NEW YORK UNIVERSITY SCHOOL OF MEDICINE HEALTH AND WELFARE PLAN 401k Plan overview

Plan Name	NEW YORK UNIVERSITY SCHOOL OF MEDICINE HEALTH AND WELFARE PLAN
Plan identification number	515

NEW YORK UNIVERSITY SCHOOL OF MEDICINE HEALTH AND WELFARE PLAN Benefits

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

401k Sponsoring company profile

NEW YORK UNIVERSITY has sponsored the creation of one or more 401k plans.

Company Name:	NEW YORK UNIVERSITY
Employer identification number (EIN):	135562308
NAIC Classification:	622000
NAIC Description:	Hospitals

Additional information about NEW YORK UNIVERSITY

Jurisdiction of Incorporation:	Washington Secretary of State Corporations Division
Incorporation Date:	2016-03-07
Company Identification Number:	603593869
Legal Registered Office Address:	3400 CAPITL BLVD SE STE 101 TUMWATER United States of America (USA) 98501

More information about NEW YORK UNIVERSITY

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NEW YORK UNIVERSITY SCHOOL OF MEDICINE HEALTH AND WELFARE PLAN

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
515	2022-01-01
515	2021-01-01
515	2020-01-01
515	2019-01-01
515	2018-01-01
515	2017-01-01	FRANK FRANZI		FRANK FRANZI	2018-10-08
515	2016-01-01	FRANK FRANZI
515	2015-01-01	MARGARET MEAGHER
515	2014-01-01	MARGARET MEAGHER		MARGARET MEAGHER	2015-10-15
515	2013-01-01	MARGARET MEAGHER		MARGARET MEAGHER	2014-10-15
515	2012-01-01	MARGARET MEAGHER
515	2011-01-01	MARGARET MEAGHER
515	2010-01-01	MARGARET MEAGHER		MARGARET MEAGHER	2014-10-15
515	2009-01-01	MARGARET MEAGHER

Plan Statistics for NEW YORK UNIVERSITY SCHOOL OF MEDICINE HEALTH AND WELFARE PLAN

401k plan membership statisitcs for NEW YORK UNIVERSITY SCHOOL OF MEDICINE HEALTH AND WELFARE PLAN

Measure	Date	Value
2022: NEW YORK UNIVERSITY SCHOOL OF MEDICINE HEALTH AND WELFARE PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	13,085
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	13,950
Number of retired or separated participants receiving benefits	2022-01-01	0
Number of other retired or separated participants entitled to future benefits	2022-01-01	0
Total of all active and inactive participants	2022-01-01	13,950
2021: NEW YORK UNIVERSITY SCHOOL OF MEDICINE HEALTH AND WELFARE PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	12,683
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	13,085
Total of all active and inactive participants	2021-01-01	13,085
2020: NEW YORK UNIVERSITY SCHOOL OF MEDICINE HEALTH AND WELFARE PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	12,479
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	12,683
Total of all active and inactive participants	2020-01-01	12,683
2019: NEW YORK UNIVERSITY SCHOOL OF MEDICINE HEALTH AND WELFARE PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	11,830
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	12,479
Total of all active and inactive participants	2019-01-01	12,479
2018: NEW YORK UNIVERSITY SCHOOL OF MEDICINE HEALTH AND WELFARE PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	11,632
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	11,830
Total of all active and inactive participants	2018-01-01	11,830
2017: NEW YORK UNIVERSITY SCHOOL OF MEDICINE HEALTH AND WELFARE PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	10,506
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	11,632
Number of retired or separated participants receiving benefits	2017-01-01	76
Total of all active and inactive participants	2017-01-01	11,708
2016: NEW YORK UNIVERSITY SCHOOL OF MEDICINE HEALTH AND WELFARE PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	9,610
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	10,429
Number of retired or separated participants receiving benefits	2016-01-01	77
Total of all active and inactive participants	2016-01-01	10,506
2015: NEW YORK UNIVERSITY SCHOOL OF MEDICINE HEALTH AND WELFARE PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	9,210
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	9,555
Number of retired or separated participants receiving benefits	2015-01-01	55
Total of all active and inactive participants	2015-01-01	9,610
2014: NEW YORK UNIVERSITY SCHOOL OF MEDICINE HEALTH AND WELFARE PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	8,698
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	9,147
Number of retired or separated participants receiving benefits	2014-01-01	63
Number of other retired or separated participants entitled to future benefits	2014-01-01	0
Total of all active and inactive participants	2014-01-01	9,210
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	9,210
2013: NEW YORK UNIVERSITY SCHOOL OF MEDICINE HEALTH AND WELFARE PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	8,140
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	8,633
Number of retired or separated participants receiving benefits	2013-01-01	65
Total of all active and inactive participants	2013-01-01	8,698
2012: NEW YORK UNIVERSITY SCHOOL OF MEDICINE HEALTH AND WELFARE PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	10,471
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	8,047
Number of retired or separated participants receiving benefits	2012-01-01	93
Total of all active and inactive participants	2012-01-01	8,140
Total participants	2012-01-01	8,140
2011: NEW YORK UNIVERSITY SCHOOL OF MEDICINE HEALTH AND WELFARE PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	7,624
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	10,390
Number of retired or separated participants receiving benefits	2011-01-01	81
Total of all active and inactive participants	2011-01-01	10,471
Total participants	2011-01-01	10,471
2010: NEW YORK UNIVERSITY SCHOOL OF MEDICINE HEALTH AND WELFARE PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	7,445
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	7,525
Number of retired or separated participants receiving benefits	2010-01-01	668
Number of other retired or separated participants entitled to future benefits	2010-01-01	0
Total of all active and inactive participants	2010-01-01	8,193
2009: NEW YORK UNIVERSITY SCHOOL OF MEDICINE HEALTH AND WELFARE PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	6,934
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	6,776
Number of retired or separated participants receiving benefits	2009-01-01	669
Number of other retired or separated participants entitled to future benefits	2009-01-01	0
Total of all active and inactive participants	2009-01-01	7,445
Total participants	2009-01-01	7,445

Financial Data on NEW YORK UNIVERSITY SCHOOL OF MEDICINE HEALTH AND WELFARE PLAN

Measure	Date	Value
2010 : NEW YORK UNIVERSITY SCHOOL OF MEDICINE HEALTH AND WELFARE PLAN 2010 401k financial data
Total unrealized appreciation/depreciation of assets	2010-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$4,138,278
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total income from all sources (including contributions)	2010-12-31	$89,864,703
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$70,138,738
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$68,139,821
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$89,801,637
Value of total assets at end of year	2010-12-31	$19,725,965
Value of total assets at beginning of year	2010-12-31	$0
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$1,998,917
Total interest from all sources	2010-12-31	$16,466
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$27,412
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Administrative expenses professional fees incurred	2010-12-31	$1,998,917
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$20,000,000
If this is an individual account plan, was there a blackout period	2010-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Contributions received from participants	2010-12-31	$1,407,716
Value of other receiveables (less allowance for doubtful accounts) at end of year	2010-12-31	$3,376
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Income. Non cash contributions	2010-12-31	$0
Value of net income/loss	2010-12-31	$19,725,965
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$15,587,687
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2010-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2010-12-31	No
Were any leases to which the plan was party in default or uncollectible	2010-12-31	No
Value of interest in common/collective trusts at end of year	2010-12-31	$19,722,589
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2010-12-31	$16,466
Expenses. Payments to insurance carriers foe the provision of benefits	2010-12-31	$17,608,609
Net investment gain or loss from common/collective trusts	2010-12-31	$19,188
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2010-12-31	No
Was there a failure to transmit to the plan any participant contributions	2010-12-31	No
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Contributions received in cash from employer	2010-12-31	$88,393,921
Income. Dividends from common stock	2010-12-31	$27,412
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$50,531,212
Liabilities. Value of benefit claims payable at end of year	2010-12-31	$4,138,278
Did the plan have assets held for investment	2010-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2010-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2010-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2010-12-31	Disclaimer
Accountancy firm name	2010-12-31	PRICEWATERHOUSE COOPERS
Accountancy firm EIN	2010-12-31	134008324

Form 5500 Responses for NEW YORK UNIVERSITY SCHOOL OF MEDICINE HEALTH AND WELFARE PLAN

2022: NEW YORK UNIVERSITY SCHOOL OF MEDICINE HEALTH AND WELFARE PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Submission has been amended	No
2022-01-01	This submission is the final filing	No
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-01-01	Plan is a collectively bargained plan	No
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan 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: NEW YORK UNIVERSITY SCHOOL OF MEDICINE HEALTH AND WELFARE PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan 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: NEW YORK UNIVERSITY SCHOOL OF MEDICINE HEALTH AND WELFARE PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan 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: NEW YORK UNIVERSITY SCHOOL OF MEDICINE HEALTH AND WELFARE PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan 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: NEW YORK UNIVERSITY SCHOOL OF MEDICINE HEALTH AND WELFARE PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan 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: NEW YORK UNIVERSITY SCHOOL OF MEDICINE HEALTH AND WELFARE PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan 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: NEW YORK UNIVERSITY SCHOOL OF MEDICINE HEALTH AND WELFARE PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan 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: NEW YORK UNIVERSITY SCHOOL OF MEDICINE HEALTH AND WELFARE PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan 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: NEW YORK UNIVERSITY SCHOOL OF MEDICINE HEALTH AND WELFARE PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan 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: NEW YORK UNIVERSITY SCHOOL OF MEDICINE HEALTH AND WELFARE PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan 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: NEW YORK UNIVERSITY SCHOOL OF MEDICINE HEALTH AND WELFARE PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan 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: NEW YORK UNIVERSITY SCHOOL OF MEDICINE HEALTH AND WELFARE PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan 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
2010: NEW YORK UNIVERSITY SCHOOL OF MEDICINE HEALTH AND WELFARE PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	Yes
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	No
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2009: NEW YORK UNIVERSITY SCHOOL OF MEDICINE HEALTH AND WELFARE PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan 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

