insurance company USD $1,749 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $90,728 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $4,536 Amount paid for insurance broker fees 1749 Additional information about fees paid to insurance broker OVERRIDE Insurance broker organization code? 3 Insurance broker name HUB INTERNATIONAL NORTHEAST LIMITED
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	TM05913692
Policy instance	2
Insurance contract or identification number TM05913692 Number of Individuals Covered 457 Insurance policy start date 2015-01-01 Insurance policy end date 2015-12-31 Total amount of commissions paid to insurance broker USD $6,373 Total amount of fees paid to insurance company USD $11,772 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $209,651 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $6,373 Amount paid for insurance broker fees 11772 Additional information about fees paid to insurance broker SUPPLEMENTAL (11,520) AND NON-MONETARY COMPENSATION (252) Insurance broker organization code? 3 Insurance broker name HUB INTERNATIONAL NORTHEAST LIMITED
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract number	NYDO10184
Policy instance	5
Insurance contract or identification number NYDO10184 Number of Individuals Covered 653 Insurance policy start date 2015-01-01 Insurance policy end date 2015-12-31 Total amount of commissions paid to insurance broker USD $5,807 Total amount of fees paid to insurance company USD $838 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit Yes Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided PREGNANCY Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $46,453 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $5,807 Amount paid for insurance broker fees 838 Additional information about fees paid to insurance broker OVERRIDE Insurance broker organization code? 3 Insurance broker name HUB INTERNATIONAL NORTHEAST LIMITED
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract number	NYK960009
Policy instance	4
Insurance contract or identification number NYK960009 Number of Individuals Covered 357 Insurance policy start date 2015-01-01 Insurance policy end date 2015-12-31 Total amount of commissions paid to insurance broker USD $3,516 Total amount of fees paid to insurance company USD $667 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit Yes Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $35,313 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $3,516 Amount paid for insurance broker fees 667 Additional information about fees paid to insurance broker OVERRIDE Insurance broker organization code? 3 Insurance broker name HUB INTERNATIONAL NORTHEAST LIMITED
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number	0865728
Policy instance	1
Insurance contract or identification number 0865728 Number of Individuals Covered 533 Insurance policy start date 2015-01-01 Insurance policy end date 2015-12-31 Total amount of commissions paid to insurance broker USD $93,017 Total amount of fees paid to insurance company USD $14,263 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit Yes Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $3,114,656 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $93,017 Amount paid for insurance broker fees 14263 Additional information about fees paid to insurance broker 2014/2015 PPP ENGAGEMENT CREDIT Insurance broker organization code? 3 Insurance broker name HUB INTERNATIONAL NORTHEAST LIMITED
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47029 )
Policy contract number	12082796
Policy instance	3
Insurance contract or identification number 12082796 Number of Individuals Covered 362 Insurance policy start date 2015-01-01 Insurance policy end date 2015-12-31 Total amount of commissions paid to insurance broker USD $1,312 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit Yes Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $26,857 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $1,312 Insurance broker organization code? 3 Insurance broker name HUB INTERNATIONAL NORTHEAST LIMITED
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract number	FLY960076
Policy instance	6
Insurance contract or identification number FLY960076 Number of Individuals Covered 362 Insurance policy start date 2014-01-01 Insurance policy end date 2014-12-31 Total amount of commissions paid to insurance broker USD $4,364 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit Yes Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $87,288 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $4,364 Insurance broker organization code? 3 Insurance broker name HUB INTERNATIONAL NORTHEAST LIMITED
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract number	NYD010184
Policy instance	5
Insurance contract or identification number NYD010184 Number of Individuals Covered 582 Insurance policy start date 2014-01-01 Insurance policy end date 2014-12-31 Total amount of commissions paid to insurance broker USD $5,264 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit Yes Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $42,111 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $5,264 Insurance broker organization code? 3 Insurance broker name HUB INTERNATIONAL NORTHEAST LIMITED
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract number	NYK960009
Policy instance	4
Insurance contract or identification number NYK960009 Number of Individuals Covered 332 Insurance policy start date 2014-01-01 Insurance policy end date 2014-12-31 Total amount of commissions paid to insurance broker USD $3,409 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit Yes Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $33,180 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $3,409 Insurance broker organization code? 3 Insurance broker name HUB INTERNATIONAL NORTHEAST LIMITED
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47029 )
Policy contract number	12082796
Policy instance	3
Insurance contract or identification number 12082796 Number of Individuals Covered 367 Insurance policy start date 2014-01-01 Insurance policy end date 2014-12-31 Total amount of commissions paid to insurance broker USD $1,283 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit Yes Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $25,905 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $1,283 Insurance broker organization code? 3 Insurance broker name HUB INTERNATIONAL NORTHEAST LTD
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	TM05913692
Policy instance	2
Insurance contract or identification number TM05913692 Number of Individuals Covered 457 Insurance policy start date 2014-01-01 Insurance policy end date 2014-12-31 Total amount of commissions paid to insurance broker USD $5,659 Total amount of fees paid to insurance company USD $11,602 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $198,448 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $5,659 Amount paid for insurance broker fees 11602 Additional information about fees paid to insurance broker SUPPLEMENTARY COMPENSATION 11,557 NON-MONETARY COMPENSATION 45 Insurance broker organization code? 3 Insurance broker name HUB INTERNATIONAL NORTHEAST LTD
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number	0865728
Policy instance	1
Insurance contract or identification number 0865728 Number of Individuals Covered 533 Insurance policy start date 2014-01-01 Insurance policy end date 2014-12-31 Total amount of commissions paid to insurance broker USD $78,872 Total amount of fees paid to insurance company USD $9,654 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit Yes Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $2,876,438 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $78,872 Amount paid for insurance broker fees 9654 Additional information about fees paid to insurance broker NE 4Q-JAN MEDICAL BONUS Insurance broker organization code? 3 Insurance broker name HUB INTERNATIONAL NORTHEAST LIMITED
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract number	YOK960090
Policy instance	7
