ARROWOOD INDEMNITY COMPANY has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan THE HEALTH & WELFARE BENEFIT PLAN OF ARROWOOD INDEMNITY COMPANY
401k plan membership statisitcs for THE HEALTH & WELFARE BENEFIT PLAN OF ARROWOOD INDEMNITY COMPANY
| Measure | Date | Value |
|---|
| 2022: THE HEALTH & WELFARE BENEFIT PLAN OF ARROWOOD INDEMNITY COMPANY 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-01-01 | 116 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 105 |
| Total of all active and inactive participants | 2022-01-01 | 105 |
| Total participants | 2022-01-01 | 105 |
| 2021: THE HEALTH & WELFARE BENEFIT PLAN OF ARROWOOD INDEMNITY COMPANY 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-01-01 | 121 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 116 |
| Total of all active and inactive participants | 2021-01-01 | 116 |
| Total participants | 2021-01-01 | 116 |
| 2020: THE HEALTH & WELFARE BENEFIT PLAN OF ARROWOOD INDEMNITY COMPANY 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-01-01 | 130 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 121 |
| Total of all active and inactive participants | 2020-01-01 | 121 |
| Total participants | 2020-01-01 | 121 |
| 2019: THE HEALTH & WELFARE BENEFIT PLAN OF ARROWOOD INDEMNITY COMPANY 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-01-01 | 133 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 130 |
| Number of retired or separated participants receiving benefits | 2019-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2019-01-01 | 0 |
| Total of all active and inactive participants | 2019-01-01 | 130 |
| Total participants | 2019-01-01 | 130 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2019-01-01 | 0 |
| Number of participants with account balances | 2019-01-01 | 0 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2019-01-01 | 0 |
| 2018: THE HEALTH & WELFARE BENEFIT PLAN OF ARROWOOD INDEMNITY COMPANY 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-01-01 | 147 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 133 |
| Number of retired or separated participants receiving benefits | 2018-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2018-01-01 | 0 |
| Total of all active and inactive participants | 2018-01-01 | 133 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2018-01-01 | 0 |
| Total participants | 2018-01-01 | 133 |
| Number of participants with account balances | 2018-01-01 | 0 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2018-01-01 | 0 |
| 2017: THE HEALTH & WELFARE BENEFIT PLAN OF ARROWOOD INDEMNITY COMPANY 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-01-01 | 157 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 147 |
| Number of retired or separated participants receiving benefits | 2017-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2017-01-01 | 0 |
| Total of all active and inactive participants | 2017-01-01 | 147 |
| Total participants | 2017-01-01 | 147 |
| 2016: THE HEALTH & WELFARE BENEFIT PLAN OF ARROWOOD INDEMNITY COMPANY 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-01-01 | 164 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 157 |
| Total of all active and inactive participants | 2016-01-01 | 157 |
| Total participants | 2016-01-01 | 157 |
| 2015: THE HEALTH & WELFARE BENEFIT PLAN OF ARROWOOD INDEMNITY COMPANY 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-01-01 | 171 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 164 |
| Total of all active and inactive participants | 2015-01-01 | 164 |
| Total participants | 2015-01-01 | 164 |
| 2014: THE HEALTH & WELFARE BENEFIT PLAN OF ARROWOOD INDEMNITY COMPANY 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-01-01 | 183 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 171 |
| Total of all active and inactive participants | 2014-01-01 | 171 |
| Total participants | 2014-01-01 | 171 |
| 2013: THE HEALTH & WELFARE BENEFIT PLAN OF ARROWOOD INDEMNITY COMPANY 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-01-01 | 198 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 183 |
| Total of all active and inactive participants | 2013-01-01 | 183 |
| Total participants | 2013-01-01 | 183 |
| 2012: THE HEALTH & WELFARE BENEFIT PLAN OF ARROWOOD INDEMNITY COMPANY 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-01-01 | 213 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 198 |
| Total of all active and inactive participants | 2012-01-01 | 198 |
| Total participants | 2012-01-01 | 198 |
| 2011: THE HEALTH & WELFARE BENEFIT PLAN OF ARROWOOD INDEMNITY COMPANY 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-01-01 | 2,217 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 213 |
| Total of all active and inactive participants | 2011-01-01 | 213 |
| Total participants | 2011-01-01 | 213 |
| 2009: THE HEALTH & WELFARE BENEFIT PLAN OF ARROWOOD INDEMNITY COMPANY 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-01-01 | 758 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 268 |
| Number of retired or separated participants receiving benefits | 2009-01-01 | 2,359 |
| Total of all active and inactive participants | 2009-01-01 | 2,627 |