Insurance Providers Used on plan

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	0101899
Policy instance	4
Insurance contract or identification number 903873306 Number of Individuals Covered 259 Insurance policy start date 2017-01-01 Insurance policy end date 2017-12-31 Total amount of commissions paid to insurance broker USD $16,050 Total amount of fees paid to insurance company USD $1,011,407 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit Yes Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $1,011,407 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $16,050 Amount paid for insurance broker fees 95 Additional information about fees paid to insurance broker NON-MONETARY 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 number	3329827
Policy instance	1
Insurance contract or identification number 3329827 Number of Individuals Covered 2851 Insurance policy start date 2022-01-01 Insurance policy end date 2022-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $3,649 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $613,481 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $0 Amount paid for insurance broker fees 3649 Additional information about fees paid to insurance broker GENERAL AGENT PAYMENTS Insurance broker organization code? 3
DELTA DENTAL OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 55263 )
Policy contract number	NY03305
Policy instance	2
Insurance contract or identification number NY03305 Number of Individuals Covered 8597 Insurance policy start date 2022-01-01 Insurance policy end date 2022-12-31 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $3,096,091 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 )
Policy contract number	721262
Policy instance	3
Insurance contract or identification number 721262 Number of Individuals Covered 15041 Insurance policy start date 2022-01-01 Insurance policy end date 2022-12-31 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit Yes Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $775,104 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	0144239
Policy instance	5
Insurance contract or identification number 0144239 Number of Individuals Covered 14381 Insurance policy start date 2022-01-01 Insurance policy end date 2022-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $97,846 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit Yes Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided ACCIDENTAL DEATH & DISMEMBERMENT Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $5,774,978 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $0 Amount paid for insurance broker fees 97846 Additional information about fees paid to insurance broker SUPPLEMENTAL COMPENSATION NON-MONETARY COMPENSATION Insurance broker organization code? 3
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract number	NYD075467
Policy instance	6
Insurance contract or identification number NYD075467 Number of Individuals Covered 9102 Insurance policy start date 2022-01-01 Insurance policy end date 2022-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided STATUTORY DISABILITY Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $3,626,418 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract number	NYK980018
Policy instance	7
Insurance contract or identification number NYK980018 Number of Individuals Covered 11310 Insurance policy start date 2022-01-01 Insurance policy end date 2022-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit Yes Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $4,678,264 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract number	NYK980019
Policy instance	8
Insurance contract or identification number NYK980019 Number of Individuals Covered 3103 Insurance policy start date 2022-01-01 Insurance policy end date 2022-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit Yes Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $1,644,192 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	GTP0009148574
Policy instance	1
Insurance contract or identification number GTP0009148574 Number of Individuals Covered 13085 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $9,000 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided ACCIDENTAL DEATH & DISMEMBERMENT, PARALYSIS, COMA & LOSS OF USE Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $60,000 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Amount paid for insurance broker fees 9000 Additional information about fees paid to insurance broker COMMISSIONS Insurance broker organization code? 3
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number	3329827
Policy instance	4
Insurance contract or identification number 3329827 Number of Individuals Covered 2441 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $573,028 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract number	NYK980019
Policy instance	5
Insurance contract or identification number NYK980019 Number of Individuals Covered 13085 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $3,974 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided SHORT TERM DISABILTY Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $119,554 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Amount paid for insurance broker fees 3974 Additional information about fees paid to insurance broker SALES & SERVICES Insurance broker organization code? 3
EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 )
Policy contract number	G1921
Policy instance	7
Insurance contract or identification number G1921 Number of Individuals Covered 13817 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit Yes Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $719,998 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
DELTA DENTAL OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 55263 )
Policy contract number	NY3305
Policy instance	6
Insurance contract or identification number NY3305 Number of Individuals Covered 7895 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $2,992,156 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	0144239
Policy instance	8
Insurance contract or identification number 0144239 Number of Individuals Covered 13715 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $76,986 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit Yes Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided ACCIDENTAL DEATH AND DISMEMBERMENT Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $5,309,275 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Amount paid for insurance broker fees 76931 Additional information about fees paid to insurance broker SUPPLEMENTAL COMPENSATION Insurance broker organization code? 3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	0101899
Policy instance	9
Insurance contract or identification number 0101899 Number of Individuals Covered 9655 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $55 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $8,304,559 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Amount paid for insurance broker fees 55 Additional information about fees paid to insurance broker NON-MONETARY COMPENSATION Insurance broker organization code? 3
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract number	NYK980018
Policy instance	3
Insurance contract or identification number NYK980018 Number of Individuals Covered 13085 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $7,098 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit Yes Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $373,068 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Amount paid for insurance broker fees 7098 Additional information about fees paid to insurance broker SALES & SERVICE Insurance broker organization code? 3
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract number	NYD075457
Policy instance	2
Insurance contract or identification number NYD075457 Number of Individuals Covered 13085 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $7,098 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided STATUTORY DISABILITY Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $386,797 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Amount paid for insurance broker fees 7098 Additional information about fees paid to insurance broker SALES & SERVICE Insurance broker organization code? 3
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract number	NYK980019
Policy instance	12
Insurance contract or identification number NYK980019 Number of Individuals Covered 13085 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided SHORT TERM DISABILITY Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $902,987 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract number	NYD075467
Policy instance	11
Insurance contract or identification number NYD075467 Number of Individuals Covered 13085 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided STATUTORY DISABILITY Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $2,712,472 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract number	NYK980018
Policy instance	10
Insurance contract or identification number NYK980018 Number of Individuals Covered 13085 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit Yes Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $2,246,535 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
DELTA DENTAL OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 55263 )
Policy contract number	NY3305
Policy instance	6
Insurance contract or identification number NY3305 Number of Individuals Covered 3484 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $2,992,492 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 )
Policy contract number	G1921
Policy instance	7
Insurance contract or identification number G1921 Number of Individuals Covered 12498 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit Yes Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $594,852 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	0101899
Policy instance	9
Insurance contract or identification number 0101899 Number of Individuals Covered 10187 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $53 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $9,243,730 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Amount paid for insurance broker fees 53 Additional information about fees paid to insurance broker NON-MONETARY COMPENSATION Insurance broker organization code? 3
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract number	NYK980018
Policy instance	2
Insurance contract or identification number NYK980018 Number of Individuals Covered 12683 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $6,384 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit Yes Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $2,075,564 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Amount paid for insurance broker fees 6384 Additional information about fees paid to insurance broker SALES AND SERVICE Insurance broker organization code? 7
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract number	NYD075467
Policy instance	5
Insurance contract or identification number NYD075467 Number of Individuals Covered 12683 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $5,946 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided STATUTORY DISABILITY Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $1,350,049 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Amount paid for insurance broker fees 5946 Additional information about fees paid to insurance broker SALES & SERVICE Insurance broker organization code? 7
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number	3329827
Policy instance	4
Insurance contract or identification number 3329827 Number of Individuals Covered 2039 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $489,912 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	0144239
Policy instance	8
Insurance contract or identification number 0144239 Number of Individuals Covered 12772 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $49,334 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit Yes Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided ACCIDENTAL DEATH AND DISMEMBERMENT Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $4,716,348 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Amount paid for insurance broker fees 49334 Additional information about fees paid to insurance broker NON-MONETARY COMPENSATION Insurance broker organization code? 3
NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 )
Policy contract number	GTP0009148574
Policy instance	1
Insurance contract or identification number GTP0009148574 Number of Individuals Covered 12683 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $23,556 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided ACCIDENTAL DEATH & DISMEMBERMENT, PARALYSIS, COMA & LOSS OF USE Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $157,037 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Amount paid for insurance broker fees 23556 Additional information about fees paid to insurance broker COMMISSIONS Insurance broker organization code? 3
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract number	NYK980019-75467
Policy instance	3
Insurance contract or identification number NYK980019-75467 Number of Individuals Covered 8077 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $9,093 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided SHORT TERM AND STATUTORY DISABILITY Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $745,588 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Amount paid for insurance broker fees 9093 Additional information about fees paid to insurance broker SALES AND SERVICE Insurance broker organization code? 7
STANDARD SECURITY LIFE (National Association of Insurance Commissioners NAIC id number: 69078 )
Policy contract number	9687138/53/46
Policy instance	7
Insurance contract or identification number 9687138/53/46 Number of Individuals Covered 12949 Insurance policy start date 2019-01-01 Insurance policy end date 2019-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit Yes Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $730,511 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	3329827
Policy instance	4
Insurance contract or identification number 3329827 Number of Individuals Covered 1290 Insurance policy start date 2019-01-01 Insurance policy end date 2019-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $180 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $473,088 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Amount paid for insurance broker fees 180 Additional information about fees paid to insurance broker GENERAL AGENT PAYMENTS Insurance broker organization code? 3
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract number	NYK980019-75467
Policy instance	3
Insurance contract or identification number NYK980019-75467 Number of Individuals Covered 8336 Insurance policy start date 2019-01-01 Insurance policy end date 2019-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $2,276 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided SHORT TERM AND STATUTORY DISABILITY Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $474,228 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Amount paid for insurance broker fees 2276 Additional information about fees paid to insurance broker COMMISSIONS Insurance broker organization code? 7
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract number	NYK980018
Policy instance	2
Insurance contract or identification number NYK980018 Number of Individuals Covered 12479 Insurance policy start date 2019-01-01 Insurance policy end date 2019-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $5,980 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit Yes Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $1,988,039 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Amount paid for insurance broker fees 5980 Additional information about fees paid to insurance broker COMMISSIONS Insurance broker organization code? 7
NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 )
Policy contract number	GTP0009148574
Policy instance	1
Insurance contract or identification number GTP0009148574 Number of Individuals Covered 12479 Insurance policy start date 2019-01-01 Insurance policy end date 2019-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $23,556 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided ACCIDENTAL DEATH & DISMEMBERMENT, PARALYSIS, COMA & LOSS OF USE Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $157,037 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Amount paid for insurance broker fees 23556 Additional information about fees paid to insurance broker ADDITIONAL COMPENSATION Insurance broker organization code? 3
DELTA DENTAL OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 55263 )
Policy contract number	NY3305
Policy instance	6
Insurance contract or identification number NY3305 Number of Individuals Covered 4280 Insurance policy start date 2019-01-01 Insurance policy end date 2019-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $3,100,024 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	0144239
Policy instance	8
Insurance contract or identification number 0144239 Number of Individuals Covered 12705 Insurance policy start date 2019-01-01 Insurance policy end date 2019-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $77 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit Yes Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided ACCIDENTAL DEATH AND DISMEMBERMENT Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $4,485,074 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Amount paid for insurance broker fees 77 Additional information about fees paid to insurance broker NON-MONETARY COMPENSATION Insurance broker organization code? 3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	0101899
Policy instance	9