Insurance contract or identification number YOK960090 Number of Individuals Covered 362 Insurance policy start date 2013-12-01 Insurance policy end date 2014-12-01 Total amount of commissions paid to insurance broker USD $283 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided ACCIDENTAL DEATH Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $5,661 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $283 Insurance broker organization code? 3 Insurance broker name HUB INTERNATIONAL NORTHEAST LIMITED
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number	PH8066
Policy instance	1
Insurance contract or identification number PH8066 Number of Individuals Covered 489 Insurance policy start date 2013-01-01 Insurance policy end date 2013-12-31 Total amount of commissions paid to insurance broker USD $95,609 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit Yes Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $2,917,317 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $95,609 Additional information about fees paid to insurance broker BONUS ADMINISTRATIVE SERVICES NON-MONETARY PAYMENT Insurance broker organization code? 3 Insurance broker name HUB INTERNATIONAL NORTHEAST
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	00474777
Policy instance	2
Insurance contract or identification number 00474777 Number of Individuals Covered 264 Insurance policy start date 2013-01-01 Insurance policy end date 2013-12-31 Total amount of commissions paid to insurance broker USD $5,105 Total amount of fees paid to insurance company USD $8,684 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $207,007 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $5,105 Amount paid for insurance broker fees 8684 Insurance broker name HUB INTERNATIONAL NE LTD
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47029 )
Policy contract number	12082796
Policy instance	3
Insurance contract or identification number 12082796 Number of Individuals Covered 336 Insurance policy start date 2013-01-01 Insurance policy end date 2013-12-31 Total amount of commissions paid to insurance broker USD $1,278 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit Yes Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $25,747 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $1,278 Insurance broker name HUB INTERNATIONAL NORTHEAST LIMITED
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract number	NYK960009
Policy instance	4
Insurance contract or identification number NYK960009 Number of Individuals Covered 303 Insurance policy start date 2013-01-01 Insurance policy end date 2013-12-31 Total amount of commissions paid to insurance broker USD $3,406 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit Yes Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $33,126 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $3,406 Insurance broker name HUB INTERNATIONAL NORTHEAST
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract number	FLY960076
Policy instance	6
Insurance contract or identification number FLY960076 Number of Individuals Covered 365 Insurance policy start date 2012-12-01 Insurance policy end date 2013-12-01 Total amount of commissions paid to insurance broker USD $4,472 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit Yes Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $89,443 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $4,472 Insurance broker name HUB INTERNATIONAL NORTHEAST
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract number	YOK960090
Policy instance	7
Insurance contract or identification number YOK960090 Number of Individuals Covered 335 Insurance policy start date 2012-12-01 Insurance policy end date 2013-12-01 Total amount of commissions paid to insurance broker USD $291 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided ACCIDENTAL DEATH Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $5,815 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $291 Insurance broker name HUB INTERNATIONAL NORTHEAST
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract number	ABY007698
Policy instance	8
Insurance contract or identification number ABY007698 Number of Individuals Covered 335 Insurance policy start date 2012-06-24 Insurance policy end date 2013-06-24 Total amount of commissions paid to insurance broker USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided ACCIDENTAL DEATH (BUSINESS TRAVEL) Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $0 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract number	NYD010184
Policy instance	5
Insurance contract or identification number NYD010184 Number of Individuals Covered 1555 Insurance policy start date 2013-01-01 Insurance policy end date 2013-12-31 Total amount of commissions paid to insurance broker USD $5,602 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit Yes Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $44,819 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $5,602 Insurance broker name HUB INTERNATIONAL NORTHEAST
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	00474777
Policy instance	2
Insurance contract or identification number 00474777 Number of Individuals Covered 287 Insurance policy start date 2012-01-12 Insurance policy end date 2012-12-31 Total amount of commissions paid to insurance broker USD $4,717 Dental Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $181,141 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $4,717 Insurance broker name HUB INTERNATIONAL NE LTD
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47029 )
Policy contract number	12082796
Policy instance	3
Insurance contract or identification number 12082796 Number of Individuals Covered 354 Insurance policy start date 2012-01-01 Insurance policy end date 2012-12-31 Total amount of commissions paid to insurance broker USD $1,312 Vision Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $26,882 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Amount paid for insurance broker fees 1312 Insurance broker name HUB INTERNATIONAL NORTHEAST LIMITED
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract number	NYK960009
Policy instance	4
Insurance contract or identification number NYK960009 Number of Individuals Covered 320 Insurance policy start date 2012-01-01 Insurance policy end date 2012-12-31 Total amount of commissions paid to insurance broker USD $3,185 Long Term Disability Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $33,474 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $3,185 Insurance broker name HUB INTERNATIONAL NORTHEAST LTD.
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract number	NYD010184
Policy instance	5
Insurance contract or identification number NYD010184 Number of Individuals Covered 582 Insurance policy start date 2012-01-01 Insurance policy end date 2012-12-31 Total amount of commissions paid to insurance broker USD $4,592 Temporary Disability Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $36,739 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $4,592 Insurance broker name HUB INTERNATIONAL NORTHEAST LTD.
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract number	FLY960076
Policy instance	6
Insurance contract or identification number FLY960076 Number of Individuals Covered 377 Insurance policy start date 2011-12-01 Insurance policy end date 2012-12-01 Total amount of commissions paid to insurance broker USD $4,772 Life Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $95,433 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $4,772 Additional information about fees paid to insurance broker SALES AND SERVICE Insurance broker name HUB INTERNATIONAL NORTHEAST LTD.
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract number	ABY007698
Policy instance	8
Insurance contract or identification number ABY007698 Number of Individuals Covered 353 Insurance policy start date 2011-06-24 Insurance policy end date 2012-06-24 Total amount of commissions paid to insurance broker USD $722 Other welfare benefits provided ACCIDENTAL DEATH (BUSINESS TRAVEL) Welfare Benefit Premiums Paid to Carrier USD $4,814 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $722 Insurance broker name HUB INTERNATIONAL NORTHEAST LTD.
