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THE CENTER FOR FAMILY SUPPORT, NEW JERSEY, INC. HEALTH PLAN 401k Plan overview

Plan NameTHE CENTER FOR FAMILY SUPPORT, NEW JERSEY, INC. HEALTH PLAN
Plan identification number 501

THE CENTER FOR FAMILY SUPPORT, NEW JERSEY, INC. HEALTH PLAN Benefits

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

401k Sponsoring company profile

THE CENTER FOR FAMILY SUPPORT, NEW JERSEY, INC. has sponsored the creation of one or more 401k plans.

Company Name:THE CENTER FOR FAMILY SUPPORT, NEW JERSEY, INC.
Employer identification number (EIN):133920232
NAIC Classification:624100
NAIC Description: Individual and Family Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THE CENTER FOR FAMILY SUPPORT, NEW JERSEY, INC. HEALTH PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01KEN D. SEMPLE2023-07-31
5012021-01-01KEN D. SEMPLE2022-08-16
5012020-01-01KEN D. SEMPLE2021-08-31
5012019-01-01KEN D. SEMPLE2020-10-15
5012018-01-01KEN SEMPLE
5012017-01-01MICHAEL MAZZOCCO
5012016-01-01MICHAEL MAZZOCCO
5012015-01-01MICHAEL MAZZOCCO
5012014-01-01MICHAEL MAZZOCCO
5012013-01-01MICHAEL MAZZOCCO
5012012-01-01MICHAEL MAZZOCCO
5012011-01-01MICHAEL MAZZOCCO
5012010-01-01MICHAEL MAZZOCCO
5012009-01-01MICHAEL MAZZOCCO
5012008-01-01MICHAEL MAZZOCCO

Plan Statistics for THE CENTER FOR FAMILY SUPPORT, NEW JERSEY, INC. HEALTH PLAN

401k plan membership statisitcs for THE CENTER FOR FAMILY SUPPORT, NEW JERSEY, INC. HEALTH PLAN

Measure Date Value
2022: THE CENTER FOR FAMILY SUPPORT, NEW JERSEY, INC. HEALTH PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01269
Total number of active participants reported on line 7a of the Form 55002022-01-01260
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-01260
Number of employers contributing to the scheme2022-01-010
2021: THE CENTER FOR FAMILY SUPPORT, NEW JERSEY, INC. HEALTH PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01279
Total number of active participants reported on line 7a of the Form 55002021-01-01269
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-01269
Number of employers contributing to the scheme2021-01-010
2020: THE CENTER FOR FAMILY SUPPORT, NEW JERSEY, INC. HEALTH PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01285
Total number of active participants reported on line 7a of the Form 55002020-01-01279
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-01279
Number of employers contributing to the scheme2020-01-010
2019: THE CENTER FOR FAMILY SUPPORT, NEW JERSEY, INC. HEALTH PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01329
Total number of active participants reported on line 7a of the Form 55002019-01-01285
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-01285
Number of employers contributing to the scheme2019-01-010
2018: THE CENTER FOR FAMILY SUPPORT, NEW JERSEY, INC. HEALTH PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01339
Total number of active participants reported on line 7a of the Form 55002018-01-01329
Total of all active and inactive participants2018-01-01329
2017: THE CENTER FOR FAMILY SUPPORT, NEW JERSEY, INC. HEALTH PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01329
Total number of active participants reported on line 7a of the Form 55002017-01-01339
Total of all active and inactive participants2017-01-01339
Total participants2017-01-01339
2016: THE CENTER FOR FAMILY SUPPORT, NEW JERSEY, INC. HEALTH PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01336
Total number of active participants reported on line 7a of the Form 55002016-01-01329
Total of all active and inactive participants2016-01-01329
Total participants2016-01-01329
2015: THE CENTER FOR FAMILY SUPPORT, NEW JERSEY, INC. HEALTH PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01340
Total number of active participants reported on line 7a of the Form 55002015-01-01336
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-01336
Total participants2015-01-01336
2014: THE CENTER FOR FAMILY SUPPORT, NEW JERSEY, INC. HEALTH PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01327
Total number of active participants reported on line 7a of the Form 55002014-01-01340
Total of all active and inactive participants2014-01-01340
Total participants2014-01-01340
2013: THE CENTER FOR FAMILY SUPPORT, NEW JERSEY, INC. HEALTH PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01326
Total number of active participants reported on line 7a of the Form 55002013-01-01327
Total of all active and inactive participants2013-01-01327
Total participants2013-01-01327
2012: THE CENTER FOR FAMILY SUPPORT, NEW JERSEY, INC. HEALTH PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01308
Total number of active participants reported on line 7a of the Form 55002012-01-01326
Total of all active and inactive participants2012-01-01326
Total participants2012-01-01326
2011: THE CENTER FOR FAMILY SUPPORT, NEW JERSEY, INC. HEALTH PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01302
Total number of active participants reported on line 7a of the Form 55002011-01-01308
Total of all active and inactive participants2011-01-01308
Total participants2011-01-01308
2010: THE CENTER FOR FAMILY SUPPORT, NEW JERSEY, INC. HEALTH PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-01302
Total number of active participants reported on line 7a of the Form 55002010-01-01302
Total of all active and inactive participants2010-01-01302
Total participants2010-01-01302
2009: THE CENTER FOR FAMILY SUPPORT, NEW JERSEY, INC. HEALTH PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01591
Total number of active participants reported on line 7a of the Form 55002009-01-01591
Total of all active and inactive participants2009-01-01591
Total participants2009-01-01591
2008: THE CENTER FOR FAMILY SUPPORT, NEW JERSEY, INC. HEALTH PLAN 2008 401k membership
Total participants, beginning-of-year2008-01-01297
Total number of active participants reported on line 7a of the Form 55002008-01-01297
Total of all active and inactive participants2008-01-01297
Total participants2008-01-01297