Insurance contract or identification number 0101899 Number of Individuals Covered 9759 Insurance policy start date 2019-01-01 Insurance policy end date 2019-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $77 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $8,460,109 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Amount paid for insurance broker fees 77 Additional information about fees paid to insurance broker NON-MONETARY COMPENSATION Insurance broker organization code? 3
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract number	NYD075467
Policy instance	5
Insurance contract or identification number NYD075467 Number of Individuals Covered 8336 Insurance policy start date 2019-01-01 Insurance policy end date 2019-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $4,233 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided STATUTORY DISABILITY Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $865,472 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Amount paid for insurance broker fees 4233 Additional information about fees paid to insurance broker SALES & SERVICE Insurance broker organization code? 7
NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 )
Policy contract number	GTP0009148574
Policy instance	1
Insurance contract or identification number GTP0009148574 Number of Individuals Covered 11830 Insurance policy start date 2018-01-01 Insurance policy end date 2018-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $23,556 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided ACCIDENTAL DEATH & DISMEMBERMENT, PARALYSIS, COMA & LOSS OF USE Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $157,037 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Amount paid for insurance broker fees 23556 Additional information about fees paid to insurance broker ADDITIONAL COMPENSATION Insurance broker organization code? 3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	0144239
Policy instance	7
Insurance contract or identification number 0144239 Number of Individuals Covered 11716 Insurance policy start date 2018-01-01 Insurance policy end date 2018-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit Yes Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided ACCIDENTAL DEATH AND DISMEMBERMENT Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $3,848,715 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
STANDARD SECURITY LIFE (National Association of Insurance Commissioners NAIC id number: 69078 )
Policy contract number	9687138/53/46
Policy instance	6
Insurance contract or identification number 9687138/53/46 Number of Individuals Covered 11404 Insurance policy start date 2018-01-01 Insurance policy end date 2018-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit Yes Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $781,339 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	3329827
Policy instance	4
Insurance contract or identification number 3329827 Number of Individuals Covered 1251 Insurance policy start date 2018-01-01 Insurance policy end date 2018-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $404,121 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
DELTA DENTAL OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 55263 )
Policy contract number	NY3305
Policy instance	5
Insurance contract or identification number NY3305 Number of Individuals Covered 8094 Insurance policy start date 2018-01-01 Insurance policy end date 2018-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $2,829,250 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract number	NYK980018
Policy instance	2
Insurance contract or identification number NYK980018 Number of Individuals Covered 9191 Insurance policy start date 2018-01-01 Insurance policy end date 2018-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $791 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit Yes Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $1,645,443 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Amount paid for insurance broker fees 791 Additional information about fees paid to insurance broker COMMISSIONS Insurance broker organization code? 7
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	0101899
Policy instance	8
Insurance contract or identification number 0101899 Number of Individuals Covered 9023 Insurance policy start date 2018-01-01 Insurance policy end date 2018-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $7,878,775 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract number	NYK980019-75467
Policy instance	3
Insurance contract or identification number NYK980019-75467 Number of Individuals Covered 11830 Insurance policy start date 2018-01-01 Insurance policy end date 2018-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $181 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided SHORT TERM AND STATUTORY DISABILITY Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $1,025,948 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Amount paid for insurance broker fees 181 Additional information about fees paid to insurance broker COMMISSIONS Insurance broker organization code? 7
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract number	NYK980019-75467
Policy instance	3
Insurance contract or identification number NYK980019-75467 Number of Individuals Covered 11632 Insurance policy start date 2017-01-01 Insurance policy end date 2017-12-31 Total amount of commissions paid to insurance broker USD $4,611 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided SHORT TERM AND STATUTORY DISABILITY Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $463,472 Commission paid to Insurance Broker USD $4,611 Insurance broker organization code? 3 Insurance broker name MERCER HEALTH & BENEFITS
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number	3329827
Policy instance	4
Insurance contract or identification number 3329827 Number of Individuals Covered 1181 Insurance policy start date 2017-01-01 Insurance policy end date 2017-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract number	NYK980018
Policy instance	2
Insurance contract or identification number NYK980018 Number of Individuals Covered 8482 Insurance policy start date 2017-01-01 Insurance policy end date 2017-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $12,940 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit Yes Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $1,442,210 Commission paid to Insurance Broker USD $0 Amount paid for insurance broker fees 12940 Additional information about fees paid to insurance broker COMMISSIONS Insurance broker organization code? 3 Insurance broker name MERCER HELATH AND BENEFITS
NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 )
Policy contract number	GTP0009148574
Policy instance	1
Insurance contract or identification number GTP0009148574 Number of Individuals Covered 11632 Insurance policy start date 2017-01-01 Insurance policy end date 2017-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $26,172 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided ACCIDENTAL DEATH & DISMEMBERMENT, PARALYSIS, COMA & LOSS OF USE Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $174,478 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Amount paid for insurance broker fees 26172 Additional information about fees paid to insurance broker ADDITIONAL COMPENSATION Insurance broker organization code? 3 Insurance broker name MERCER HEALTH & BENEFITS
STANDARD SECURITY LIFE (National Association of Insurance Commissioners NAIC id number: 69078 )
Policy contract number	9687138/53/46
Policy instance	6
Insurance contract or identification number 9687138/53/46 Number of Individuals Covered 10703 Insurance policy start date 2017-01-01 Insurance policy end date 2017-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit Yes Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $606,113 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	0144239
Policy instance	7
Insurance contract or identification number 0144239 Number of Individuals Covered 11424 Insurance policy start date 2017-01-01 Insurance policy end date 2017-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit Yes Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided ACCIDENTAL DEATH AND DISMEMBERMENT Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No 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	0101899
Policy instance	8
Insurance contract or identification number 0101899 Number of Individuals Covered 8516 Insurance policy start date 2017-01-01 Insurance policy end date 2017-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
DELTA DENTAL OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 55263 )
Policy contract number	NY3305
Policy instance	5
Insurance contract or identification number NY3305 Number of Individuals Covered 6586 Insurance policy start date 2017-01-01 Insurance policy end date 2017-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No 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	GTP0009148574
Policy instance	1
Insurance contract or identification number GTP0009148574 Number of Individuals Covered 9555 Insurance policy start date 2015-01-01 Insurance policy end date 2015-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $25,204 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided ACCIDENTAL DEATH & DISMEMBERMENT, PARALYSIS, COMA & LOSS OF USE Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $168,025 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Amount paid for insurance broker fees 25204 Additional information about fees paid to insurance broker ADDITIONAL COMPENSATION Insurance broker organization code? 3 Insurance broker name MERCER HEALTH & BENEFITS
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	0144239
Policy instance	8
Insurance contract or identification number 0144239 Number of Individuals Covered 9655 Insurance policy start date 2015-01-01 Insurance policy end date 2015-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit Yes Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided ACCIDENTAL DEATH AND DISMEMBERMENT Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $2,742,764 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	0101899
Policy instance	9
Insurance contract or identification number 0101899 Number of Individuals Covered 7001 Insurance policy start date 2015-01-01 Insurance policy end date 2015-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $6,127,295 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 number	549405
Policy instance	7
Insurance contract or identification number 549405 Number of Individuals Covered 6828 Insurance policy start date 2015-01-01 Insurance policy end date 2015-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit Yes Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $377,889 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 number	549407
Policy instance	6
Insurance contract or identification number 549407 Number of Individuals Covered 7321 Insurance policy start date 2015-01-01 Insurance policy end date 2015-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit Yes Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $2,084,318 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
STANDARD SECURITY LIFE (National Association of Insurance Commissioners NAIC id number: 69078 )
Policy contract number	9687138/53/46
Policy instance	5
Insurance contract or identification number 9687138/53/46 Number of Individuals Covered 8266 Insurance policy start date 2015-01-01 Insurance policy end date 2015-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit Yes Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $395,244 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
WELLCHOICE HMO OF NEW JERSEY (National Association of Insurance Commissioners NAIC id number: 95433 )
Policy contract number	377308
Policy instance	4
Insurance contract or identification number 377308 Number of Individuals Covered 561 Insurance policy start date 2015-01-01 Insurance policy end date 2015-12-31 Total amount of commissions paid to insurance broker USD $78,912 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit Yes Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $4,940,996 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $78,912 Insurance broker organization code? 3 Insurance broker name MERCER HEALTH & BENEFITS LLC
DELTA DENTAL OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 55263 )
Policy contract number	NY3305
Policy instance	3
Insurance contract or identification number NY3305 Number of Individuals Covered 5540 Insurance policy start date 2015-01-01 Insurance policy end date 2015-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $2,223,470 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	3329827
Policy instance	2
Insurance contract or identification number 3329827 Number of Individuals Covered 1691 Insurance policy start date 2015-01-01 Insurance policy end date 2015-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $697 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $361,059 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Amount paid for insurance broker fees 697 Additional information about fees paid to insurance broker GENERAL AGENT PAYMENT Insurance broker organization code? 3 Insurance broker name MERCER HEALTH & BENEFITS LLC
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract number	549407
Policy instance	2
Insurance contract or identification number 549407 Number of Individuals Covered 6629 Insurance policy start date 2014-01-01 Insurance policy end date 2014-12-31 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit Yes Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $1,950,519 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
DELTA DENTAL OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 55263 )
Policy contract number	NY3305
Policy instance	1
Insurance contract or identification number NY3305 Number of Individuals Covered 5053 Insurance policy start date 2014-01-01 Insurance policy end date 2014-12-31 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $1,961,161 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
STANDARD SECURITY LIFE (National Association of Insurance Commissioners NAIC id number: 69078 )
Policy contract number	9687138/53/46
Policy instance	3
Insurance contract or identification number 9687138/53/46 Number of Individuals Covered 6749 Insurance policy start date 2014-01-01 Insurance policy end date 2014-12-31 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit Yes Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $325,084 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	0101899
Policy instance	4
Insurance contract or identification number 0101899 Number of Individuals Covered 6376 Insurance policy start date 2014-01-01 Insurance policy end date 2014-12-31 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $5,145,719 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	3329827
Policy instance	5
Insurance contract or identification number 3329827 Number of Individuals Covered 1758 Insurance policy start date 2014-01-01 Insurance policy end date 2014-12-31 Total amount of fees paid to insurance company USD $655 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $332,402 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Insurance broker organization code? 3 Insurance broker name MERCER HELATH & BENEFITS LLC-CONTRT
ACE AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 22667 )
Policy contract number	NO4830696
Policy instance	6
Insurance contract or identification number NO4830696 Number of Individuals Covered 9147 Insurance policy start date 2014-01-01 Insurance policy end date 2014-12-31 Total amount of commissions paid to insurance broker USD $5,685 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided TRAVEL ACCIDENT ACCIDENTAL DEATH & DISMEMBERMENT Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $37,900 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Insurance broker organization code? 3 Insurance broker name MERCER HEALTH & BENEFITS
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	0144239
Policy instance	7
Insurance contract or identification number 0144239 Number of Individuals Covered 8544 Insurance policy start date 2014-01-01 Insurance policy end date 2014-12-31 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit Yes Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided ACCIDENTAL DEATH AND DISMEMBERMENT Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $2,663,518 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
WELLCHOICE HMO OF NEW JERSEY (National Association of Insurance Commissioners NAIC id number: 95433 )
Policy contract number	377308
Policy instance	8
Insurance contract or identification number 377308 Number of Individuals Covered 660 Insurance policy start date 2014-01-01 Insurance policy end date 2014-12-31 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit Yes Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $5,352,527 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $81,312 Insurance broker organization code? 3 Insurance broker name MERCER HEALTH & BENEFITS LLC
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract number	549405
Policy instance	9
Insurance contract or identification number 549405 Number of Individuals Covered 6506 Insurance policy start date 2014-01-01 Insurance policy end date 2014-12-31 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit Yes Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $364,130 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
DELTA DENTAL OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 55263 )
Policy contract number	NY3305
Policy instance	1
Insurance contract or identification number NY3305 Number of Individuals Covered 4548 Insurance policy start date 2013-01-01 Insurance policy end date 2013-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $1,765,463 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
STANDARD SECURITY LIFE (National Association of Insurance Commissioners NAIC id number: 69078 )
Policy contract number	9687138/53/46
Policy instance	3
Insurance contract or identification number 9687138/53/46 Number of Individuals Covered 5932 Insurance policy start date 2013-01-01 Insurance policy end date 2013-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit Yes Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $277,863 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	0101899