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract number	YOK960090
Policy instance	7
Insurance contract or identification number YOK960090 Number of Individuals Covered 353 Insurance policy start date 2011-12-01 Insurance policy end date 2012-12-01 Total amount of commissions paid to insurance broker USD $332 Other welfare benefits provided ACCIDENTAL DEATH Welfare Benefit Premiums Paid to Carrier USD $6,646 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $332 Insurance broker name HUB INTERNATIONAL NORTHEAST LTD.
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number	PH8066
Policy instance	1
Insurance contract or identification number PH8066 Number of Individuals Covered 591 Insurance policy start date 2012-01-01 Insurance policy end date 2012-12-31 Total amount of commissions paid to insurance broker USD $97,790 Health Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $3,280,047 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $97,790 Insurance broker name HUB INTERNATIONAL NORTHEAST
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract number	NYK960009
Policy instance	4
Insurance contract or identification number NYK960009 Number of Individuals Covered 295 Insurance policy start date 2011-01-01 Insurance policy end date 2011-12-31 Total amount of commissions paid to insurance broker USD $3,350 Total amount of fees paid to insurance company USD $0 Long Term Disability Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $30,236 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract number	FLY960076
Policy instance	6
Insurance contract or identification number FLY960076 Number of Individuals Covered 373 Insurance policy start date 2010-12-01 Insurance policy end date 2011-12-01 Total amount of commissions paid to insurance broker USD $5,452 Total amount of fees paid to insurance company USD $0 Life Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $109,036 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract number	ABY007698
Policy instance	8
Insurance contract or identification number ABY007698 Number of Individuals Covered 327 Insurance policy start date 2011-06-24 Insurance policy end date 2012-06-24 Total amount of commissions paid to insurance broker USD $722 Total amount of fees paid to insurance company USD $0 Other welfare benefits provided ACCIDENTAL DEATH Welfare Benefit Premiums Paid to Carrier USD $4,814 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract number	YDK960090
Policy instance	7
Insurance contract or identification number YDK960090 Number of Individuals Covered 327 Insurance policy start date 2010-12-01 Insurance policy end date 2011-12-01 Total amount of commissions paid to insurance broker USD $395 Total amount of fees paid to insurance company USD $0 Other welfare benefits provided ACCIDENTAL DEATH Welfare Benefit Premiums Paid to Carrier USD $7,906 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract number	NYD010184
Policy instance	5
Insurance contract or identification number NYD010184 Number of Individuals Covered 696 Insurance policy start date 2011-01-01 Insurance policy end date 2011-12-31 Total amount of commissions paid to insurance broker USD $7,274 Total amount of fees paid to insurance company USD $0 Temporary Disability Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $58,193 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 number	PH8066
Policy instance	1
Insurance contract or identification number PH8066 Number of Individuals Covered 588 Insurance policy start date 2011-01-01 Insurance policy end date 2011-12-31 Total amount of commissions paid to insurance broker USD $99,770 Total amount of fees paid to insurance company USD $0 Health Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $3,235,315 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: 47029 )
Policy contract number	12082796
Policy instance	3
Insurance contract or identification number 12082796 Number of Individuals Covered 346 Insurance policy start date 2011-01-01 Insurance policy end date 2011-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $1,418 Vision Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $30,524 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 )
Policy contract number	3332815
Policy instance	2
Insurance contract or identification number 3332815 Number of Individuals Covered 286 Insurance policy start date 2011-01-01 Insurance policy end date 2011-12-31 Total amount of commissions paid to insurance broker USD $7,228 Total amount of fees paid to insurance company USD $0 Dental Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $226,287 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 )
