WATCHGUARD, INC. has sponsored the creation of one or more 401k plans.
Additional information about WATCHGUARD, INC.
Submission information for form 5500 for 401k plan WATCHGUARD VIDEO EMPLOYEE BENEFIT PLAN
SAFEGUARD HEALTH PLANS, INC. A TEXAS CORPORATION (National Association of Insurance Commissioners NAIC id number: 95051 ) |
Policy contract number | 5941822 |
Policy instance | 2 |
Insurance contract or identification number | 5941822 | Number of Individuals Covered | 55 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $418 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $3,665 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $418 | Insurance broker organization code? | 3 |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 0214624 |
Policy instance | 8 |
Insurance contract or identification number | 0214624 | Number of Individuals Covered | 93 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $4,265 | Total amount of fees paid to insurance company | USD $56 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $8,473 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,986 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 56 | Additional information about fees paid to insurance broker | NON-MONETARY COMPENSATION |
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HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 ) |
Policy contract number | 406737A |
Policy instance | 4 |
Insurance contract or identification number | 406737A | Number of Individuals Covered | 0 | 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 $0 | Welfare Benefit Premiums Paid to Carrier | USD $329,306 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Insurance broker organization code? | 3 |
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WESTPOINT INSURANCE CORPORATION (National Association of Insurance Commissioners NAIC id number: 39845 ) |
Policy contract number | ESL110007202 |
Policy instance | 3 |
Insurance contract or identification number | ESL110007202 | Number of Individuals Covered | 0 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $3,032 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | TRANSPLANT | Welfare Benefit Premiums Paid to Carrier | USD $30,329 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,032 | Insurance broker organization code? | 3 |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 0214620 |
Policy instance | 5 |
Insurance contract or identification number | 0214620 | Number of Individuals Covered | 37 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $6,577 | Total amount of fees paid to insurance company | USD $56 | Temporary Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | WORKPLACE SHORT TERM DISABILITY | Welfare Benefit Premiums Paid to Carrier | USD $17,158 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,604 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 56 | Additional information about fees paid to insurance broker | NON-MONETARY COMPENSATION |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 0214621 |
Policy instance | 6 |
Insurance contract or identification number | 0214621 | Number of Individuals Covered | 75 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $2,993 | Total amount of fees paid to insurance company | USD $914 | Other welfare benefits provided | CRITICAL ILLNESS - CII | Welfare Benefit Premiums Paid to Carrier | USD $10,558 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,095 | Amount paid for insurance broker fees | 500 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 0214623 |
Policy instance | 7 |
Insurance contract or identification number | 0214623 | Number of Individuals Covered | 230 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $4,028 | Total amount of fees paid to insurance company | USD $57 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $11,944 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,820 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 56 | Additional information about fees paid to insurance broker | NON-MONETARY COMPENSATION |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 5941822 |
Policy instance | 1 |
Insurance contract or identification number | 5941822 | Number of Individuals Covered | 572 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $40,393 | Total amount of fees paid to insurance company | USD $57 | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $293,797 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $40,392 | Amount paid for insurance broker fees | 56 | Additional information about fees paid to insurance broker | NONMONETARY COMPENSATION | Insurance broker organization code? | 3 |
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WESTPOINT INSURANCE CORPORATION (National Association of Insurance Commissioners NAIC id number: 39845 ) |
Policy contract number | ESL110007200 |
Policy instance | 5 |
Insurance contract or identification number | ESL110007200 | Number of Individuals Covered | 271 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $3,955 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | TRANSPLANT | Welfare Benefit Premiums Paid to Carrier | USD $39,550 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,955 | Insurance broker organization code? | 3 | Insurance broker name | GPA |
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COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
Policy contract number | E7974702 |
Policy instance | 1 |
Insurance contract or identification number | E7974702 | Number of Individuals Covered | 45 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $3,053 | Total amount of fees paid to insurance company | USD $71 | Other welfare benefits provided | SUPPLEMENTAL HEALTH | Welfare Benefit Premiums Paid to Carrier | USD $25,515 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,405 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 71 | Additional information about fees paid to insurance broker | FEES | Insurance broker name | DAVID EVANS |
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WESTPOINT INSURANCE CORPORATION (National Association of Insurance Commissioners NAIC id number: 39845 ) |
Policy contract number | ESL110007200 |