| Total participants | 2009-01-01 | 2,627 |
| 2022: THE HEALTH & WELFARE BENEFIT PLAN OF ARROWOOD INDEMNITY COMPANY 2022 form 5500 responses |
|---|
| 2022-01-01 | Type of plan entity | Single employer plan |
| 2022-01-01 | Plan funding arrangement – Insurance | Yes |
| 2022-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2022-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2022-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2021: THE HEALTH & WELFARE BENEFIT PLAN OF ARROWOOD INDEMNITY COMPANY 2021 form 5500 responses |
|---|
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | Plan funding arrangement – Insurance | Yes |
| 2021-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2021-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2021-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2020: THE HEALTH & WELFARE BENEFIT PLAN OF ARROWOOD INDEMNITY COMPANY 2020 form 5500 responses |
|---|
| 2020-01-01 | Type of plan entity | Single employer plan |
| 2020-01-01 | Plan funding arrangement – Insurance | Yes |
| 2020-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2020-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2020-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2019: THE HEALTH & WELFARE BENEFIT PLAN OF ARROWOOD INDEMNITY COMPANY 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 | Plan funding arrangement – Insurance | Yes |
| 2019-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2019-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2019-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2018: THE HEALTH & WELFARE BENEFIT PLAN OF ARROWOOD INDEMNITY COMPANY 2018 form 5500 responses |
|---|
| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | Plan funding arrangement – Insurance | Yes |
| 2018-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2018-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2018-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2017: THE HEALTH & WELFARE BENEFIT PLAN OF ARROWOOD INDEMNITY COMPANY 2017 form 5500 responses |
|---|
| 2017-01-01 | Type of plan entity | Single employer plan |
| 2017-01-01 | Plan funding arrangement – Insurance | Yes |
| 2017-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2017-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2017-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2016: THE HEALTH & WELFARE BENEFIT PLAN OF ARROWOOD INDEMNITY COMPANY 2016 form 5500 responses |
|---|
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | Plan funding arrangement – Insurance | Yes |
| 2016-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2016-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2016-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2015: THE HEALTH & WELFARE BENEFIT PLAN OF ARROWOOD INDEMNITY COMPANY 2015 form 5500 responses |
|---|
| 2015-01-01 | Type of plan entity | Single employer plan |
| 2015-01-01 | Plan funding arrangement – Insurance | Yes |
| 2015-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2015-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2015-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2014: THE HEALTH & WELFARE BENEFIT PLAN OF ARROWOOD INDEMNITY COMPANY 2014 form 5500 responses |
|---|
| 2014-01-01 | Type of plan entity | Single employer plan |
| 2014-01-01 | Plan funding arrangement – Insurance | Yes |
| 2014-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2014-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2014-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2013: THE HEALTH & WELFARE BENEFIT PLAN OF ARROWOOD INDEMNITY COMPANY 2013 form 5500 responses |
|---|
| 2013-01-01 | Type of plan entity | Single employer plan |
| 2013-01-01 | Plan funding arrangement – Insurance | Yes |
| 2013-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2013-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2013-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2012: THE HEALTH & WELFARE BENEFIT PLAN OF ARROWOOD INDEMNITY COMPANY 2012 form 5500 responses |
|---|
| 2012-01-01 | Type of plan entity | Single employer plan |
| 2012-01-01 | Plan funding arrangement – Insurance | Yes |
| 2012-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2012-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2012-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2011: THE HEALTH & WELFARE BENEFIT PLAN OF ARROWOOD INDEMNITY COMPANY 2011 form 5500 responses |
|---|
| 2011-01-01 | Type of plan entity | Single employer plan |
| 2011-01-01 | Plan funding arrangement – Insurance | Yes |
| 2011-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2011-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2011-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2009: THE HEALTH & WELFARE BENEFIT PLAN OF ARROWOOD INDEMNITY COMPANY 2009 form 5500 responses |
|---|
| 2009-01-01 | Type of plan entity | Single employer plan |
| 2009-01-01 | Submission has been amended | Yes |
| 2009-01-01 | Plan funding arrangement – Insurance | Yes |
| 2009-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2009-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2009-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0154858 |
| Policy instance | 3 |