Policy contract number	3332815
Policy instance	1
Insurance contract or identification number 3332815 Number of Individuals Covered 423 Insurance policy start date 2010-01-01 Insurance policy end date 2010-12-31 Total amount of commissions paid to insurance broker USD $117,704 Total amount of fees paid to insurance company USD $0 Health Insurance Welfare Benefit Yes Dental Insurance Welfare Benefit Yes Welfare Benefit Premiums Paid to Carrier USD $3,926,229 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract number	NYK960009
Policy instance	2
Insurance contract or identification number NYK960009 Number of Individuals Covered 405 Insurance policy start date 2010-01-01 Insurance policy end date 2010-12-31 Total amount of commissions paid to insurance broker USD $2,519 Long Term Disability Insurance Welfare Benefit Yes 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: 47029 )
Policy contract number	12082796
Policy instance	3
Insurance contract or identification number 12082796 Number of Individuals Covered 434 Insurance policy start date 2010-01-01 Insurance policy end date 2010-12-31 Total amount of commissions paid to insurance broker USD $1,532 Vision Insurance Welfare Benefit Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract number	NYD010184
Policy instance	4
Insurance contract or identification number NYD010184 Number of Individuals Covered 434 Insurance policy start date 2010-01-01 Insurance policy end date 2010-12-31 Total amount of commissions paid to insurance broker USD $3,308 Temporary Disability Insurance Welfare Benefit Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract number	YDK960090
Policy instance	5
Insurance contract or identification number YDK960090 Number of Individuals Covered 434 Insurance policy start date 2009-12-01 Insurance policy end date 2010-12-01 Total amount of commissions paid to insurance broker USD $415 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract number	FLY960076
Policy instance	6
Insurance contract or identification number FLY960076 Number of Individuals Covered 601 Insurance policy start date 2009-12-01 Insurance policy end date 2010-12-01 Total amount of commissions paid to insurance broker USD $5,240 Life Insurance Welfare Benefit Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No

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• EMPLOYEE BENEFIT PLAN OF 1992 INTERNATIONAL LTD. DBA/ SUTTON ASSOCIATES, I [EIN = 113004076]
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• EMPLOYEE BENEFIT PLAN OF ALCOHOL & DRUG ABUSE SERVICES, INC. [EIN = 251488805]
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• EMPLOYEE BENEFIT PLAN OF HEALTHCARE PARTNERS OF SOUTH CAROLINA, INC. [EIN = 570679807]
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• EMPLOYEE BENEFIT PLAN OF UCPC BEHAVIORAL HEALTHCARE, INC. [EIN = 221500557]
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• EMPLOYEE BENEFIT PLAN OF CAMPBELL LODGE BOYS HOME [EIN = 610570965]
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• EMPLOYEE BENEFIT PLAN OF UNITED WAY OF SANTA BARBARA COUNTY, INC. [EIN = 951641968]
• EMPLOYEE BENEFIT PLAN OF MENTAL HEALTH AMERICA OF GREATER TARRANT COUNTY, I [EIN = 750983834]
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• EMPLOYEE BENEFIT PLAN OF MONROE HARDING, INC. [EIN = 620476670]
• EMPLOYEE BENEFIT PLAN OF SECURITY BICYCLE ACCESSORIES, INC [EIN = 135588438]
• EMPLOYEE BENEFIT PLAN OF PASSAIC COUNTY COURT APPOINTED SPECIAL ADVOCATES ( [EIN = 208456398]
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• EMPLOYEE BENEFIT PLAN OF NEW START DEVELOPMENT, LLC [EIN = 263955966]
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• EMPLOYEE BENEFIT PLAN OF BELFORD PATRICK, INC. [EIN = 330602976]
• EMPLOYEE BENEFIT PLAN OF THE RACQUET AND TENNIS CLUB, INC. [EIN = 131194010]
• EMPLOYEE BENEFIT PLAN OF LIFE CONNECTION OF OHIO [EIN = 311285637]
• EMPLOYEE BENEFIT PLAN OF ALASKA SUMMIT ENTERPRISE, INC. [EIN = 470924715]
• EMPLOYEE BENEFIT PLAN OF BOWER'S HEALTHCARE, INC. [EIN = 060924419]
• EMPLOYEE BENEFIT PLAN OF ILAN D. BORNSTEIN, M.D.,LLC [EIN = 205189556]
• EMPLOYEE BENEFIT PLAN OF COMMUNITY ACTION COMMITTEE OF CAPE COD & ISLANDS, [EIN = 042396835]
• EMPLOYEE BENEFIT PLAN OF PARTNERS FOR KIDS AND FAMILIES, INC. [EIN = 223764656]