Policy instance | 4 |
Insurance contract or identification number | ESL110007200 | Number of Individuals Covered | 271 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Welfare Benefit Premiums Paid to Carrier | USD $391,179 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | KM05941822 |
Policy instance | 2 |
Insurance contract or identification number | KM05941822 | Number of Individuals Covered | 797 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $56,438 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $368,680 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $56,438 | Insurance broker organization code? | 3 | Insurance broker name | ANBTX INSURANCE SERVICES INC |
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SAFEGUARD HEALTH PLANS, INC. A TEXAS CORPORATION (National Association of Insurance Commissioners NAIC id number: 95051 ) |
Policy contract number | KM05941822 |
Policy instance | 3 |
Insurance contract or identification number | KM05941822 | Number of Individuals Covered | 116 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $1,123 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $8,649 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,123 | Insurance broker organization code? | 3 | Insurance broker name | ANBTX INSURANCE SERVICES INC |
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STANDARD SECURITY LIFE (National Association of Insurance Commissioners NAIC id number: 69078 ) |
Policy contract number | OTSIHCRS0022 |
Policy instance | 6 |
Insurance contract or identification number | OTSIHCRS0022 | Number of Individuals Covered | 165 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $2,154 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | TRANSPLANT | Welfare Benefit Premiums Paid to Carrier | USD $21,547 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,154 | Insurance broker organization code? | 3 | Insurance broker name | GPA |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 5914814 |
Policy instance | 5 |
Insurance contract or identification number | 5914814 | Number of Individuals Covered | 401 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $10,795 | Total amount of fees paid to insurance company | USD $1,753 | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $103,942 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $10,795 | Amount paid for insurance broker fees | 1753 | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | ANBTX INSURANCE SERVICES INC |
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SAFEGUARD HEALTH PLANS, INC. A TEXAS CORPORATION (National Association of Insurance Commissioners NAIC id number: 95051 ) |
Policy contract number | 5914814 |
Policy instance | 4 |
Insurance contract or identification number | 5914814 | Number of Individuals Covered | 119 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $789 | Total amount of fees paid to insurance company | USD $123 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $6,770 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $789 | Amount paid for insurance broker fees | 123 | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | ANBTX INSURANCE SERVI9CES INC |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00463937 |
Policy instance | 3 |
Insurance contract or identification number | 00463937 | Number of Individuals Covered | 182 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $13,444 | Total amount of fees paid to insurance company | USD $4,619 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D, OPTIONAL LIFE | Welfare Benefit Premiums Paid to Carrier | USD $89,624 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $13,444 | Amount paid for insurance broker fees | 4619 | Insurance broker organization code? | 3 | Insurance broker name | ANBTX INSURANCE SERVI9CES INC |
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COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
Policy contract number | E7974702 |
Policy instance | 2 |
Insurance contract or identification number | E7974702 | Number of Individuals Covered | 40 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $12,130 | Total amount of fees paid to insurance company | USD $3,414 | Other welfare benefits provided | SUPPLEMENTAL HEALTH | Welfare Benefit Premiums Paid to Carrier | USD $22,598 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,397 | Amount paid for insurance broker fees | 1068 | Additional information about fees paid to insurance broker | BONUSES | Insurance broker organization code? | 3 | Insurance broker name | DAVID EVANS |
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STANDARD SECURITY LIFE (National Association of Insurance Commissioners NAIC id number: 69078 ) |
Policy contract number | SSLIHCRS00668 |
Policy instance | 1 |
Insurance contract or identification number | SSLIHCRS00668 | Number of Individuals Covered | 164 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Welfare Benefit Premiums Paid to Carrier | USD $233,936 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | KM05914814 |
Policy instance | 5 |
Insurance contract or identification number | KM05914814 | Number of Individuals Covered | 325 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $7,902 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $94,274 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $7,902 | Insurance broker organization code? | 3 | Insurance broker name | ANBTX INSURANCE SERVICES INC |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00463937 |
Policy instance | 3 |
Insurance contract or identification number | 00463937 | Number of Individuals Covered | 148 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $12,718 | Total amount of fees paid to insurance company | USD $6,595 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D, OPTIONAL LIFE | Welfare Benefit Premiums Paid to Carrier | USD $84,787 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $12,718 | Amount paid for insurance broker fees | 6595 | Insurance broker organization code? | 3 | Insurance broker name | ANBTX INSURANCE SERVI9CES INC |
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COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