Form 5500 Responses for THE CENTER FOR FAMILY SUPPORT, NEW JERSEY, INC. HEALTH PLAN

2022: THE CENTER FOR FAMILY SUPPORT, NEW JERSEY, INC. HEALTH PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – InsuranceYes
2021: THE CENTER FOR FAMILY SUPPORT, NEW JERSEY, INC. HEALTH PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – InsuranceYes
2020: THE CENTER FOR FAMILY SUPPORT, NEW JERSEY, INC. HEALTH PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – InsuranceYes
2019: THE CENTER FOR FAMILY SUPPORT, NEW JERSEY, INC. HEALTH PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: THE CENTER FOR FAMILY SUPPORT, NEW JERSEY, INC. HEALTH PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: THE CENTER FOR FAMILY SUPPORT, NEW JERSEY, INC. HEALTH PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: THE CENTER FOR FAMILY SUPPORT, NEW JERSEY, INC. HEALTH PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: THE CENTER FOR FAMILY SUPPORT, NEW JERSEY, INC. HEALTH PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: THE CENTER FOR FAMILY SUPPORT, NEW JERSEY, INC. HEALTH PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: THE CENTER FOR FAMILY SUPPORT, NEW JERSEY, INC. HEALTH PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: THE CENTER FOR FAMILY SUPPORT, NEW JERSEY, INC. HEALTH PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: THE CENTER FOR FAMILY SUPPORT, NEW JERSEY, INC. HEALTH PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2010: THE CENTER FOR FAMILY SUPPORT, NEW JERSEY, INC. HEALTH PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – InsuranceYes
2009: THE CENTER FOR FAMILY SUPPORT, NEW JERSEY, INC. HEALTH PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes
2008: THE CENTER FOR FAMILY SUPPORT, NEW JERSEY, INC. HEALTH PLAN 2008 form 5500 responses
2008-01-01Type of plan entitySingle employer plan
2008-01-01First time form 5500 has been submittedYes
2008-01-01Plan funding arrangement – InsuranceYes
2008-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract number570052
Policy instance 2
Insurance contract or identification number570052
Number of Individuals Covered260
Insurance policy start date2022-01-01
Insurance policy end date2022-10-31
Total amount of commissions paid to insurance brokerUSD $1,046
Total amount of fees paid to insurance companyUSD $87
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $6,971
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $1,046
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 )
Policy contract number300580
Policy instance 1
Insurance contract or identification number300580
Number of Individuals Covered366
Insurance policy start date2021-02-01
Insurance policy end date2022-01-31
Total amount of commissions paid to insurance brokerUSD $192,948
Total amount of fees paid to insurance companyUSD $20,646
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,602,896
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $192,948
Amount paid for insurance broker fees20646
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number530685
Policy instance 3
Insurance contract or identification number530685
Number of Individuals Covered50
Insurance policy start date2022-01-01
Insurance policy end date2022-10-31
Total amount of commissions paid to insurance brokerUSD $4,372
Total amount of fees paid to insurance companyUSD $429
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT,LONG TERM CARE
Welfare Benefit Premiums Paid to CarrierUSD $41,546
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $4,372
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number625432
Policy instance 1
Insurance contract or identification number625432
Number of Individuals Covered269
Insurance policy start date2021-01-01
Insurance policy end date2021-01-31
Total amount of commissions paid to insurance brokerUSD $13,549
Total amount of fees paid to insurance companyUSD $1,253
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $137,332
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,549
Amount paid for insurance broker fees1253
Additional information about fees paid to insurance brokerGENERAL AGENT PAYMENTS
Insurance broker organization code?3
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract number530685
Policy instance 4
Insurance contract or identification number530685
Number of Individuals Covered210
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $1,481
Total amount of fees paid to insurance companyUSD $123
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $88,426
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,481
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number530685
Policy instance 3
Insurance contract or identification number530685
Number of Individuals Covered88
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $4,146
Total amount of fees paid to insurance companyUSD $276
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT,LONG TERM CARE
Welfare Benefit Premiums Paid to CarrierUSD $32,673
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,146
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number625432
Policy instance 2
Insurance contract or identification number625432
Number of Individuals Covered314
Insurance policy start date2020-02-01
Insurance policy end date2021-01-31