• EMPLOYEE BENEFIT PLAN OF MILWAUKEE URBAN LEAGUE MILWAUKEE URBAN LEAGUE [EIN = 390826861]
• EMPLOYEE BENEFIT PLAN OF THE ARC OF ST. MARTIN, INC. [EIN = 720693091]
• EMPLOYEE BENEFIT PLAN OF UNITED WAY OF CENTRAL GEORGIA, INC. [EIN = 580639811]
• EMPLOYEE BENEFIT PLAN OF ALDRICH RENT-ALL, INC. [EIN = 592860174]
• EMPLOYEE BENEFIT PLAN OF STEVEN R. JENKINS CO., INC. [EIN = 351499425]
• EMPLOYEE BENEFIT PLAN OF PROFESSIONAL IMAGE, INC. [EIN = 990184341]
• EMPLOYEE BENEFIT PLAN OF THE AULSON CO., INC. [EIN = 043107307]
• EMPLOYEE BENEFIT PLAN OF SELECT MILWAUKEE, INC. [EIN = 391793410]
• EMPLOYEE BENEFIT PLAN OF LMI INSURANCE COMPANY [EIN = 340368340]
• EMPLOYEE BENEFIT PLAN OF ARC OF HAMILTON COUNTY, INC. [EIN = 237009946]
• EMPLOYEE BENEFIT PLAN OF ST. MARKS BROOKLYN ASSOCIATES L. L. C. DBA CROWN HEIGHTS CENTER FOR NURS [EIN = 460772413]
• EMPLOYEE BENEFIT PLAN OF TIMMERMANN INSURANCE SERVICES, INC. [EIN = 560774883]
• EMPLOYEE BENEFIT PLAN OF UNITED WAY OF RUTHERFORD COUNTY,INC. [EIN = 561030597]
• EMPLOYEE BENEFIT PLAN OF THE LAW OFFICES OF ROMEO R. PEREZ,P.C. [EIN = 202123712]
• EMPLOYEE BENEFIT PLAN OF IMAGINE A CHILD'S CAPACITY, INC. [EIN = 421580057]
• EMPLOYEE BENEFIT PLAN TAX DEFERRED ANNUITY [EIN = 370661504]
• EMPLOYEE BENEFIT PLAN OF SOUTHWEST COMMUNITY SERVICES, INC. [EIN = 237136028]
• EMPLOYEE BENEFIT 401(K) PROFIT SHARING PLAN FOR THE EMPLOYEES OF ALSTON WILKES SOCIETY [EIN = 570477907]
• EMPLOYEE BENEFITS PLAN OF NILES HOME FOR CHILDREN [EIN = 440565392]
• EMPLOYEE BENEFIT PLAN OF IONIA R WHIPPER HOME, INC. [EIN = 530227958]
• EMPLOYEE BENEFITS PLAN OF THE COMMUNITY CORPORATIO [EIN = 340714598]
• EMPLOYEE BENEFIT PLAN OF GREATER SACRAMENTO URBAN LEAGUE [EIN = 941686314]
• EMPLOYEE BENEFIT PLAN OF THE PEOPLE CONNECTION, INC. [EIN = 942938415]
• EMPLOYEE BENEFIT PLAN OF CAMDEN AHEC, INC. [EIN = 222358827]
• EMPLOYEE BENEFITS PLAN OF ASHTABULA COUNTY PUBLIC DEFENDER, INC. [EIN = 341770634]
• EMPLOYEE BENEFIT PLAN OF RISK AND INSURANCE BROKERAGE CORPORATION [EIN = 593031297]
• EMPLOYEE BENEFIT PLAN OF ROSALIE MANOR COMMUNITY AND FAMILY SERVICES, INC. [EIN = 391154354]
• EMPLOYEE BENEFIT PLAN OF THE PENNSYLVANIA PRISON SOCIETY [EIN = 231352267]
• EMPLOYEE BENEFIT PLAN OF TECHMATES GROUP, LLC [EIN = 464610913]
• EMPLOYEE BENEFITS PLAN OF UNITED WAY OF LUBBOCK IN [EIN = 750961812]
• EMPLOYEE BENEFIT PLAN OF JEWISH COMMUNITY RELATIONS COUNCIL [EIN = 205631988]
• EMPLOYEE BENEFIT PLAN OF FARM PUMP AND IRRIGATION COMPANY, INC. [EIN = 953868044]
• EMPLOYEE BENEFIT PLAN OF THE FRANCES CLARK CENTER FOR KEYBOARD PEDAGOGY, I [EIN = 221843506]
• EMPLOYEE BENEFIT PLAN OF RESORT HOLDINGS LLC [EIN = 010566098]
• EMPLOYEE BENEFIT PLAN OF M.Y.S.A. - MASSACHUSETTS YOUTH SOCCER ASSOCIATION [EIN = 042627953]
• EMPLOYEE BENEFIT PLAN OF AVIATION DEVELOPMENT COUNCIL [EIN = 112597513]
• EMPLOYEE BENEFIT PLAN OF AIRPORT FOUNDATION MSP [EIN = 364088129]
• EMPLOYEE BENEFIT PLAN OF THE ARC OF SOUTHSIDE [EIN = 540675097]
• EMPLOYEE BENEFIT PLAN OF ARRIBA JUNTOS [EIN = 941663434]
• EMPLOYEE BENEFIT PLAN OF UNITED WAY OF THE COLUMBIA-WILLAMETTE [EIN = 930582124]
• EMPLOYEE BENEFIT PLAN OF QCI NURSE SPECIALISTS, INC. [EIN = 383375662]
• EMPLOYEE BENEFIT PLAN OF BMC METALWORKS, LLC [EIN = 270608329]
• EMPLOYEE BENEFIT PLAN OF VICTIMS INFORMATION BUREAU OF SUFFOLK [EIN = 112411984]
• EMPLOYEE BENEFIT PLAN OF PICKERSGILL, INC. [EIN = 520591530]
• EMPLOYEE BENEFIT PLAN OF THE O'DONNELL GROUP, INC. [EIN = 330418874]
• EMPLOYEE BENEFIT PLAN OF COMMUNITY NETWORKS, INC. [EIN = 550662121]
• EMPLOYEE BENEFIT PLAN OF ETA IMPORT AND EXPORT, LTD. [EIN = 112911842]
• EMPLOYEE BENEFIT PLAN OF A. S. R. ELECTRICAL CONTRACTING, INC. [EIN = 113129921]
• EMPLOYEE BENEFIT PLAN OF VITALISTIC THERAPEUTIC CENTER, INC [EIN = 231875409]
• EMPLOYEE BENEFIT PLAN OF CHILD GUIDANCE CENTER OF SOUTHERN CONNECTICUT, INC [EIN = 060712058]
• EMPLOYEE BENEFIT PLAN OF UNITED WAY OF THE VIRGINIA PENINSULA [EIN = 540535602]
• EMPLOYEE BENEFIT PLAN OF ABBOTT HOUSE, INC. [EIN = 460229822]
• EMPLOYEE BENEFIT PLAN OF GIBRALTAR GROUP, INC. [EIN = 751662287]
• EMPLOYEE BENEFIT PLAN OF THE ALLIANCE GROUP LLC [EIN = 113345242]
• EMPLOYEE BENEFIT PLAN OF FLORIDA AERO PRECISION, INC. [EIN = 592112908]
• EMPLOYEE BENEFIT PLAN OF THE NORTH FLORIDA CENTER FOR EQUALJUSTICE, INC. [EIN = 260181144]
• EMPLOYEE BENEFIT PLAN OF JUNEAU CONVENTION & VISITORS BUREAU [EIN = 920109696]
• EMPLOYEE BENEFIT PLAN OF THE CENTER FOR INDEPENDENCE, INC. [EIN = 591492617]