Policy contract number | E7974702 |
Policy instance | 2 |
Insurance contract or identification number | E7974702 | Number of Individuals Covered | 3 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $338 | Total amount of fees paid to insurance company | USD $569 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Other welfare benefits provided | SUPPLEMENTAL HEALTH | Welfare Benefit Premiums Paid to Carrier | USD $4,526 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $99 | Amount paid for insurance broker fees | 565 | Additional information about fees paid to insurance broker | BONUSES & NON CASH INCENTIVES | Insurance broker organization code? | 3 | Insurance broker name | COLONIAL OF NORTH TEXAS INSURANCE G |
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CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
Policy contract number | 00608707 |
Policy instance | 1 |
Insurance contract or identification number | 00608707 | Number of Individuals Covered | 200 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $54,169 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $251,578 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $54,169 | Insurance broker organization code? | 3 | Insurance broker name | ANTBX INSURANCE SERVICES INC. |
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SAFEGUARD HEALTH PLANS, INC. A TEXAS CORPORATION (National Association of Insurance Commissioners NAIC id number: 95051 ) |
Policy contract number | KM05914814 |
Policy instance | 4 |
Insurance contract or identification number | KM05914814 | Number of Individuals Covered | 170 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $872 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $10,417 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $872 | Insurance broker organization code? | 3 | Insurance broker name | ANBTX INSURANCE SERVI9CES INC |
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CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
Policy contract number | 00608707 |
Policy instance | 1 |
Insurance contract or identification number | 00608707 | Number of Individuals Covered | 178 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $46,774 | Total amount of fees paid to insurance company | USD $2,500 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $244,011 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $46,774 | Amount paid for insurance broker fees | 2500 | Additional information about fees paid to insurance broker | INCENTIVE COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | ANTBX INSURANCE SERVICES |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00463937 |
Policy instance | 3 |
Insurance contract or identification number | 00463937 | Number of Individuals Covered | 131 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $19,333 | Total amount of fees paid to insurance company | USD $3,869 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | OPTIONAL LIFE | Welfare Benefit Premiums Paid to Carrier | USD $149,355 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $18,886 | Amount paid for insurance broker fees | 3869 | Insurance broker organization code? | 3 | Insurance broker name | JOHN J MCGURRAN |
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COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
Policy contract number | E7974702 |
Policy instance | 2 |
Insurance contract or identification number | E7974702 | Number of Individuals Covered | 4 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $267 | Total amount of fees paid to insurance company | USD $31 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Other welfare benefits provided | SUPPLEMENTAL HEALTH | Welfare Benefit Premiums Paid to Carrier | USD $3,446 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $168 | Amount paid for insurance broker fees | 2 | Additional information about fees paid to insurance broker | BONUS | Insurance broker organization code? | 3 | Insurance broker name | COLONIAL OF NORTH TEXAS INSURANCE G |
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PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
Policy contract number | 03600 |
Policy instance | 2 |
Insurance contract or identification number | 03600 | Number of Individuals Covered | 114 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $7,456 | Total amount of fees paid to insurance company | USD $38 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | VOL LIFE, VOL DEP LIFE, AD&D | Welfare Benefit Premiums Paid to Carrier | USD $49,772 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $7,456 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 38 | Additional information about fees paid to insurance broker | THIRD PARTY ADMINISTRATION FEES | Insurance broker name | AXA ASSISTANCE, USA |
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COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
Policy contract number | E7974702 |
Policy instance | 3 |
Insurance contract or identification number | E7974702 | Number of Individuals Covered | 4 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $325 | Total amount of fees paid to insurance company | USD $11 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Other welfare benefits provided | SUPPLEMENTAL HEALTH | Welfare Benefit Premiums Paid to Carrier | USD $4,824 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $183 | Amount paid for insurance broker fees | 8 | Additional information about fees paid to insurance broker | BONUS | Insurance broker organization code? | 3 | Insurance broker name | COLONIAL OF NORTH TEXAS INSURANCE G |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00463937 |
Policy instance | 4 |
Insurance contract or identification number | 00463937 | Number of Individuals Covered | 93 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $7,408 | Total amount of fees paid to insurance company | USD $3,990 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $68,289 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $7,335 | Amount paid for insurance broker fees | 3990 | Insurance broker organization code? | 3 | Insurance broker name | ERIK G LILJENWALL |
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BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | 029250 |