| Insurance contract or identification number | 0154858 | | Number of Individuals Covered | 0 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $8,188 | | Total amount of fees paid to insurance company | USD $3,910 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $220,022 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,188 | | Amount paid for insurance broker fees | 3147 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION NON-MONETARY COMPENSATION | | Insurance broker organization code? | 3 |
|
| NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 ) |
| Policy contract number | GTP 9060850-C |
| Policy instance | 2 |
| Insurance contract or identification number | GTP 9060850-C | | Number of Individuals Covered | 105 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Other welfare benefits provided | BUSINESS TRAVEL ACCIDENT | | 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 HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 00617017 |
| Policy instance | 1 |
| Insurance contract or identification number | 00617017 | | Number of Individuals Covered | 170 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $2,279,549 | | 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 number | 0154858 |
| Policy instance | 3 |
| Insurance contract or identification number | 0154858 | | Number of Individuals Covered | 267 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $8,185 | | Total amount of fees paid to insurance company | USD $13,027 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $223,584 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,185 | | Amount paid for insurance broker fees | 13027 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION AND NON-MONETARY COMPENSATION | | Insurance broker organization code? | 3 |
|
| NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 ) |
| Policy contract number | GTP 9060850-C |
| Policy instance | 2 |
| Insurance contract or identification number | GTP 9060850-C | | Number of Individuals Covered | 116 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Other welfare benefits provided | BUSINESS TRAVEL ACCIDENT | | 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 HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 00617017 |
| Policy instance | 1 |
| Insurance contract or identification number | 00617017 | | Number of Individuals Covered | 191 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $2,357,074 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 00617017 |
| Policy instance | 1 |
| Insurance contract or identification number | 00617017 | | Number of Individuals Covered | 278 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $2,456,541 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 ) |
| Policy contract number | GTP 9060850-C |
| Policy instance | 2 |
| Insurance contract or identification number | GTP 9060850-C | | Number of Individuals Covered | 121 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $1,920 | | Other welfare benefits provided | BUSINESS TRAVEL AND ACCIDENT | | Welfare Benefit Premiums Paid to Carrier | USD $7,679 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,920 | | Insurance broker organization code? | 3 |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0154858 |
| Policy instance | 3 |
| Insurance contract or identification number | 0154858 | | Number of Individuals Covered | 283 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $1,299 | | Total amount of fees paid to insurance company | USD $31,503 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $241,833 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,299 | | Amount paid for insurance broker fees | 31503 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION AND NON-MONETARY COMPENSATION | | Insurance broker organization code? | 3 |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0154858 |
| Policy instance | 3 |
| Insurance contract or identification number | 0154858 | | Number of Individuals Covered | 279 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $1,705 | | Total amount of fees paid to insurance company | USD $3,105 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $254,191 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,705 | | Amount paid for insurance broker fees | 3105 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION AND NON-MONETARY COMPENSATON | | Insurance broker organization code? | 3 |
|
| NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 ) |
| Policy contract number | GTP 9060850-B |
| Policy instance | 2 |
| Insurance contract or identification number | GTP 9060850-B | | Number of Individuals Covered | 130 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Other welfare benefits provided | BUSINESS TRAVEL AND ACCIDENT | | 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 HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 00617017 |
| Policy instance | 1 |
| Insurance contract or identification number | 00617017 | | Number of Individuals Covered | 303 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $2,492,353 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 006170017 |
| Policy instance | 1 |