Total amount of commissions paid to insurance brokerUSD $1,108
Total amount of fees paid to insurance companyUSD $175,955
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,562,189
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,108
Amount paid for insurance broker fees175955
Additional information about fees paid to insurance brokerBENEFIT ADVISOR FEE, INCENTIVE COMPENSATION
Insurance broker organization code?3
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number625432
Policy instance 2
Insurance contract or identification number625432
Number of Individuals Covered325
Insurance policy start date2019-02-01
Insurance policy end date2020-01-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $140,195
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,944,036
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees140195
Additional information about fees paid to insurance brokerBENEFIT ADVISOR FEES
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number484808
Policy instance 3
Insurance contract or identification number484808
Number of Individuals Covered279
Insurance policy start date2020-01-01
Insurance policy end date2020-01-31
Total amount of commissions paid to insurance brokerUSD $1,351
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Welfare Benefit Premiums Paid to CarrierUSD $13,503
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,350
Amount paid for insurance broker fees0
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number530685
Policy instance 4
Insurance contract or identification number530685
Number of Individuals Covered90
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $4,499
Total amount of fees paid to insurance companyUSD $233
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT,LONG TERM CARE
Welfare Benefit Premiums Paid to CarrierUSD $30,236
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,499
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract number570052
Policy instance 1
Insurance contract or identification number570052
Number of Individuals Covered17
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $1,153
Total amount of fees paid to insurance companyUSD $96
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $7,683
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,153
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 )
Policy contract number8504W
Policy instance 1
Insurance contract or identification number8504W
Number of Individuals Covered111
Insurance policy start date2019-01-01
Insurance policy end date2019-01-31
Total amount of commissions paid to insurance brokerUSD $2,184
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $79,953
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,184
Amount paid for insurance broker fees0
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number530685
Policy instance 2
Insurance contract or identification number530685
Number of Individuals Covered300
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $10,418
Total amount of fees paid to insurance companyUSD $1,223
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT,LONG TERM CARE
Welfare Benefit Premiums Paid to CarrierUSD $82,609
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,418
Amount paid for insurance broker fees1223
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number484808
Policy instance 3
Insurance contract or identification number484808
Number of Individuals Covered285
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $20,012
Total amount of fees paid to insurance companyUSD $9,841
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Welfare Benefit Premiums Paid to CarrierUSD $199,962
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $19,996
Amount paid for insurance broker fees9841
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0865855
Policy instance 7
Insurance contract or identification number0865855
Number of Individuals Covered12
Insurance policy start date2017-02-01
Insurance policy end date2018-01-31
Total amount of commissions paid to insurance brokerUSD $7,823
Total amount of fees paid to insurance companyUSD $2,608
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $263,280
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,823
Amount paid for insurance broker fees2608
Insurance broker organization code?3
HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 )
Policy contract number8504W
Policy instance 6
Insurance contract or identification number8504W
Number of Individuals Covered118
Insurance policy start date2017-02-01
Insurance policy end date2018-01-31
Total amount of commissions paid to insurance brokerUSD $10,177
Welfare Benefit Premiums Paid to CarrierUSD $291,372
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,177
Insurance broker organization code?3
HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 )
Policy contract number8504W
Policy instance 5
Insurance contract or identification number8504W
Number of Individuals Covered118
Insurance policy start date2017-02-01
Insurance policy end date2018-01-31
Total amount of commissions paid to insurance brokerUSD $22,404
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $640,962
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $22,404