Policy instance | 1 |
Insurance contract or identification number | 029250 | Number of Individuals Covered | 223 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $41,039 | Total amount of fees paid to insurance company | USD $1,128 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $820,360 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $41,039 | Amount paid for insurance broker fees | 1128 | Additional information about fees paid to insurance broker | BROKER BONUS | Insurance broker organization code? | 3 | Insurance broker name | ANTBX INSURANCE SERVICES |
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PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
Policy contract number | 03600 |
Policy instance | 2 |
Insurance contract or identification number | 03600 | Number of Individuals Covered | 102 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $6,605 | Total amount of fees paid to insurance company | USD $38 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | VOL LIFE, VOL DEP LIFE, AD&D | Welfare Benefit Premiums Paid to Carrier | USD $44,036 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | 029250 |
Policy instance | 1 |
Insurance contract or identification number | 029250 | Number of Individuals Covered | 201 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $43,373 | Total amount of fees paid to insurance company | USD $1,224 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $946,623 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00463937 |
Policy instance | 4 |
Insurance contract or identification number | 00463937 | Number of Individuals Covered | 85 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $6,597 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $58,917 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
Policy contract number | E7974702 |
Policy instance | 3 |
Insurance contract or identification number | E7974702 | Number of Individuals Covered | 4 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $502 | Total amount of fees paid to insurance company | USD $16 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Other welfare benefits provided | SUPPLEMENTAL HEALTH | Welfare Benefit Premiums Paid to Carrier | USD $5,930 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | 029250 |
Policy instance | 1 |
Insurance contract or identification number | 029250 | Number of Individuals Covered | 225 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $38,168 | Total amount of fees paid to insurance company | USD $1,707 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $762,695 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $38,168 | Amount paid for insurance broker fees | 1707 | Additional information about fees paid to insurance broker | SPECIAL PROGRAMS | Insurance broker organization code? | 3 | Insurance broker name | SLEEPERSEWELL INSURANCE SERVICES IN |
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BLOCK VISION (National Association of Insurance Commissioners NAIC id number: 95387 ) |
Policy contract number | 321320 |
Policy instance | 4 |
Insurance contract or identification number | 321320 | Number of Individuals Covered | 146 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $749 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $7,490 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $749 | Insurance broker organization code? | 3 | Insurance broker name | SLEEPERSEWELL INSURANCE SERVICES IN |
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PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
Policy contract number | 03600 |
Policy instance | 5 |
Insurance contract or identification number | 03600 | Number of Individuals Covered | 107 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $6,110 | Total amount of fees paid to insurance company | USD $33 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | VOL LIFE, VOL DEP LIFE, AD&D | Welfare Benefit Premiums Paid to Carrier | USD $40,735 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,110 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 33 | Additional information about fees paid to insurance broker | THIRD PARTY ADMINISTRATOR FEES | Insurance broker name | AXA ASSISTANCE USA |
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COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
Policy contract number | E7974702 |
Policy instance | 6 |
Insurance contract or identification number | E7974702 | Number of Individuals Covered | 11 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $1,358 | Total amount of fees paid to insurance company | USD $79 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Other welfare benefits provided | SUPPLEMENTAL HEALTH | Welfare Benefit Premiums Paid to Carrier | USD $7,869 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $779 | Amount paid for insurance broker fees | 43 | Additional information about fees paid to insurance broker | BONUS | Insurance broker organization code? | 3 | Insurance broker name | STEPHEN MAUS |
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SAFEGUARD HEALTH PLANS, INC. A TEXAS CORPORATION (National Association of Insurance Commissioners NAIC id number: 95051 ) |
Policy contract number | KMO5735506 |
Policy instance | 3 |
Insurance contract or identification number | KMO5735506 | Number of Individuals Covered | 66 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $845 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $6,203 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $845 | Insurance broker organization code? | 3 | Insurance broker name | SLEEPERSEWELL INSURANCE SERVICES IN |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | KMO5735506 |
Policy instance | 2 |
Insurance contract or identification number | KMO5735506 | Number of Individuals Covered | 135 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $4,011 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $43,917 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,011 | Insurance broker organization code? | 3 | Insurance broker name | SLEEPERSEWELL INSURANCE SERVICES IN |
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