• EMPLOYEE BENEFIT PLAN OF E. E. ROBBINS, LLC [EIN = 911998697]
• EMPLOYEE BENEFIT PLAN OF SUPERIOR ELECTRIC SUPPLY COMPANY [EIN = 340204190]
• EMPLOYEE BENEFIT PLAN OF COMMUNITY CARE CONNECTIONS, INC. [EIN = 251211863]
• EMPLOYEE BENEFITS PLAN OF THE UNITED WAY OF LACKAWANNA COUNTY [EIN = 240824164]
• EMPLOYEE BENEFIT PLAN OF MONTGOMERY COUNTY COLLABORATION COUNCIL FOR CHILDR [EIN = 141904589]
• EMPLOYEE BENEFIT PLAN OF COUNCIL OF INTERNATIONAL PROGRAMS USA [EIN = 340929221]
• EMPLOYEE BENEFIT PLAN OF CHAMBER OF COMMERCE OF WAYNE COUNTY, INC. [EIN = 560172525]
• EMPLOYEE BENEFIT PLAN OF OLD WESTBURY GARDENS, INC. [EIN = 111902968]
• EMPLOYEE BENEFIT PLAN OF ACORD COMPANIES [EIN = 731095633]
• EMPLOYEE BENEFIT PLAN OF PRO CAREERS, INC. [EIN = 550704556]
• EMPLOYEE BENEFIT PLAN OF ROSS COUNTY COMMUNITY ACTION COMMISSION, INC. [EIN = 316059908]
• EMPLOYEE BENEFIT PLAN OF ACTIVE FEED COMPANY [EIN = 383150105]
• EMPLOYEE BENEFIT PLAN OF AVON PARK COMMUNITY CHILD DEVELOPMENT CENTER [EIN = 510182725]
• EMPLOYEE BENEFIT PLAN OF UNITED WAY OF ASHEVILLE AND BUNCOMBE COUNTY, INC. [EIN = 560576157]
• EMPLOYEE BENEFIT PLAN OF UNITED WAY OF THE MID-SOUTH [EIN = 561010742]
• EMPLOYEE BENEFIT PLAN OF YSLETA DEL SUR PUEBLO [EIN = 741851338]
• EMPLOYEE BENEFIT PLAN OF WASTE-AID SYSTEMS, INC. [EIN = 593455654]
• EMPLOYEE BENEFIT PLAN OF THE RACQUET AND TENNIS CLUB, INC. [EIN = 131194010]
• EMPLOYEE BENEFIT PLAN OF HEARTLAND COMMUNITY ACTION AGENCY,INC. [EIN = 410904860]
• EMPLOYEE BENEFIT PLAN OF AREA AGENCY ON AGING OF CENTRAL FLORIDA, INC. D/B [EIN = 593144723]
• EMPLOYEE BENEFIT PLAN OF LANGLEY WIRE CLOTH PRODUCTS, INC. [EIN = 621325695]
• EMPLOYEE BENEFIT PLAN OF FOOTHILLS BEHAVIORAL HEALTH PARTNERS, LLC [EIN = 263511032]
• EMPLOYEE BENEFIT PLAN OF TRANSIT FOR LIVABLE COMMUNITIES [EIN = 411833066]
• EMPLOYEE BENEFIT PLAN OF BURNS GLASS SERVICES, LTD. [EIN = 161191108]
• EMPLOYEE BENEFIT PLAN OF JACKSON'S INTERNATIONAL AUCTIONEERS & APPRAISERS [EIN = 421407002]
• EMPLOYEE BENEFIT PLAN OF THE JM FOUNDATION [EIN = 136068340]
• EMPLOYEE BENEFIT PLAN OF FROMI USA CORP. [EIN = 208938829]
• EMPLOYEE BENEFIT PLAN OF CAPITAL AREA AGENCY ON AGING - DISTRICT II, INC. [EIN = 727038045]
• EMPLOYEE BENEFIT PLAN OF OVERHEAD DOOR COMPANY OF RALEIGH, INC. [EIN = 560634491]
• EMPLOYEE BENEFIT PLAN OF WALTON OPTIONS FOR INDEPENDENT LIVING, INC. [EIN = 582132383]
• EMPLOYEE BENEFIT PLAN OF LOUISVILLE URBAN LEAGUE [EIN = 610444771]
• EMPLOYEE BENEFIT PLAN OF LINES UNLIMITED, INC. [EIN = 561301391]
• EMPLOYEE BENEFIT PLAN OF PURITY PRODUCTS, INC. [EIN = 940786020]
• EMPLOYEE BENEFIT PLAN OF THE LEAGUE OF WOMEN VOTERS OF THE UNITED STATES [EIN = 530115655]
• EMPLOYEE BENEFIT PLAN OF GIRL SCOUTS OF SOUTHEAST FLORIDA, INC. [EIN = 590657327]
• EMPLOYEE BENEFIT PLAN OF UNITED WAY ASSOCIATION OF SOUTH CAROLINA, INC. [EIN = 570515275]
• EMPLOYEE BENEFIT PLAN OF WAIANAE COAST COMMUNITY MENTAL HEALTH CENTER, INC [EIN = 990256258]
• EMPLOYEE BENEFIT PLAN OF PELLHAM-PHILLIPS ARCHITECTS AND ENGINEERS, INC. [EIN = 431175080]
• EMPLOYEE BENEFIT PLAN OF CENTRAL VIRGINIA LEGAL AID SOCIETY [EIN = 540900644]
• EMPLOYEE BENEFIT PLAN OF PACIFIC ELECTRICAL SALES AGENCY, INC. [EIN = 990116894]
• EMPLOYEE BENEFIT PLAN OF HAWAI I ALLIANCE OF NONPROFIT ORGANIZATIONS [EIN = 990073497]
• EMPLOYEE BENEFIT PLAN OF 21 PLUS, INC. [EIN = 222286760]
• EMPLOYEE BENEFIT PLAN OF NORTHWEST ONCOLOGY, P.C. [EIN = 300200047]
• EMPLOYEE BENEFIT PLAN OF SOUTHSIDE LEARNING & DEVELOPMENT CENTER [EIN = 314379811]
• EMPLOYEE BENEFIT PLAN OF INTERSTATE INSURANCE SERVICES GROUP, INC. [EIN = 593235163]
• EMPLOYEE BENEFIT PLAN OF LIFEWELL BEHAVIORAL WELLNESS [EIN = 860292390]
• EMPLOYEE BENEFIT PLAN OF PORTLAND FISH EXCHANGE [EIN = 222689746]
• EMPLOYEE BENEFIT PLAN FOR EMPLOYEES OF FALCON SUPPLY CO., INC. [EIN = 222252994]
• EMPLOYEE BENEFIT PLAN OF BOETTCHER SUPPLY INC. [EIN = 480687760]
• EMPLOYEE BENEFITS PLAN OF ALASKA LEGAL SERVICES CORPORATION [EIN = 920034754]
• EMPLOYEE BENEFIT PLAN OF THE ARC BIG BEND, INC. [EIN = 591568446]
• EMPLOYEE BENEFITS PLAN OF GIRL SCOUTS OF WESTERN NEW YORK, INC. [EIN = 160743096]
• EMPLOYEE BENEFITS PLAN OF CENTRAL AGENCY FOR JEWISH EDUCATION [EIN = 237123583]
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• EMPLOYEE BENEFIT PLAN OF KAHULUI SERVICE , INC. KAHULUI SERVICE, INC. [EIN = 990273692]
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• EMPLOYEE BENEFIT PLAN OF BRYANT'S HEATING & COOLING, INC. [EIN = 631010294]