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00539686
Policy instance 4
Insurance contract or identification number00539686
Number of Individuals Covered82
Insurance policy start date2018-02-01
Insurance policy end date2019-01-31
Total amount of commissions paid to insurance brokerUSD $788
Total amount of fees paid to insurance companyUSD $298
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,878
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $788
Amount paid for insurance broker fees270
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number299814
Policy instance 3
Insurance contract or identification number299814
Number of Individuals Covered63
Insurance policy start date2018-01-01
Insurance policy end date2019-01-01
Total amount of commissions paid to insurance brokerUSD $2,634
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $12,307
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,634
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number484808
Policy instance 2
Insurance contract or identification number484808
Number of Individuals Covered329
Insurance policy start date2018-02-01
Insurance policy end date2019-01-31
Total amount of commissions paid to insurance brokerUSD $20,459
Total amount of fees paid to insurance companyUSD $9,916
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $204,591
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $20,459
Amount paid for insurance broker fees9916
Insurance broker organization code?3
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract number530685
Policy instance 1
Insurance contract or identification number530685
Number of Individuals Covered224
Insurance policy start date2018-01-01
Insurance policy end date2019-01-01
Total amount of commissions paid to insurance brokerUSD $7,830
Total amount of fees paid to insurance companyUSD $1,228
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $64,213
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,830
Amount paid for insurance broker fees1228
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00539686
Policy instance 5
Insurance contract or identification number00539686
Number of Individuals Covered70
Insurance policy start date2017-06-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $415
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,864
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $386
Insurance broker nameFERRARA FINANCIAL GROUP, LLC
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number299814
Policy instance 4
Insurance contract or identification number299814
Number of Individuals Covered79
Insurance policy start date2017-01-01
Insurance policy end date2018-01-01
Total amount of commissions paid to insurance brokerUSD $5,662
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $29,174
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,662
Insurance broker namePREFERRED BENEFITS GROUP
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number484808
Policy instance 3
Insurance contract or identification number484808
Number of Individuals Covered339
Insurance policy start date2016-02-01
Insurance policy end date2017-01-31
Total amount of commissions paid to insurance brokerUSD $21,229
Total amount of fees paid to insurance companyUSD $9,300
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $212,288
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $21,229
Amount paid for insurance broker fees9300
Insurance broker organization code?3
Insurance broker namePREFERRED BENEFITS GROUP
AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95287 )
Policy contract number0865851HNO
Policy instance 2
Insurance contract or identification number0865851HNO
Number of Individuals Covered171
Insurance policy start date2016-02-01
Insurance policy end date2017-01-31
Total amount of commissions paid to insurance brokerUSD $44,299
Total amount of fees paid to insurance companyUSD $8,860
Welfare Benefit Premiums Paid to CarrierUSD $898,198
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $44,299
Amount paid for insurance broker fees8860
Additional information about fees paid to insurance brokerPM KP BONUS
Insurance broker organization code?3
Insurance broker namePREFERRED BENEFITS GROUP, INC.
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract number530685
Policy instance 1
Insurance contract or identification number530685
Number of Individuals Covered228
Insurance policy start date2017-01-01
Insurance policy end date2018-01-01
Total amount of commissions paid to insurance brokerUSD $8,074
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $78,437
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,074
Insurance broker organization code?3
Insurance broker namePREFERRED BENEFITS GROUP INC
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract number530685
Policy instance 1
Insurance contract or identification number530685
Number of Individuals Covered336
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $6,869
Total amount of fees paid to insurance companyUSD $718
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedADD
Welfare Benefit Premiums Paid to CarrierUSD $57,500
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,869
Amount paid for insurance broker fees718
Insurance broker organization code?3
Insurance broker namePREFERRED BENEFITS GROUP INC
AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95287 )
Policy contract number0865851HNO
Policy instance 2
Insurance contract or identification number0865851HNO
Number of Individuals Covered187
Insurance policy start date2014-02-01
Insurance policy end date2015-01-31
Total amount of commissions paid to insurance brokerUSD $42,358
Total amount of fees paid to insurance companyUSD $12,197
Welfare Benefit Premiums Paid to CarrierUSD $908,304
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $42,358
Amount paid for insurance broker fees12197
Insurance broker organization code?3
Insurance broker namePREFERRED BENEFITS GROUP, INC.
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number484808
Policy instance 3
Insurance contract or identification number484808
Number of Individuals Covered164
Insurance policy start date2014-02-01
Insurance policy end date2015-01-31
Total amount of commissions paid to insurance brokerUSD $20,286
Total amount of fees paid to insurance companyUSD $9,036
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $101,433
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $20,286
Amount paid for insurance broker fees9036
Insurance broker organization code?3
Insurance broker namePREFERRED BENEFITS GROUP
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number299814
Policy instance 4
Insurance contract or identification number299814
Long Term Disability Insurance Welfare BenefitYes
Insurance broker namePREFERRED BENEFITS GROUP
AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95287 )
Policy contract numberUS068551
Policy instance 2
Insurance contract or identification numberUS068551
Number of Individuals Covered284
Insurance policy start date2013-02-01
Insurance policy end date2014-01-31
Total amount of commissions paid to insurance brokerUSD $46,457
Total amount of fees paid to insurance companyUSD $9,236
Welfare Benefit Premiums Paid to CarrierUSD $943,032
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $46,457
Amount paid for insurance broker fees9236
Insurance broker organization code?3
Insurance broker namePREFERRED BENEFITS GROUP, INC.
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number299814
Policy instance 4
Insurance contract or identification number299814
Number of Individuals Covered21
Total amount of commissions paid to insurance brokerUSD $841
Total amount of fees paid to insurance companyUSD $53
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,205
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $841
Amount paid for insurance broker fees53
Insurance broker namePREFERRED BENEFITS GROUP
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number484808
Policy instance 3
Insurance contract or identification number484808
Number of Individuals Covered170
Total amount of commissions paid to insurance brokerUSD $10,508
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $105,080
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,508
Insurance broker namePREFERRED BENEFITS GROUP
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract number530685
Policy instance 1
Insurance contract or identification number530685
Number of Individuals Covered323
Insurance policy start date2014-01-01
Insurance policy end date2015-01-01
Total amount of commissions paid to insurance brokerUSD $5,714
Total amount of fees paid to insurance companyUSD $643
Life Insurance Welfare BenefitYes
Other welfare benefits providedADD
Welfare Benefit Premiums Paid to CarrierUSD $51,464
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,714
Amount paid for insurance broker fees643
Insurance broker organization code?3
Insurance broker namePREFERRED BENEFITS GROUP INC
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract number530685
Policy instance 1
Insurance contract or identification number530685
Number of Individuals Covered327
Insurance policy start date2012-01-01
Insurance policy end date2013-01-01
Total amount of commissions paid to insurance brokerUSD $5,108
Total amount of fees paid to insurance companyUSD $563
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedADD
Welfare Benefit Premiums Paid to CarrierUSD $45,057
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,108
Amount paid for insurance broker fees563
Insurance broker organization code?3
Insurance broker namePREFERRED BENEFITS GROUP INC
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberTM05982218
Policy instance 2
Insurance contract or identification numberTM05982218
Number of Individuals Covered351
Insurance policy start date2012-02-01
Insurance policy end date2013-01-31
Total amount of commissions paid to insurance brokerUSD $11,375
Total amount of fees paid to insurance companyUSD $276
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $105,475
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,449
Amount paid for insurance broker fees276
Insurance broker organization code?3
Insurance broker nameNFP INS SERVICES INC
AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95287 )
Policy contract numberUS068551
Policy instance 3
Insurance contract or identification numberUS068551
Number of Individuals Covered266
Insurance policy start date2012-02-01
Insurance policy end date2013-01-31
Total amount of commissions paid to insurance brokerUSD $44,748