Policy instance	4
Insurance contract or identification number 0101899 Number of Individuals Covered 5376 Insurance policy start date 2013-01-01 Insurance policy end date 2013-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $4,634,444 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
ACE AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 22667 )
Policy contract number	N04830696
Policy instance	6
Insurance contract or identification number N04830696 Number of Individuals Covered 8633 Insurance policy start date 2013-01-01 Insurance policy end date 2013-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided TRAVEL ACCIDENT-ACCIDENTAL DEATH & DISMEMBERMENT Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $37,900 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $5,685 Insurance broker organization code? 3 Insurance broker name MERCER HEALTH & BENEFITS
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	144239
Policy instance	7
Insurance contract or identification number 144239 Number of Individuals Covered 7857 Insurance policy start date 2013-01-01 Insurance policy end date 2013-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit Yes Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided ACCIDENTAL DEATH AND DISMEMBERMENT Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $2,529,909 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
WELLCHOICE HMO OF NEW JERSEY (National Association of Insurance Commissioners NAIC id number: 95433 )
Policy contract number	377308
Policy instance	8
Insurance contract or identification number 377308 Number of Individuals Covered 695 Insurance policy start date 2013-01-01 Insurance policy end date 2013-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit Yes Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $4,761,986 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $91,097 Insurance broker organization code? 3 Insurance broker name MERCER HEALTH & BENEFITS LLC
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number	3329827
Policy instance	5
Insurance contract or identification number 3329827 Number of Individuals Covered 1620 Insurance policy start date 2013-01-01 Insurance policy end date 2013-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $635 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $311,589 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Insurance broker organization code? 3 Insurance broker name MERCER HEALTH & BENEFITS LLC-CONTRT
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract number	549405
Policy instance	9
Insurance contract or identification number 549405 Number of Individuals Covered 7103 Insurance policy start date 2013-01-01 Insurance policy end date 2013-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit Yes Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $331,647 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 number	549407
Policy instance	2
Insurance contract or identification number 549407 Number of Individuals Covered 4974 Insurance policy start date 2013-01-01 Insurance policy end date 2013-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit Yes Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $1,575,733 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	0101899
Policy instance	1
Insurance contract or identification number 0101899 Number of Individuals Covered 5257 Insurance policy start date 2012-01-01 Insurance policy end date 2012-12-31 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $4,324,912 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
ACE AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 22667 )
Policy contract number	N04830696
Policy instance	2
Insurance contract or identification number N04830696 Number of Individuals Covered 8047 Insurance policy start date 2012-01-01 Insurance policy end date 2012-12-31 Total amount of commissions paid to insurance broker USD $5,685 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided TRAVEL ACCIDENT-ACCIDENTAL DEATH & DISMEMBERMENT Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $37,900 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Insurance broker organization code? 3 Insurance broker name MERCER HEALTH & BENEFITS
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract number	549405
Policy instance	10
Insurance contract or identification number 549405 Number of Individuals Covered 6538 Insurance policy start date 2012-01-01 Insurance policy end date 2012-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit Yes Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $313,789 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
HIP HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 55247 )
Policy contract number	1000753-000
Policy instance	3
Insurance contract or identification number 1000753-000 Number of Individuals Covered 115 Insurance policy start date 2012-01-01 Insurance policy end date 2012-12-31 Total amount of commissions paid to insurance broker USD $23,984 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit Yes Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $600,609 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Insurance broker organization code? 3 Insurance broker name MERCER HEALTH & BENEFITS, LLC
DELTA DENTAL OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 55263 )
Policy contract number	NY3305
Policy instance	4
Insurance contract or identification number NY3305 Number of Individuals Covered 4233 Insurance policy start date 2012-01-01 Insurance policy end date 2012-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $1,562,200 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
STANDARD SECURITY LIFE (National Association of Insurance Commissioners NAIC id number: 69078 )
Policy contract number	9687138/53/46
Policy instance	5
Insurance contract or identification number 9687138/53/46 Number of Individuals Covered 5264 Insurance policy start date 2012-01-01 Insurance policy end date 2012-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit Yes Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $250,274 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 number	549407
Policy instance	7
Insurance contract or identification number 549407 Number of Individuals Covered 4819 Insurance policy start date 2012-01-01 Insurance policy end date 2012-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit Yes Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $1,230,417 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
WELLCHOICE HMO OF NEW JERSEY (National Association of Insurance Commissioners NAIC id number: 95433 )
Policy contract number	377308
Policy instance	6
Insurance contract or identification number 377308 Number of Individuals Covered 639 Insurance policy start date 2012-01-01 Insurance policy end date 2012-12-31 Total amount of commissions paid to insurance broker USD $103,298 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit Yes Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $4,445,971 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $103,298 Insurance broker organization code? 3 Insurance broker name MERCER HEALTH & BENEFITS LLC
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	144239
Policy instance	8
Insurance contract or identification number 144239 Number of Individuals Covered 7594 Insurance policy start date 2012-01-01 Insurance policy end date 2012-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit Yes Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided ACCIDENTAL DEATH AND DISMEMBERMENT Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $2,234,139 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 )
Policy contract number	3329827
Policy instance	9
Insurance contract or identification number 3329827 Number of Individuals Covered 1644 Insurance policy start date 2012-01-01 Insurance policy end date 2012-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $624 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $290,587 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Insurance broker organization code? 3 Insurance broker name MERCER HEALTH & BENEFITS LLC-CONTRT
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number	NS2121
Policy instance	9
Insurance contract or identification number NS2121 Number of Individuals Covered 1636 Insurance policy start date 2011-01-01 Insurance policy end date 2011-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit Yes Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $7,475,200 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
STANDARD SECURITY LIFE (National Association of Insurance Commissioners NAIC id number: 69078 )
Policy contract number	9687138/53/46
Policy instance	7
Insurance contract or identification number 9687138/53/46 Number of Individuals Covered 4712 Insurance policy start date 2011-01-01 Insurance policy end date 2011-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit Yes Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $224,167 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
DELTA DENTAL OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 55263 )
Policy contract number	NY3305
Policy instance	2
Insurance contract or identification number NY3305 Number of Individuals Covered 4023 Insurance policy start date 2011-01-01 Insurance policy end date 2011-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $1,479,185 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 number	549407
Policy instance	11
Insurance contract or identification number 549407 Number of Individuals Covered 4476 Insurance policy start date 2011-01-01 Insurance policy end date 2011-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit Yes Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $1,095,838 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 )
Policy contract number	3329827
Policy instance	10
Insurance contract or identification number 3329827 Number of Individuals Covered 1579 Insurance policy start date 2011-01-01 Insurance policy end date 2011-12-31 Total amount of commissions paid to insurance broker USD $677 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $276,977 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
HIP HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 55247 )
Policy contract number	1000753-000
Policy instance	8
Insurance contract or identification number 1000753-000 Number of Individuals Covered 129 Insurance policy start date 2011-01-01 Insurance policy end date 2011-12-31 Total amount of commissions paid to insurance broker USD $26,773 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit Yes Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $666,749 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
WELLCHOICE HMO OF NEW JERSEY (National Association of Insurance Commissioners NAIC id number: 95433 )
Policy contract number	377308
Policy instance	6
Insurance contract or identification number 377308 Number of Individuals Covered 722 Insurance policy start date 2011-01-01 Insurance policy end date 2011-12-31 Total amount of commissions paid to insurance broker USD $112,553 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit Yes Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $4,678,147 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	0101899
Policy instance	5
Insurance contract or identification number 0101899 Number of Individuals Covered 4626 Insurance policy start date 2011-01-01 Insurance policy end date 2011-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $3,813,161 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
ACE AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 22667 )
Policy contract number	N04830696
Policy instance	4
Insurance contract or identification number N04830696 Number of Individuals Covered 10390 Insurance policy start date 2011-01-01 Insurance policy end date 2011-12-31 Total amount of commissions paid to insurance broker USD $5,836 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided TRAVEL ACCIDENT-ACCIDENTAL DEATH & DISMEMBERMENT Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $38,906 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 number	549405
Policy instance	3
Insurance contract or identification number 549405 Number of Individuals Covered 6138 Insurance policy start date 2011-01-01 Insurance policy end date 2011-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit Yes Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $294,776 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	144239
Policy instance	1
Insurance contract or identification number 144239 Number of Individuals Covered 7074 Insurance policy start date 2011-01-01 Insurance policy end date 2011-12-31 Total amount of commissions paid to insurance broker USD $0 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit Yes Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided ACCIDENTAL DEATH AND DISMEMBERMENT Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $1,937,400 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	144239
Policy instance	12
Insurance contract or identification number 144239 Number of Individuals Covered 6690 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 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit Yes Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided ACCIDENTAL DEATH AND DISMEMBERMENT Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $1,698,345 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	0101899
Policy instance	1
Insurance contract or identification number 0101899 Number of Individuals Covered 4256 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 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $3,402,740 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
DELTA DENTAL OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 55263 )
Policy contract number	NY3305
Policy instance	4
Insurance contract or identification number NY3305 Number of Individuals Covered 3633 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 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $1,366,032
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number	NS2121
Policy instance	5
Insurance contract or identification number NS2121 Number of Individuals Covered 969 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 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit Yes Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $3,842,845 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 )
Policy contract number	3329827
Policy instance	6
Insurance contract or identification number 3329827 Number of Individuals Covered 1428 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 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit Yes Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $254,985 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
HIP HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 55247 )
Policy contract number	1000753-000
Policy instance	2
Insurance contract or identification number 1000753-000 Number of Individuals Covered 130 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 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit Yes Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $626,183 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
ACE AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 22667 )
Policy contract number	N04830696
Policy instance	8
Insurance contract or identification number N04830696 Number of Individuals Covered 7525 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 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Other welfare benefits provided TRAVEL ACCIDENT-ACCIDENTAL DEATH & DISMEMBERMENT Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $38,853 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
HIP HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 55247 )
Policy contract number	1009122-001
Policy instance	9
Insurance contract or identification number 1009122-001 Number of Individuals Covered 3 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 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit Yes Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $13,612 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
STANDARD SECURITY LIFE (National Association of Insurance Commissioners NAIC id number: 69078 )
Policy contract number	9687138/53/46
Policy instance	10
Insurance contract or identification number 9687138/53/46 Number of Individuals Covered 3876 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 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit Yes Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $268,215 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
WELLCHOICE HMO OF NEW JERSEY (National Association of Insurance Commissioners NAIC id number: 95433 )
Policy contract number	377308
Policy instance	7
Insurance contract or identification number 377308 Number of Individuals Covered 787 Insurance policy start date 2010-01-01 Insurance policy end date 2010-12-31 Total amount of commissions paid to insurance broker USD $123,395 Total amount of fees paid to insurance company USD $0 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit Yes Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $4,756,976 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 number	549407
Policy instance	11
Insurance contract or identification number 549407 Number of Individuals Covered 4230 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 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit Yes Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $995,308 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 number	549405
Policy instance	3
Insurance contract or identification number 549405 Number of Individuals Covered 5820 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 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit Yes Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Welfare Benefit Premiums Paid to Carrier USD $265,713 Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No