• EMPLOYEE BENEFIT PLAN OF PARAGON BUILDING CORPORATION [EIN = 561851722]
• EMPLOYEE BENEFIT PLAN OF MINNESOTA COMMUNITY ACTION PARTNERSHIP [EIN = 411407742]
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• EMPLOYEE BENEFIT PLAN OF UNITED JEWISH FEDERATION OF GREATER PITTSBURGH [EIN = 251017602]
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• EMPLOYEE BENEFIT PLAN OF SCHOOL FACILITY MANAGEMENT, LLC [EIN = 621735375]
• EMPLOYEE BENEFIT PLAN OF THE COMMISSION ON ACCREDITATION OF REHABILITATION FACILITIES [EIN = 366149979]
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• EMPLOYEE BENEFIT PLAN OF GIRL SCOUTS OF GATEWAY COUNCIL, INC. [EIN = 590637857]
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• EMPLOYEE BENEFIT PLAN OF UNITED WAY OF GREATER PLYMOUTH COUNTY, INC. [EIN = 042103940]
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• EMPLOYEE BENEFIT PLAN OF LJ CREATE INCORPORATED [EIN = 112867444]
• EMPLOYEE BENEFIT PLAN OF PINELLAS OPPORTUNITY COUNCIL, INC. [EIN = 591227051]
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• EMPLOYEE BENEFIT PLAN OF WAYSIDE HOUSE, INC [EIN = 591590644]
• EMPLOYEE BENEFIT PLAN OF COALITION FOR INDEPENDENT LIVING OPTIONS INC [EIN = 650174695]
• EMPLOYEE BENEFIT PLAN OF GIRL SCOUTS OF NORTHERN NEW JERSEY, INC. [EIN = 221482204]
• EMPLOYEE BENEFIT SYSTEMS, INC. 401(K) PLAN [EIN = 161408013]
• EMPLOYEE BENEFIT PLAN OF CONTINUOUS SALES CORP [EIN = 110645690]
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• EMPLOYEE BENEFIT PLAN OF UNITED WAY OF ERIE COUNTY UNITED WAY OF ERIE COUNTY [EIN = 251053091]
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• EMPLOYEE BENEFIT PLAN OF 123-24 ROCKAWAY BOULEVARD CORPORATION D/B/A NEW E [EIN = 112616961]
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• EMPLOYEE BENEFIT PLAN OF M.C.O. CONSTRUCTION AND S SERVICES, INC. [EIN = 650400906]
• EMPLOYEE BENEFIT PLAN OF RIVERSIDE COUNTY CHILD CARE CONSORTIUM [EIN = 330265253]
• EMPLOYEE BENEFIT PLAN OF LOUISVILLE ASSET BUILDING COALITION, INC. [EIN = 455273568]
• EMPLOYEE BENEFIT PLAN OF SENIOR ACTION, INC. [EIN = 570507961]
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• EMPLOYEE BENEFIT PLAN OF FAIR HOUSING PARTNERSHIP OF GREATER PITTSBURGH, I [EIN = 251485362]
• EMPLOYEE BENEFIT PLAN OF MOTION MACHINE COMPANY [EIN = 382366972]
• EMPLOYEE BENEFIT PLAN OF THE ECONOMIC DEVELOPMENT CORPORATION SERVING FRESNO COUNTY [EIN = 942816185]
• EMPLOYEE BENEFIT PLAN OF FAMILY INTERVENTION CENTER [EIN = 060920277]
• EMPLOYEE BENEFIT PLAN OF DESERT ISLAND GOLF AND COUNTRY CLUB [EIN = 953559723]
• EMPLOYEE BENEFIT PLAN OF ATLANTIC FINANCIAL FEDERAL CREDIT UNION [EIN = 520635106]
• EMPLOYEE BENEFIT PLAN OF THE BLOOD CENTER OF SOUTHEAST LOUISIANA [EIN = 720725401]
• EMPLOYEE BENEFIT PLAN OF WALLY'S PHARMACY [EIN = 561520830]
• EMPLOYEE BENEFIT PLAN OF HAZARD PERRY COUNTY COMMUNITY MINISTRIES [EIN = 610899221]
• EMPLOYEE BENEFIT CONCEPTS, INC. 401(K) PLAN [EIN = 201291783]
• EMPLOYEE BENEFIT PLAN OF CHILDRENS HOUSE OF THE WINDSORS, INC. [EIN = 200855414]
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• EMPLOYEE BENEFIT PLAN OF CABRAL WESTERN MOTORS INCORPORATED [EIN = 942359258]
• EMPLOYEE BENEFIT PLAN OF M-B-W, INC. M-B-W, INC. [EIN = 391081431]
• EMPLOYEE BENEFIT PLAN OF THE DETROIT ECONOMIC GROWTH CORPORATION [EIN = 382192028]
• EMPLOYEE BENEFIT PLAN OF SERVICE COORDINATION OF SOUTH CENTRAL PENNSYLVANI [EIN = 455330283]
• EMPLOYEE BENEFIT PLAN OF NATIONAL ATHLETIC TRAINERS ASSOCIATION [EIN = 752575595]
• EMPLOYEE BENEFIT PLAN OF CHATHAM COUNTY COUNCIL ON AGING, INC. [EIN = 561084260]
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• EMPLOYEE BENEFIT PLAN OF THE A. G. GASTON BOYS AND GIRLS CLUB INC [EIN = 630514348]
• EMPLOYEE BENEFIT PLAN OF SAWYER BENTWOOD, INC. [EIN = 030215936]
• EMPLOYEE BENEFIT PLAN OF THE ARC OF PALM BEACH COUNTY, INC. [EIN = 590883386]
• EMPLOYEE BENEFIT PLAN OF COMMUNITY MEDICAL GROUP - ST. CHARLES, INC. [EIN = 463447107]
• EMPLOYEE BENEFIT PLAN OF NEIGHBORHOOD LEGAL SERVICES,INC. [EIN = 510198935]
• EMPLOYEE BENEFIT PLAN OF UNITED WAY OF BEAUMONT AND NORTH JEFFERSON COUNTY [EIN = 741200117]
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• EMPLOYEE BENEFIT PLAN OF DOMESTIC VIOLENCE INTERVENTIOIN CENTER [EIN = 630818014]
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• EMPLOYEE BENEFIT PLAN OF MENTAL HEALTH ASSOCIATION IN SANTABARBARA COUNTY DBA MENTAL WELLNESS [EIN = 951962659]