| Insurance contract or identification number | 006170017 | | Number of Individuals Covered | 347 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $2,112,894 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 ) |
| Policy contract number | GTP 9060850-A |
| Policy instance | 2 |
| Insurance contract or identification number | GTP 9060850-A | | Number of Individuals Covered | 147 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Other welfare benefits provided | BUSINESS TRAVEL AND ACCIDENT | | 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 number | 0154858 |
| Policy instance | 3 |
| Insurance contract or identification number | 0154858 | | Number of Individuals Covered | 246 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $1,957 | | Total amount of fees paid to insurance company | USD $3,890 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $307,665 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,957 | | Amount paid for insurance broker fees | 3890 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | | Insurance broker organization code? | 3 | | Insurance broker name | TRION GROUP |
|
| BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 ) |
| Policy contract number | 081019 |
| Policy instance | 1 |
| Insurance contract or identification number | 081019 | | Number of Individuals Covered | 344 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of fees paid to insurance company | USD $843 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,929,780 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 843 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | | Insurance broker organization code? | 3 | | Insurance broker name | EDMUND F GARNO III |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0154858 |
| Policy instance | 4 |
| Insurance contract or identification number | 0154858 | | Number of Individuals Covered | 397 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $1,728 | | Total amount of fees paid to insurance company | USD $2,043 | | Dental Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $506,249 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,728 | | Amount paid for insurance broker fees | 2043 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION NON-MONETARY COMPENSATION | | Insurance broker organization code? | 3 | | Insurance broker name | TRION GROUP |
|
| NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 ) |
| Policy contract number | GTP 9060850-A |
| Policy instance | 3 |
| Insurance contract or identification number | GTP 9060850-A | | Number of Individuals Covered | 164 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Other welfare benefits provided | BUSINESS TRAVEL AND ACCIDENT | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 9771817 |
| Policy instance | 2 |
| Insurance contract or identification number | 9771817 | | Number of Individuals Covered | 313 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $18,324 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 228543 |
| Policy instance | 1 |
| Insurance contract or identification number | 228543 | | Number of Individuals Covered | 328 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $2,011,630 | | 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 number | 0154858 |
| Policy instance | 5 |
| Insurance contract or identification number | 0154858 | | Number of Individuals Covered | 291 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $5,974 | | Total amount of fees paid to insurance company | USD $4,367 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $342,135 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,974 | | Amount paid for insurance broker fees | 4367 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION NON-MONETARY COMPENSATION | | Insurance broker organization code? | 3 | | Insurance broker name | MERCER |
|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 3335194 |
| Policy instance | 4 |
| Insurance contract or identification number | 3335194 | | Number of Individuals Covered | 391 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $223,449 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 ) |
| Policy contract number | GTP 9060850-A |
| Policy instance | 3 |
| Insurance contract or identification number | GTP 9060850-A | | Number of Individuals Covered | 171 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $1,383 | | Other welfare benefits provided | BUSINESS TRAVEL ACCIDENT | | Welfare Benefit Premiums Paid to Carrier | USD $9,223 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,383 | | Insurance broker organization code? | 3 | | Insurance broker name | SPECIAL RISK INSURANCE SERVICES INC |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 9771817 |
| Policy instance | 2 |
| Insurance contract or identification number | 9771817 | | Number of Individuals Covered | 313 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $19,152 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 3335194 |
| Policy instance | 7 |
| Insurance contract or identification number | 3335194 | | Number of Individuals Covered | 413 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $199,348 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 9771817 |