Total amount of fees paid to insurance companyUSD $8,950
Welfare Benefit Premiums Paid to CarrierUSD $897,826
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $44,748
Amount paid for insurance broker fees8950
Additional information about fees paid to insurance brokerPM KP BONUS
Insurance broker organization code?3
Insurance broker namePREFERRED BENEFITS GROUP, INC.
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberTM05982218
Policy instance 2
Insurance contract or identification numberTM05982218
Number of Individuals Covered326
Insurance policy start date2011-02-01
Insurance policy end date2012-01-31
Total amount of commissions paid to insurance brokerUSD $9,163
Total amount of fees paid to insurance companyUSD $5
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $93,157
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,537
Amount paid for insurance broker fees5
Additional information about fees paid to insurance brokerNON-MONETARY COMPENSATION
Insurance broker organization code?3
Insurance broker nameNFP INS SERVICES INC
AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95287 )
Policy contract numberUS068551
Policy instance 3
Insurance contract or identification numberUS068551
Number of Individuals Covered259
Total amount of commissions paid to insurance brokerUSD $46,652
Total amount of fees paid to insurance companyUSD $8,443
Welfare Benefit Premiums Paid to CarrierUSD $860,285
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $46,652
Amount paid for insurance broker fees8443
Additional information about fees paid to insurance brokerPM KP BONUS
Insurance broker organization code?3
Insurance broker namePREFERRED BENEFITS GROUP, INC.
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract number530685
Policy instance 1
Insurance contract or identification number530685
Number of Individuals Covered326
Insurance policy start date2011-02-01
Insurance policy end date2012-02-01
Total amount of commissions paid to insurance brokerUSD $5,046
Total amount of fees paid to insurance companyUSD $549
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedADD
Welfare Benefit Premiums Paid to CarrierUSD $43,958
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,046
Amount paid for insurance broker fees549
Insurance broker organization code?3
Insurance broker namePREFERRED BENEFITS GROUP INC
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberTM057240970001
Policy instance 2
Insurance contract or identification numberTM057240970001
Insurance policy start date2010-02-01
Insurance policy end date2011-01-31
Total amount of commissions paid to insurance brokerUSD $1,847
Total amount of fees paid to insurance companyUSD $14
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $841
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract number530685
Policy instance 1
Insurance contract or identification number530685
Number of Individuals Covered308
Insurance policy start date2010-01-01
Insurance policy end date2011-01-01
Total amount of commissions paid to insurance brokerUSD $4,932
Total amount of fees paid to insurance companyUSD $527
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedADD
Welfare Benefit Premiums Paid to CarrierUSD $42,178
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberTM057240970001
Policy instance 3
Insurance contract or identification numberTM057240970001
Number of Individuals Covered253
Insurance policy start date2009-02-01
Insurance policy end date2010-01-31
Total amount of commissions paid to insurance brokerUSD $6,134
Total amount of fees paid to insurance companyUSD $1,221
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $62,180
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,134
Amount paid for insurance broker fees1221
Insurance broker organization code?3
Insurance broker namePREFERRED BENEFITS GROUP INC
AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95287 )
Policy contract numberUS068551
Policy instance 2
Insurance contract or identification numberUS068551
Number of Individuals Covered251
Insurance policy start date2009-02-01
Insurance policy end date2010-01-31
Total amount of commissions paid to insurance brokerUSD $31,986
Total amount of fees paid to insurance companyUSD $6,528
Welfare Benefit Premiums Paid to CarrierUSD $667,679
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $31,986
Amount paid for insurance broker fees6528
Additional information about fees paid to insurance brokerPM KP BONUS
Insurance broker organization code?3
Insurance broker namePREFERRED BENEFITS GROUP, INC.
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract number530685
Policy instance 1
Insurance contract or identification number530685
Number of Individuals Covered302
Insurance policy start date2009-01-01
Insurance policy end date2010-01-01
Total amount of commissions paid to insurance brokerUSD $4,930
Total amount of fees paid to insurance companyUSD $526
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedADD
Welfare Benefit Premiums Paid to CarrierUSD $42,040
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,930
Amount paid for insurance broker fees526
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
Insurance broker namePREFERRED BENEFITS GROUP INC

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