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• EMPLOYEE BENEFITS PLAN OF WHITTIER STREET HEALTH CENTER COMMITTEE, INC. [EIN = 042619517]
• EMPLOYEE BENEFITS PLAN OF BERKSHIRE CHILDREN AND FAMILIES, INC. [EIN = 042226238]
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• EMPLOYEE BENEFIT PLAN OF EASTER SEALS OKLAHOMA, INC. [EIN = 730580276]
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• EMPLOYEE BENEFIT PLAN OF UNION SETTLEMENT HOME CARE SERVICES, INC. [EIN = 133018240]
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• EMPLOYEE BENEFIT PLAN OF DAYTONA CUSTOM MOTORCYCLES, LLC, D/B/A [EIN = 593753043]
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• EMPLOYEE BENEFITS PLAN OF GRAHAM COUNTY ARC, INC. [EIN = 860225278]
• EMPLOYEE BENEFIT PL OF CLEVELAND PSYCHOSOCIAL SERVICES INC [EIN = 561526107]
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• EMPLOYEE BENEFIT LIFE INSURANCE FOR EMPLOYEES OF RODEY, DICKASON, SLOAN, AKIN & ROBB, P.A. [EIN = 850216511]
• EMPLOYEE BENEFIT PLAN FOR THE VISITING NURSE ASSOCIATION OF TEXAS [EIN = 750800692]
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• EMPLOYEE BENEFIT PLAN FOR EMPLOYEES OF ACR ELECTRONICS [EIN = 650160389]
• EMPLOYEE BENEFIT PLAN OF MAYO KNITTING MILL, INC. [EIN = 560513625]
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• EMPLOYEE BENEFITS PLAN OF FOR STOROX NEIGHBORHOOD CORPORATION [EIN = 237181440]
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• EMPLOYEE BENEFIT TRUST FOR EMPLOYEES OF MCA, INC. [EIN = 953806396]
• EMPLOYEE BENEFIT PLAN OF SACRED HEART REHABILITATION CENTER INC [EIN = 381880385]
• EMPLOYEE BENEFIT PLAN OF PUEBLO YOUTH SERVICE BUREAU INC [EIN = 840690750]
• EMPLOYEE BENEFIT PLAN TRUST J SHORT-TERM INVESTMENT FUND OF PNC BANK, NATIONAL ASSOCIATION [EIN = 526169143]
• EMPLOYEE BENEFITS PLAN OF GAYLORD & DOROTHY DONNELLEY FOUNDATION [EIN = 366108460]
• EMPLOYEE BENEFIT PLAN OF EPILEPSY FOUNDATION OF LOUISIANA [EIN = 720824847]
• EMPLOYEE BENEFIT PLAN OF AMERICAN RED CROSS WASHINGTON COUNTY MD CHAPTER [EIN = 520677793]
• EMPLOYEE BENEFITS PLAN FOR WEST TRAVEL EMPLOYEES [EIN = 911032583]
• EMPLOYEE BENEFIT PLAN FOR SEITZ CORPORATION [EIN = 061127121]
• EMPLOYEE BENEFIT PLAN OF LAKES AND PRAIRIES COMMUNITY ACTION PARTNERSHIP [EIN = 410905871]
• EMPLOYEE BENEFIT PLAN OF BEHAVIORAL CONNECTIONS OF WOOD CO [EIN = 341262376]
• EMPLOYEE BENEFIT SOLUTIONS, INC. 401K PLAN [EIN = 263964852]
• EMPLOYEE BENEFITS PLAN OF JEWISH FAMILY SERVICE OF NORTH JERSEY [EIN = 221487228]
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• EMPLOYEE BENEFIT PLAN OF STONE & WEBSTER INC AND PARTICIPATING SUBSIDIARIES [EIN = 135416910]
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• EMPLOYEE BENEFIT PLAN FOR MINTZ & HOKE LIFE, AD&D, LTD [EIN = 060871841]
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• EMPLOYEE BENEFIT PLAN OF THE CULINARIANS HOME FOUNDATION, INC. [EIN = 131635296]
• EMPLOYEE BENEFIT PLAN OF AIDS COMMUNITY SERVICES OF WESTERN NEW YORK, INC. [EIN = 161202971]
• EMPLOYEE BENEFIT PLAN OF SURFACE PHARMACEUTICALS, INC. [EIN = 352602593]
• EMPLOYEE BENEFIT PLAN OF FERRER & HO PSYCHOLOGY CORPORATION [EIN = 475238232]
• EMPLOYEE BENEFIT PLAN OF VOLUNTEER LAWYERS NETWORK, LTD. [EIN = 410988459]
• EMPLOYEE BENEFIT PLAN OF SOUTHWEST GEORGIA PROJECT FOR COMMUNITY EDUCATION, INC. [EIN = 581172475]
• EMPLOYEE BENEFIT PLAN OF THE UNITED WAYS OF TEXAS, INC. [EIN = 741618608]
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• EMPLOYEE BENEFIT PLAN OF DRIVING DYNAMICS, INC. [EIN = 222991138]
• EMPLOYEE BENEFIT PLAN OF MESA RENO, LLC [EIN = 810912214]
• EMPLOYEE BENEFIT PLAN OF KELLY THOMPSON CONSTRUCTION, LLC [EIN = 550915741]
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• EMPLOYEE BENEFIT PLAN OF ROSENBALM ROCKERY, INC. [EIN = 810593127]
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• EMPLOYEE BENEFIT PLAN OF MENTAL HEALTH EMPOWERMENT PROJECT, INC. [EIN = 141777470]
• EMPLOYEE BENEFIT PLAN OF ASSOCIATION OF INTERNATIONAL EDUCATION ADMINISTRATORS [EIN = 431427422]
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• EMPLOYEE BENEFIT PLAN OF SALE INSURANCE AGENCY, INC. [EIN = 592994812]
• EMPLOYEE BENEFIT PLAN OF ASSOCIATION OF COMMUNITY ACTION PARTNERSHIP OF LOUISIANA [EIN = 463956278]
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• EMPLOYEE BENEFIT PLAN OF COASTAL DETOX, INC. [EIN = 472527897]
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