| Policy instance | 2 |
| Insurance contract or identification number | 9771817 | | Number of Individuals Covered | 333 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $17,400 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 228543 |
| Policy instance | 1 |
| Insurance contract or identification number | 228543 | | Number of Individuals Covered | 295 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $2,161,116 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | FLX 051668 |
| Policy instance | 3 |
| Insurance contract or identification number | FLX 051668 | | Number of Individuals Covered | 433 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $13,401 | | Total amount of fees paid to insurance company | USD $-6,025 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $219,024 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $13,401 | | Amount paid for insurance broker fees | -6025 | | Additional information about fees paid to insurance broker | SUPP COMMISSION AND OVERRIDE | | Insurance broker organization code? | 3 | | Insurance broker name | MARSH & MCLENNAN AGENCY LLC |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | OK 960191 |
| Policy instance | 4 |
| Insurance contract or identification number | OK 960191 | | Number of Individuals Covered | 134 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $452 | | Total amount of fees paid to insurance company | USD $-204 | | Other welfare benefits provided | ACCIDENTAL DEATH | | Welfare Benefit Premiums Paid to Carrier | USD $8,001 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $452 | | Amount paid for insurance broker fees | -204 | | Additional information about fees paid to insurance broker | SUPP COMMISSION AND OVERRIDE | | Insurance broker organization code? | 3 | | Insurance broker name | MARSH & MCLENNAN AGENCY LLC |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | FLK 960078 |
| Policy instance | 5 |
| Insurance contract or identification number | FLK 960078 | | Number of Individuals Covered | 181 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $6,907 | | Total amount of fees paid to insurance company | USD $-3,081 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $123,981 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,907 | | Amount paid for insurance broker fees | -3081 | | Additional information about fees paid to insurance broker | SUPP COMMISSION AND OVERRIDE | | Insurance broker organization code? | 3 | | Insurance broker name | MARSH & MCLENNAN AGENCY LLC |
|
| NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 ) |
| Policy contract number | GTP 9060850 |
| Policy instance | 6 |
| Insurance contract or identification number | GTP 9060850 | | Number of Individuals Covered | 183 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $336 | | Other welfare benefits provided | BUSINESS TRAVEL ACCIDENT | | Welfare Benefit Premiums Paid to Carrier | USD $2,243 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $336 | | Insurance broker organization code? | 3 | | Insurance broker name | SPECIAL RISK INSURANCE SERVICES INC |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | FLK 960078 |
| Policy instance | 5 |
| Insurance contract or identification number | FLK 960078 | | Number of Individuals Covered | 194 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $1,045 | | Total amount of fees paid to insurance company | USD $3,081 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $126,411 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,045 | | Amount paid for insurance broker fees | 3081 | | Additional information about fees paid to insurance broker | SUPP. COMMISSION AND OVERRIDE | | Insurance broker organization code? | 3 | | Insurance broker name | MARSH & MCLENNAN AGENCY |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | FLX 051668 |
| Policy instance | 3 |
| Insurance contract or identification number | FLX 051668 | | Number of Individuals Covered | 472 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $2,039 | | Total amount of fees paid to insurance company | USD $6,012 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $227,087 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,039 | | Amount paid for insurance broker fees | 6012 | | Additional information about fees paid to insurance broker | SUPP. COMMISSION AND OVERRIDE | | Insurance broker organization code? | 3 | | Insurance broker name | MARSH & MCLENNAN AGENCY |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | OK 960191 |
| Policy instance | 4 |
| Insurance contract or identification number | OK 960191 | | Number of Individuals Covered | 142 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $69 | | Total amount of fees paid to insurance company | USD $204 | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $8,320 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $69 | | Amount paid for insurance broker fees | 204 | | Additional information about fees paid to insurance broker | SUPP. COMMISSION AND OVERRIDE | | Insurance broker organization code? | 3 | | Insurance broker name | MARSH & MCLENNAN AGENCY |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 9771817 |