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• NEW YORK SCHOOLS INSURANCE RECIPROCAL RETIREMENT PLAN [EIN = 112971880]
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• NEW YORK METHODIST HOSPITAL HEALTH CARE PLAN [EIN = 111631796]
• NEW YORK ACADEMY OF SCIENCES SRA PLAN [EIN = 131773640]
• NEW YORK COMMUNITY TRUST GROUP TAX DEFERRED ANNUITY [EIN = 133062214]
• NEW YORK ATHLETIC CLUB GROUP WELFARE PLAN [EIN = 131096640]
• NEW YORK LEAGUE FOR EARLY LEARNING, INC. DISCRETIONARY DEFINED BENEFIT TARGET PLAN [EIN = 112513824]
• NEW YORK CITY OUTWARD BOUND CENTER TAX DEFERRED ANNUITY RETIREMENT PLAN [EIN = 133471084]
• NEW YORK ANESTHESIOLOGY MEDICAL SPECIALTIES, P.C. EMPLOYEES' DEFERRED SAVINGS AND PROFIT SHARING PLAN [EIN = 161592210]
• NEW YORK AIR BRAKE CORPORATION A KNORR BRAKE COMPANY WELFARE BENEFIT PREMIUM PAYMENT AND FLEX PLAN [EIN = 161385584]
• NEW YORK METHODIST HOSPITAL 403(B) RETIREMENT PLAN [EIN = 111631796]
• NEW YORK THERAPY PLACEMENT INC. 401(K) PROFIT SHARING PLAN [EIN = 113139640]
• NEW YORK SOCIETY FOR THE RELIEF OF THE RUPTURED AND CRIPPLED MAINTAINING THE HOSPITAL FOR SPECIAL SURGERY MEDICAL PLAN [EIN = 131624135]
• NEW YORK YANKEES PREMIUM ONLY PLAN [EIN = 341122131]
• NEW YORK EYE AND EAR INFIRMARY EXEMPT EMPLOYEES DEFINED CONTRIBUTION PLAN [EIN = 135562304]
• NEW YORK INDEPENDENT SYSTEM OPERATOR PENSION PLAN [EIN = 141815612]
• NEW YORK BACKSTRETCH EMPLOYEES PENSION PLAN [EIN = 112236389]
• NEW YORK MEHTODIST TAX SHELTERED ANNUITY [EIN = 111631796]
• NEW YORK BLOOD CENTER RETIREMENT PLAN [EIN = 131949477]
• NEW YORK ORGAN DONOR NETWORK [EIN = 132945229]
• NEW YORK COMMUNITY HOSPITAL GROUP MEDICAL PROGRAM [EIN = 111986351]
• NEW YORK DIRECT MARKETING CORP. DEFINED BENEFIT PLAN [EIN = 271244876]
• NEW YORK INDEPENDENT SYSTEM INC. 401(K) RETIREMENT PLAN [EIN = 141815612]
• NEW YORK EYE AND EAR INFIRMARY EMPLOYEES' PENSION PLAN [EIN = 135562304]
• NEW YORK ONCOLOGY HEMATOLOGY, P.C. 401(K) PLAN [EIN = 141799724]
• NEW YORK HOSPITAL QUEENS DEFINED CONTRIBUTION RETIREMENT PLAN [EIN = 111839362]
• NEW YORK GENEALOGICAL & BIOGRAPHICAL SOCIETY DEFINED CONTRIBUTION MONEY PURCHASE RETIREMENT PLA [EIN = 135596870]
• NEW YORK STATE RESTAURANT ASSOCIATION EMPLOYEES' PENSION PLAN [EIN = 131101544]
• NEW YORK ISLANDERS HOCKEY CLUB MEDICAL PLAN [EIN = 112254417]
• NEW YORK STATE PUBLIC EMPLOYEES FEDERATION, AFL-CIO-UNION PLAN [EIN = 132808635]
• NEW YORK TECHNOLOGIES CORP. [EIN = 161236306]
• NEW YORK STATE ASSOCIATION OF SCHOOL BUSINESS OFFICIALS [EIN = 141485303]
• NEW YORK CITY INDUSTRIES FOR THE BLIND, INC. 401(K) PLAN [EIN = 440552486]
• NEW YORK CITY FOOTBALL CLUB 401(K) PLAN [EIN = 462677915]
• NEW YORK STATE NURSES ASSOCIATION PENSION PLAN [EIN = 136604799]
• NEW YORK MEDICAL COLLEGE PREFUNDED LIFE AND HEALTH INSURANCE BENEFIT PLAN [EIN = 131099420]
• NEW YORK HOTEL TRADES COUNCIL AND HOTEL ASSOCIATION OF NYC INC HEALTH BENEFITS FUND [EIN = 136126923]
• NEW YORK AIR BRAKE CORPORATION 401(K) SAVINGS PLAN, UNION, LODGE NO. 761, DISTRICT 65 [EIN = 161385584]
• NEW YORK CENTER FOR INFANTS AND TODDLERS 401(K) PLAN [EIN = 521923613]
• NEW YORK COMPENSATION INSURANCE RATING BOARD WELFARE BENEFITS PLAN [EIN = 130594020]
• NEW YORKER HOTEL HEALTH & BENEFIT PLAN [EIN = 133761593]
• NEW YORK NEUROLOGIC ASSOCIATES LLP DEFINED BENEFIT PENSION PLAN [EIN = 113340826]
• NEW YORK FLOWER LLC 401(K) PLAN [EIN = 261578300]
• NEW YORK STATE NURSES ASSOCIATION RETIREE MEDICAL PLAN [EIN = 611617397]
• NEW YORK DISTRICT COUNCIL OF CARPENTERS ANNUITY FD [EIN = 510174279]
• NEW YORK JETS HEALTH AND WELFARE PLAN [EIN = 134095922]
• NEW YORK CITY ECONOMIC DEVELOPMENT CORPORATION HEALTH AND WELFARE BENEFIT PLAN [EIN = 132577233]
• NEW YORK INSTITUTE OF TECHNOLOGY DEFINED CONTRIBUTION RETIREMENT PLAN [EIN = 111788788]
• NEW YORK LIFE AGENTS PROGRESS-SHARING INVESTMENT PLAN [EIN = 135582869]
• NEW YORK DISABILITY BENEFITS [EIN = 133513936]
• NEW YORK RACING ASSOCIATION, INC. PENSION PLAN FOR ASSISTANT STARTERS [EIN = 611559040]
• NEW YORK LAW SCHOOL GROUP VISION PLAN [EIN = 135645885]
• NEW YORK HOTEL TRADES COUNCIL & HOTEL ASSOCIATION OF NEW YORK CITY, INC. 401K SAVINGS PLAN [EIN = 134178178]
• NEW YORK STATE PUBLIC EMPLOYEES FEDERATION, AFL-CIO-M/C PLAN [EIN = 132808635]
• NEW YORK STATE TEAMSTERS CONFERENCE PENSION & RETIREMENT FUND [EIN = 166063585]
• NEW YORK COLLEGE OF PODIATRIC MEDICINE 403(B) TDA PLAN [EIN = 131632522]
• NEW YORK ROAD RUNNERS, INC. WELFARE BENEFITS PLAN [EIN = 132949483]
• NEW YORK METS EMPLOYEE SAVINGS PLAN [EIN = 112834957]
• NEW YORK LIFE INSURANCE COMPANY TRAVEL ACCIDENT PLAN [EIN = 135582869]
• NEW YORK CITY CRIMINAL JUSTICE TAX SHELTERED ANNUITY [EIN = 132900682]
• NEW YORK URBAN PROFIT SHARING PLAN [EIN = 132988122]
• NEW YORK HEALTH CARE 401K PLAN & TRUST [EIN = 112636089]
• NEW YORK COLLEGE OF PODIATRIC MEDICINE 403(B) DC RETIREMENT PLAN [EIN = 131632522]
• NEW YORK HOTEL TRADES COUNCIL AND HOTEL ASSOCIATIO OF NEW YORK CITY, INC. PENSION FUND [EIN = 131764242]
• NEW YORK TIMES COMPANIES RETIREE MEDICAL PLAN [EIN = 131102020]
• NEW YORK STATE NURSES ASSOCIATION 401(K) PLAN [EIN = 140923749]
• NEW YORK HOSPITAL MEDICAL CENTER OF QUEENS HEALTH SERV. RET. PLAN [EIN = 111839362]
• NEW YORK RAVIOLI & PASTA CO., INC. 401(K) PROFIT SHARING PLAN [EIN = 113158835]
• NEW YORK ACADEMY OF SCIENCES RA PLAN [EIN = 131773640]
• NEW YORK COMPREHENSIVE CARDIOLOGY LLC 401(K) PROFIT SHARING PLAN [EIN = 203288609]
• NEW YORK MEDICAL COLLEGE UNFUNDED MEDICAL WELFARE BENEFIT PLAN [EIN = 131099420]
• NEW YORK CENTRAL MUTUAL FIRE INSURANCE COMPANY 401K RETIREMENT SAVINGS PLAN [EIN = 150398170]
• NEW YORK TECHNOLOGY PARTNERS INC. 401(K) PROFIT SHARING PLAN & TRUST [EIN = 223529507]
• NEW YORK INSTITUTE OF TECHNOLOGY TAX DEFERRED ANNUITY PLAN [EIN = 111788788]
• NEW YORK STATE BAR ASSOCIATION SUPPLEMENTAL HEALTH CARE PLAN [EIN = 140923640]
• NEW YORK STATE INDUSTRIES FOR THE DISABLED, INC. RETIREMENT PLAN [EIN = 132841179]
• NEW YORK EYE AND EAR INFIRMARY SUPPLEMENTAL RETIREMENT PLAN [EIN = 135562304]
• NEW YORK STATE CATHOLIC HEALTH PLAN, INC., DBA FIDELIS CARE NEW YORK CAFETERIA PLAN [EIN = 113153422]
• NEW YORK LEAGUE FOR EARLY LEARNING, INC. DISCRETIONARY DEFINED CONTRIBUTION RETIREMENT PLAN [EIN = 112513824]
• NEW YORK NEUROLOGICAL SURGERY PC 401K PLAN [EIN = 134165842]
• NEW YORK TECHNOLOGIES CORP. [EIN = 161236306]
• NEW YORK COUNTY DEFENDER SERVICES PROFIT SHARING PLAN [EIN = 113361008]
• NEW YORK STATE ELECTRIC & GAS CORPORATION 401(K) UNION PLAN [EIN = 150398550]
• NEW YORK CITY DISTRICT COUNCIL OF CARPENTERS WELFARE FUND [EIN = 135615576]
• NEW YORK DIALYSIS SERVICES, INC. 401(K) PLAN [EIN = 043267217]
• NEW YORK STATE BANKERS GROUP EMPLOYEE INSURANCE PLAN [EIN = 136798918]
• NEW YORK AIR BRAKE CORPORATION A KNORR BRAKE COMPANY HEALTH CARE DISABILITY LIFE INSURANCE PREMIUM PAYMENT AND FLEX PLAN IAM UNION [EIN = 161385584]
• NEW YORK ATHLETIC CLUB 401(K) SAVINGS PLAN [EIN = 131096640]
• NEW YORK METHODIST HOSPITAL DENTAL & VISION PLAN [EIN = 111631796]
• NEW YORK GROUP FOR PLASTIC SURGERY PROFIT SHARING PLAN [EIN = 133086046]
• NEW YORK MEDICAL COLLEGE UNFUNDED NON-MEDICAL WELFARE BENEFIT PLAN [EIN = 131099420]
• NEW YORK STATE TEAMSTERS COUNCIL UNITED PARCEL SER RETIREE HEALTH FUND [EIN = 464111565]
• NEW YORK STATE CATHOLIC HEALTH PLAN, INC., GROUP HEALTH INSURANCE PLAN [EIN = 113153422]
• NEW YORK WIRE EMPLOYEE BENEFIT PLAN [EIN = 810733476]
• NEW YORK STATE BAR ASSOCIATION MEDICAL AND DENTAL REIMBURSEMENT PLAN [EIN = 140923640]
• NEW YORK LAW SCHOOL GROUP LONG-TERM DISABILITY PLAN [EIN = 135645885]
• NEW YORK JETS CLUB EMPLOYEES RETIREMENT PLAN [EIN = 134095922]
• NEW YORK CPAS HEALTH BENEFITS TRUST [EIN = 467148754]
• NEW YORK HOTEL TRADES COUNCIL & AFFILIATED LOCALS, STAFF INSURANCE FUND [EIN = 131531223]
• NEW YORK GAS GROUP MONEY PURCHASE PLAN [EIN = 112301563]
• NEW YORK LIBRARY ASSOC DEFINED CONTRIBUTION MONEY PURCHASE RETIREMENT PLAN [EIN = 141407060]
• NEW YORK CENTER FOR INTERPERSONAL DEVELOPMENT 403(B) PLAN [EIN = 237085239]
• NEW YORK HEART ASSOCIATES, P.C. 401(K) PLAN [EIN = 134223518]
• NEW YORK STATE EMPLOYEES FEDERAL CREDIT UNION CAPITAL ACCUMULATION PLAN [EIN = 135609415]
• NEW YORK STATE EMPLOYEES FEDERAL CREDIT UNION 412(I) DEFINED BENEFIT PLAN AND TRUST [EIN = 135609415]
• NEW YORK CITY LOCAL 246 401K PROFIT SHARING PLAN & TRUST [EIN = 136307146]
• NEW YORK CARDIAC DIAGNOSTIC CENTER 401(K) SAVINGS PLAN [EIN = 133413929]
• NEW YORK STATE PROFESSIONAL FIRE FIGHTERS ASSOCIATION, INC. 401(K) PLAN [EIN = 111898077]
• NEW YORK BUSINESS ROUNDTABLE, INC. PROFIT SHARING PLAN [EIN = 061678963]
• NEW YORK COUNTY DENTAL SOCIETY PENSION PLAN [EIN = 135606330]
• NEW YORK BAKERY OF SYRACUSE, INC 401K PROFIT SHARING PLAN & TRUST [EIN = 161434369]
• NEW YORK FRACTURE & SPINE SALES CONSULTANTS, INC. NEW YORK FRACTURE & SPINE SALE [EIN = 113804010]
• NEW YORK DIGITAL PRINT CENTER 401(K) PROFIT SHARING PLAN [EIN = 270099634]
• NEW YORK ALLERGY AND ASTHMA PLLC PROFIT SHARING PLAN [EIN = 205638112]
• NEW YORK RENAL ASSOCIATES 401K PROFIT SHARING PLAN & TRUST [EIN = 133903802]
• NEW YORK LIGHT ENERGY, LLC NADART SALARY DEFERRAL 401(K) PLAN [EIN = 270336719]
• NEW YORK NEPHROLOGY AND DIALYSIS ACCESS SURGERY, P.C. PROFIT SHARING PLAN [EIN = 141601203]
• NEW YORK PULMONARY ASSOCIATES, PC, PROFIT SHARING PLAN [EIN = 133685359]
• NEW YORK ANESTHESIA ASSOCIATES, P.C. PROFIT SHARING PLAN [EIN = 112389931]
• NEW YORK PHYSICAL THERAPY, P.C. DEFINED BENEFIT PLAN [EIN = 112860202]
• NEW YORK SPORTS AND PHYSICAL THERAPY INSTITUTE 401(K) PLAN [EIN = 112356557]
• NEW YORK STATE RETIRED TEACHERS ASSOCIATION, INC 401(K) PROFIT SHARING PLAN [EIN = 141405516]
• NEW YORK NEWSPAPER SAVINGS PLUS PLAN [EIN = 150590976]
• NEW YORK LIVE ARTS 401(K) PROFIT SHARING PLAN [EIN = 136206608]
• NEW YORK ENERGY INC. 401-K PROFIT SHARING PLAN [EIN = 542120240]
• NEW YORK PACKAGING II LLC 401K PLAN [EIN = 043834351]
• NEW YORK ORAL & MAXILLO FACIAL SURGERY 401K PLAN [EIN = 270241626]
• NEW YORK BUS SALES, LLC/T-NINE, LLC 401(K) PLAN [EIN = 270063570]
• NEW YORK TECH SUPPLY DEFINED BENEFIT PLAN [EIN = 161115279]
• NEW YORK PLASTIC SURGERY ASSOCIATES, P.C. [EIN = 133660802]
• NEW YORK MILITARY ACADEMY 403(B) DC PLAN [EIN = 140921372]
• NEW YORK LABEL & BOX CORP. SAVINGS & INVESTMENT PLAN [EIN = 135582866]
• NEW YORK COUNCIL ON PROBLEM GAMBLING 403(B) PLAN [EIN = 141786116]
• NEW YORK CITY CENTER FOR CHART 401 K PROFIT SHARING PLAN TRUST [EIN = 200759687]
• NEW YORK ELECTRICAL INSPECTION 401 K PROFIT SHARING PLAN TRUST [EIN = 200833904]
• NEW YORK MERCHANT PROTECTIVE CO, INC. 401K PLAN [EIN = 112982540]
• NEW YORK MOTORCYCLE LTD 401 K PROFIT SHARING PLAN TRUST [EIN = 112636441]
• NEW YORK STEM CELL FOUNDATION 403(B) PLAN [EIN = 202905531]
• NEW YORK MEDICAL ASSOCIATES, P.C. 401(K) PROFIT SHARING PLAN & TRUST [EIN = 133751082]
• NEW YORK CITY GAY AND LESBIAN ANTI-VIOLENCE 403(B) RETIREMENT PLAN [EIN = 133149200]
• NEW YORK FOLKLORE SOCIETY [EIN = 222172604]
• NEW YORK METRO FEDERAL CREDIT UNION CAPITAL ACCUMULATION PLAN [EIN = 135564112]
• NEW YORK NETWORK MANAGEMENT LLC 401(K) PROFIT SHARING PLAN [EIN = 113347168]
• NEW YORK ALLERGY AND ASTHMA PLLC CASH BALANCE PLAN [EIN = 205638112]
• NEW YORK POPS 403(B) DC PLAN #358510 [EIN = 133240366]
• NEW YORK STATE DISPUTE RESOLUTION ASSOCIATION 403(B) PLAN [EIN = 161266087]
• NEW YORK MEDICAL ASSOCIATES, P.C. PENSION PLAN [EIN = 133751082]
• NEW YORK PROSECUTORS TRAINING INSTITUTE, INC. MONEY PURCHASE PLAN [EIN = 113289827]
• NEW YORK VETERINARY SPECIALTY CENTER 401(K) SAVINGS PLAN [EIN = 364530633]
• NEW YORK STATE PUBLIC HIGH SCHOOL ATHLETIC ASSOCIATION, INC. 401K PROFIT SHARING PLAN [EIN = 112652408]
• NEW YORK APPLE ASSOCIATION, INC. SAVINGS AND RETIREMENT PLAN [EIN = 160760119]
• NEW YORK SEMICONDUCTOR CORP 401 K PROFIT SHARING PLAN TRUST [EIN = 113630080]
• NEW YORK BOILER, INC. 401(K) PLAN [EIN = 112809119]
• NEW YORK UNDERGROUND, INC. 401(K) PLAN [EIN = 061834110]
• NEW YORK REPLACEMENT PARTS CORP. 401(K) PROFIT SHARING PLAN [EIN = 132963283]
• NEW YORK PRODUCTION ALLIANCE 401K PLAN AND TRUST [EIN = 134181130]
• NEW YORK COLLEGE OF HEALTH PROFESSIONS [EIN = 112705352]
• NEW YORK STATE ACADEMY OF FAMILY PHYSICIANS MONEY PURCHASE PLAN AND TRUST [EIN = 150524107]
• NEW YORK OUTDOOR, INC. 401(K) PLAN [EIN = 134012413]
• NEW YORK BANKERS ASSOCIATION 401(K) PLAN [EIN = 131882974]
• NEW YORK STATE ASSOCIATION OF INDEPENDENT SCHOOLS 403(B) DC [EIN = 141504908]
• NEW YORK COMMERCIAL FLOORING, INC. 401(K) SAFE HARBOR PLAN [EIN = 020751608]