| Policy instance | 2 |
| Insurance contract or identification number | 9771817 | | Number of Individuals Covered | 341 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $17,613 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 228543 |
| Policy instance | 1 |
| Insurance contract or identification number | 228543 | | Number of Individuals Covered | 299 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $2,175,563 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 ) |
| Policy contract number | GTP 9060850 |
| Policy instance | 6 |
| Insurance contract or identification number | GTP 9060850 | | Number of Individuals Covered | 198 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $337 | | Other welfare benefits provided | BUSINESS TRAVEL ACCIDENT | | Welfare Benefit Premiums Paid to Carrier | USD $2,243 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $337 | | Insurance broker organization code? | 3 | | Insurance broker name | SPECIAL RISK INSURANCE SERVICES INC |
|
| CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 ) |
| Policy contract number | 3335194 |
| Policy instance | 7 |
| Insurance contract or identification number | 3335194 | | Number of Individuals Covered | 436 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $211,685 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 228543 |
| Policy instance | 1 |
| Insurance contract or identification number | 228543 | | Number of Individuals Covered | 385 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $3,597,956 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 9771817 |
| Policy instance | 2 |
| Insurance contract or identification number | 9771817 | | Number of Individuals Covered | 360 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $19,124 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | FLX 051668 |
| Policy instance | 3 |
| Insurance contract or identification number | FLX 051668 | | Number of Individuals Covered | 212 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $11,365 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $266,463 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | OK 960191 |
| Policy instance | 4 |
| Insurance contract or identification number | OK 960191 | | Number of Individuals Covered | 148 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $540 | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $8,829 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | FLK 960078 |
| Policy instance | 5 |
| Insurance contract or identification number | FLK 960078 | | Number of Individuals Covered | 209 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $6,363 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $131,945 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 ) |
| Policy contract number | GTP 9060850 |
| Policy instance | 6 |
| Insurance contract or identification number | GTP 9060850 | | Number of Individuals Covered | 213 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $337 | | Other welfare benefits provided | BUSINESS TRAVEL ACCIDENT | | Welfare Benefit Premiums Paid to Carrier | USD $2,243 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | FLX 051668 |
| Policy instance | 3 |
| Insurance contract or identification number | FLX 051668 | | Number of Individuals Covered | 2184 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | BASIC LIFE, SUPP LIFE, DEP LIFE | | Welfare Benefit Premiums Paid to Carrier | USD $204,603 |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 228543 |
| Policy instance | 1 |
| Insurance contract or identification number | 228543 | | Number of Individuals Covered | 658 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | 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 $3,543,904 |
|
| NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 ) |
| Policy contract number | GTP 9060850 |
| Policy instance | 6 |
| Insurance contract or identification number | GTP 9060850 | | Number of Individuals Covered | 238 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $384 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | BUSINESS TRAVEL ACCIDENT | | Welfare Benefit Premiums Paid to Carrier | USD $2,563 | | Commission paid to Insurance Broker | USD $384 | | Additional information about fees paid to insurance broker | N/A | | Insurance broker organization code? | 3 | | Insurance broker name | SPECIAL RISK SERVICES INC |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | FLK 960078 |
| Policy instance | 5 |
| Insurance contract or identification number | FLK 960078 | | Number of Individuals Covered | 234 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $143,870 |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | OK 960191 |
| Policy instance | 4 |
| Insurance contract or identification number | OK 960191 | | Number of Individuals Covered | 164 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $9,935 |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 9771817 |
| Policy instance | 2 |
| Insurance contract or identification number | 9771817 | | Number of Individuals Covered | 409 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $21,350 |
|