• NEW YORK PHYSICAL THERAPY, P.C. PROFIT SHARING PLAN [EIN = 112860202]
• NEW YORK CENTER FOR REHABILITATION CARE RETIREMENT SAVINGS PLAN [EIN = 113626586]
• NEW YORK WINDOWS & DOORS INC. 401K PROFIT SHARING PLAN & TRUST [EIN = 113578982]
• NEW YORK FOOD COMPANY, INC. 401(K) PROFIT SHARING PLAN [EIN = 953897142]
• NEW YORK TRENCHLESS, INC. PROFIT SHARING PLAN [EIN = 113519631]
• NEW YORK STATE COALITION AGAINST SEXUAL ASSAULT, INC. 401(K) PLAN [EIN = 141700765]
• NEW YORK MUTUAL UNDERWRITERS 401(K) PLAN [EIN = 140920715]
• NEW YORK BRONX PEDIATRIC MEDICINE, PC 401K PROFIT SHARING PLAN AND TRUST [EIN = 134039698]
• NEW YORK ALLIANCE FOR DONATION INC 401(K) PLAN [EIN = 510430374]
• NEW YORK CENTER FOR LIVER TRAN 401 K PROFIT SHARING PLAN TRUST [EIN = 133510056]
• NEW YORK CARDIOLOGY GROUP, P.C. 401(K) PROFIT SHARING PLAN [EIN = 113339481]
• NEW YORK DERMATOLOGY, P.C. PROFIT SHARING PLAN AND TRUST [EIN = 113212960]
• NEW YORK COUNTY MEDICAL SOCIETY 401K PROFIT SHARING PLAN AND TRUST [EIN = 131030750]
• NEW YORK SENIOR CARE LLC 401(K) PROFIT SHARING PLAN & TRUST [EIN = 205547002]
• NEW YORK CARDIOVASCULAR ANESTHESIOLOGISTS PC RETIREMENT TRUST 401(K) PLAN [EIN = 113027215]
• NEW YORK CARDIOVASCULAR ASSOCIATES 401(K) PLAN [EIN = 260086404]
• NEW YORK PSYCHOANALYTIC INSTITUTE TAX-DEFERRED (TDA) ANNUITY PLAN [EIN = 131624130]
• NEW YORK NEUROLOGIC ASSOCIATES 401(K) P/S PLAN AND TRUST [EIN = 113340826]
• NEW YORK STATE WINE AND 401 K PROFIT SHARING PLAN TRUST [EIN = 201682175]
• NEW YORK CENTER FOR NANOMEDICI 401 K PROFIT SHARING PLAN TRUST [EIN = 471966850]
• NEW YORK TITLE RESEARCH 401(K) PROFIT SHARING PLAN & TRUST [EIN = 133873977]
• NEW YORK LAND SURVEYOR PC 401 K PROFIT SHARING PLAN TRUST [EIN = 205865530]
• NEW YORK COLLABORATES FOR AUTI 401 K PROFIT SHARING PLAN TRUST [EIN = 571136147]
• NEW YORK EYE CANCER CENTER DEFINED BENEFIT PENSION PLAN & TRUST [EIN = 134166365]
• NEW YORK CITY POLICE FOUNDATION, INC. 403(B) RETIREMENT PLAN [EIN = 132711338]
• NEW YORK CITY INDUSTRIAL TECHNOLOGY ASSISTANC E CORPORATION TAX SHELTERED ANNUITY [EIN = 133410779]
• NEW YORK STATE PUBLIC HIGH SCHOOL ATHLETIC ASSOCIATION, INC. MONEY PURCHASE PENSION PLAN [EIN = 112652408]
• NEW YORK STATE SOCIETY OF ANESTHESIOLOGISTS, INC. EMPLOYEES SAVINGS & RETIREMENT PLAN [EIN = 131938679]
• NEW YORK SECURITY SYSTEMS, INC. 401K PLAN [EIN = 141648882]
• NEW YORK STATE ASSOCIATION 401 K PROFIT SHARING PLAN TRUST [EIN = 140992970]
• NEW YORK SPACES, INC. 401(K) PS PLAN [EIN = 133559698]
• NEW YORK GOLF CENTER INC 401 K PROFIT SHARING PLAN TRUST [EIN = 133117316]
• NEW YORK BISCOTTI COMPANY [EIN = 113452788]
• NEW YORK REHABILITATIVE SERVICES LLC 401K PLAN [EIN = 770618878]
• NEW YORK STATE RESTAURANT ASSOCIATION, INC. 401(K) PLAN [EIN = 131101544]
• NEW YORK COUNCIL FOR THE HUMANITIES TAX-SHELTERED RETIREMENT ANNUITY PLAN [EIN = 510152266]
• NEW YORK STATE FUNERAL DIRECTORS ASSOCIATION, INC. RETIREMENT PLAN [EIN = 150398553]
• NEW YORK OIL HEATING ASSOCIATION, INC. 401K RETIREMENT PLAN [EIN = 135668120]
• NEW YORK CARDIOVASCULAR 401 K PROFIT SHARING PLAN TRUST [EIN = 760849946]
• NEW YORK STATE MUSEUM INSTITUTE DEFINED CONTRIBUTION RETIREMENT PLAN [EIN = 222714165]
• NEW YORK PHYSICIANS LLP 401(K) SAVINGS PLAN [EIN = 061562780]
• NEW YORK PRINTING SYSTEMS INC 401 K PROFIT SHARING PLAN TRUST [EIN = 161497587]
• NEW YORK NEEDS YOU 403(B) PLAN [EIN = 270601596]
• NEW YORK TRANS HARBOR LLC 401(K) PLAN [EIN = 470858384]
• NEW YORK PRECISION EQUIPMENT I 401 K PROFIT SHARING PLAN TRUST [EIN = 112904877]
• NEW YORK WOMENS CHAMBER OF COMMERCE [EIN = 141845651]
• NEW YORK STATE DEFENDERS ASSOCIATION, INC. 403(B) PLAN [EIN = 112461900]
• NEW YORK NUCLEAR CORP. & AFFILIATES DEFINED BENEFIT PENSION PLAN [EIN = 133149399]
• NEW YORK ASSOCIATES IN GASTROENTEROLOGY, LLP 401(K) PROFIT SHARING PLAN [EIN = 134114875]
• NEW YORK BARIATRIC AND LAPAROSCOPY, P.C. RETIREMENT PLAN [EIN = 200121622]
• NEW YORK CONSTRUCTION 401(K) PLAN [EIN = 134171043]
• NEW YORK WEALTH MANAGEMENT, LLC 401K PROFIT SHARING PLAN [EIN = 270339461]
• NEW YORKS LITTLE ELVES INC 401 K PROFIT SHARING PLAN TRUST [EIN = 133874666]
• NEW YORK YOUTH SYMPHONY 403B [EIN = 136133041]
• NEW YORK TIMES EMPLOYEES FEDERAL CREDIT UNION CAPITAL ACCUMULATION PLAN [EIN = 131780480]
• NEW YORK PAIN CONSULTANTS, LLC RETIREMENT PLAN [EIN = 200239132]
• NEW YORK STATE TECHNOLOGY ENTERPRISE CORPORATION 403B RETIREMENT PLAN [EIN = 161521105]
• NEW YORK YOUTH AT RISK [EIN = 133533428]
• NEW YORK EYE EAR INFIRMARY O 401 K PROFIT SHARING PLAN TRUST [EIN = 133660461]
• NEW YORK COUNTY DENTAL SOCIETY PROFIT SHARING PLAN [EIN = 135606330]
• NEW YORK BUILDING CONGRESS, INC. PROFIT SHARING P [EIN = 131097030]
• NEW YORK ACCESSORY GROUP, INC. 401(K) PLAN [EIN = 134175959]
• NEW YORK SAMPLE CARD CO. PROFIT SHARING PLAN [EIN = 135582882]
• NEW YORK ORAL, MAXILLOFACIAL AND IMPLANT SURGERY, P.C. 401(K) PROFIT SHARING PLAN [EIN = 112621554]
• NEW YORK JEWELERS, INC. RETIREMENT SAVINGS PLAN [EIN = 362471887]
• NEW YORK FIRE ACADEMY, INC. PROFIT SHARING PLAN [EIN = 272982077]
• NEW YORK DOUGH COMPANY, INC. 401 (K) PROFIT SHARING PLAN [EIN = 454994423]
• NEW YORK STATE REHABILITATION ASSOCIATION, INC. 401(K) PROFIT SHARING PLAN [EIN = 141748065]
• NEW YORK COUNCIL OF NONPROFITS, INC. 403(B) PLAN [EIN = 141343047]
• NEW YORK REAL ESTATE INSTITUTE 401(K) PLAN [EIN = 200484486]
• NEW YORK INSTITUTE OF MASSAGE 401 K PROFIT SHARING PLAN TRUST [EIN = 161501956]
• NEW YORKERS FOR CHILDREN, INC. 403(B) PLAN [EIN = 133904537]
• NEW YORK UNIVERSITY FEDERAL CREDIT UNION CAPITAL ACCUMULATION PLAN [EIN = 133147950]
• NEW YORK CARDIOLOGY ASSOCIATES, P.C. PROFIT SHARING PLAN [EIN = 223374409]
• NEW YORK DELI NEWS, INC. 401(K) PROFIT SHARING PLAN & TRUST [EIN = 841114774]
• NEW YORK JUNIOR TENNIS LEAGUE 401K PLAN [EIN = 237442256]
• NEW YORK TIMES EMPLOYEES FEDERAL CREDIT UNION RETIREMENT PENSION PLAN [EIN = 131780480]
• NEW YORK COLLEGE OF HEALTH PROFESSIONS [EIN = 112705352]
• NEW YORK CITY REGIONAL CENTER, LLC CASH BALANCE PLAN [EIN = 262686201]
• NEW YORK PROFESSIONAL NURSES UNION RETIREMENT PLAN [EIN = 133642959]
• NEW YORK CARDIOTHORACIC SURGEONS/ P.C. DEFINED BENEFIT PLAN [EIN = 113486382]
• NEW YORK EYE CANCER CENTER 401(K) PROFIT SHARING PLAN & TRUST [EIN = 134166365]
• NEW YORK NEUROLOGICAL ASSOCIATES, P. C. TARGET BENEFIT PLAN [EIN = 132792803]
• NEW YORK BUSINESS SYSTEMS 401(K) PROFIT SHARING PLAN [EIN = 112817533]
• NEW YORK OPHTHALMOLOGY, P.C. PROFIT SHARING PLAN [EIN = 113563467]
• NEW YORK ISPINE SPECIALIST MEDICAL 401(K) PLAN [EIN = 474507961]
• NEW YORK PAIN MANAGEMENT, PLLC PROFIT SHARING 401 K) PLAN [EIN = 421554476]
• NEW YORK CORNEA, PLLC PROFIT SHARING PLAN [EIN = 571147780]
• NEW YORK COUNTY LAWYERS' ASSOCIATION 403(B) PLAN [EIN = 135273040]
• NEW YORK MRI MANAGEMENT, INC. 401(K) PROFIT SHARING PLAN [EIN = 650967298]
• NEW YORK DESIGN CENTER, INC 401(K) PLAN [EIN = 135582860]
• NEW YORK TECHNOLOGY PARTNERS 401 K PROFIT SHARING PLAN TRUST [EIN = 134082098]
• NEW YORK METROPOLITAN REFERENCE & RESEARCH LIBRARY AGENCY (METRO) TAX DEFERRED ANNUITY PLAN [EIN = 136210582]
• NEW YORK STATE HOSPITALITY & TOURISM ASSOCIATION, INC. PROFIT SHARING AND 401(K) PLAN [EIN = 131101450]
• NEW YORK CITY RESCUE MISSION 401 K PROFIT SHARING PLAN TRUST [EIN = 135596794]
• NEW YORK STATE HEALTH FOUNDATION RETIREMENT PLAN [EIN = 300127892]
• NEW YORK PRESS SERVICE, INC. SAVINGS PLUS PLAN [EIN = 161030258]
• NEW YORK STATE WEST YOUTH SOCCER ASSOCIATION, INC 401(K) PLAN [EIN = 161185044]
• NEW YORK COMMUNICATIONS CO., INC. PROFIT SHARING PLAN AND TRUST [EIN = 141459493]
• NEW YORK E-COMMERCE ADVISORY INC. 401(K) PROFIT SHARING PLAN [EIN = 453950113]
• NEW YORK SUSTAINABLE 401 K PROFIT SHARING PLAN TRUST [EIN = 161562172]
• NEW YORK FOUNDATION FOR THE ARTS, INC. ANNUITY PLAN [EIN = 237129564]
• NEW YORK LONG TERM CARE BROKERS RETIREMENT PLAN [EIN = 141764648]
• NEW YORK HARM REDUCTION EDUCATORS 403(B) PLAN [EIN = 133678499]
• NEW YORK ADJUSTMENT BUREAU 401K PLAN [EIN = 112947108]
• NEW YORK ENVIRONMENTAL & ANALYTICAL LABS INC 401K PLAN [EIN = 113045775]
• NEW YORK PUBLIC WELFARE ASSOCIATION, INC. MONEY PURCHASE PLAN [EIN = 160968352]
• NEW YORK ST ASSOC. OF AREA AGENCIES ON AGING TDA RETIREMENT PLAN [EIN = 161107763]
• NEW YORK METROPOLITAN REFERENCE & RESEARCH LIBRARY AGENCY (METRO) DEFINED CONTRIBUTION PLAN [EIN = 136210582]
• NEW YORK INSULATION INC 401 K PROFIT SHARING PLAN TRUST [EIN = 112966988]
• NEW YORK STATE BROADCASTERS ASSOCIATION, INC. DB PENSION PLAN [EIN = 141541060]
• NEW YORK CONGREGATIONAL NURSING CENTER LOCAL 144 DIVISION OF 1199 PENSION PLAN [EIN = 113188802]
• NEW YORK NEUROLOGICAL ASSOCIATES, P. C. PROFIT SHARING & EMPLOYEES SAVINGS PLAN [EIN = 132792803]
• NEW YORK CENTER FOR INTERPERSONAL DEVELOPMENT 403(B) PLAN [EIN = 237085239]
• NEW YORK COMMUNITIES FOR CHANG 401 K PROFIT SHARING PLAN TRUST [EIN = 271359103]
• NEW YORK BOILER, INC. CASH BALANCE PLAN [EIN = 112809119]
• NEW YORK CAREER INSTITUTE, INC 401(K) PLAN [EIN = 132502849]
• NEW YORK FOOT AND ANKLE, PLLC DEFINED BENEFIT PLAN [EIN = 455012159]
• NEW YORK OPTICAL, INC. DEFINED BENEFIT PENSION PLAN [EIN = 112654052]
• NEW YORK 811, INC. 401(K) PLAN [EIN = 900289921]
• NEW YORK ELECTRICAL DESIGN INC 401 K PROFIT SHARING PLAN TRUST [EIN = 300343412]
• NEW YORK VALUE CLUB, LTD. 401(K) PROFIT SHARING PLAN [EIN = 113288102]
• NEW YORK PSYCHOANALYTIC INSTITUTE DEFINED CONTRIBUTION RETIREMENT PLAN [EIN = 131624130]
• NEW YORK STRUCTURAL BIOLOGY CENTER 403(B) DEFINED CONTRIBUTION PLAN [EIN = 134043587]
• NEW YORK CENTER FOR SPECIALIZED DENTISTRY, P.C. PROFIT SHARING 401K PLAN [EIN = 132951569]
• NEW YORK STATE ASSOCIATION FOR 401 K PROFIT SHARING PLAN TRUST [EIN = 134001946]
• NEW YORK JOINT BOARD NY CLOTHING MANUFACTURERS SCHOLARSHIP FUND [EIN = 133118573]
• NEW YORK STATE ASSOCIATION OF INDEPENDENT SCHOOLS 403(B) TDA PLAN [EIN = 141504908]
• NEW YORK SPEAKERS BUREAU, INC. 401(K) PLAN [EIN = 133793535]
• NEW YORK OTOLARYNGOLOGY GROUP, P.C. PROFIT SHARING PLAN [EIN = 133295335]
• NEW YORK APPLE SALES, INC. 401(K) PROFIT SHARING PLAN [EIN = 141772604]
• NEW YORK FOOT CARE SERVICES PLLC PROFIT SHARING PL [EIN = 204026741]
• NEW YORK STATE BROADCASTERS ASSOCIATION, INC. EMPLOYEE RETIREMENT PLAN [EIN = 141541060]
• NEW YORK SKYLINE, INC 401(K) PLAN [EIN = 113149397]
• NEW YORK MOTORS CORP. PENSION PLAN [EIN = 223477428]
• NEW YORK SECURITY SYSTEMS, INC. 401K PLAN [EIN = 141648882]
• NEW YORK DIALYSIS SERVICES, INC. MEP 401(K) PLAN [EIN = 043267217]
• NEW YORK ORAL, MAXILLOFACIAL AND IMPLANT SURGERY, P.C. MONEY PURCHASE PENSION PLAN [EIN = 112621554]
• NEW YORK PODIATRIC MEDICINE & SURGERY 401(K) PROFIT SHARING PLAN & TRUST [EIN = 203426389]
• NEW YORK CITY SOCIAL SPORTS CLUB, INC. RETIREMENT PLAN [EIN = 205774314]
• NEW YORK GRANT COMPANY 401K/PROFIT SHARING PLAN [EIN = 043680621]
• NEW YORK MUNICIPAL ADVISORS CORPORATION 401K PROFIT SHARING PLAN [EIN = 113206884]
• NEW YORK JUNIOR TENNIS LEAGUE 403(B) PLAN [EIN = 237442256]
• NEW YORK REPRESENTATIVES, LTD. PROFIT SHARING TRUST [EIN = 112657913]
• NEW YORK CITY MISSION SOCIETY 403(B) PLAN [EIN = 135562301]
• NEW YORK LANGUAGE CENTER, INC. & IT'S AFFILIATES 401(K) PROFIT SHARING PLAN [EIN = 133275377]
• NEW YORK CONCRETE CORP. 401(K) PLAN [EIN = 113076836]
• NEW YORK CITY ENERGY EFFICIENCY CORPORATION 401(K) PLAN [EIN = 273731338]
• NEW YORK ARTIFICIAL KIDNEY CENTER, INC. 401(K) PROFIT SHARING PLAN AND TRUST [EIN = 113561833]
• NEW YORK LIFE INTERNATIONAL LLC PROFIT SHARING PLAN [EIN = 134199614]
• NEW YORK QUEENS OB/GYN, P.C. CASH OR DEFERRED PLAN AND TRUST [EIN = 113395424]
• NEW YORK HEALTH PLAN ASSOCIATION, INC. PENSION PLAN [EIN = 141641053]
• NEW YORK TENT COMPANY, INC. PENSION PLAN [EIN = 113234663]
• NEW YORK TENT COMPANY, INC. 401(K) PLAN [EIN = 113234663]
• NEW YORK PROSECUTORS TRAINING INSTITUTE, INC. EMPLOYEE RETIREMENT PLAN AND TRUST [EIN = 113289827]
• NEW YORK SPINE & NEUROSURGERY ASSOCIATES, P.C. 401(K) PLAN [EIN = 200590854]
• NEW YORK COMMERCIAL REAL ESTATE, LTD 401(K) PLAN [EIN = 264179466]
• NEW YORK LASER EYE LLP 401K PLAN [EIN = 421600458]
• NEW YORK HEATING CORP. 401(K) PLAN [EIN = 112999708]
• NEW YORK STATE DENTAL ASSOCIATION RETIREMENT PLAN [EIN = 141434154]
• NEW YORK COSMOS, LLC. 401(K) PLAN [EIN = 270849852]
• NEW YORK CITY REGIONAL CENTER, LLC 401(K) PLAN [EIN = 262686201]
• NEW YORK SAMPLE CARD COMPANY PROFIT SHARING PLAN [EIN = 135582882]
• NEW YORK HOTEL AND MOTEL TRADES COUNCIL, AFL-CIO DEFINED BENEFIT PENSION PLAN [EIN = 131098484]
• NEW YORK TEMPERATURE CONTROLS, INC 401 K PROFIT SHARING PLAN TRUST [EIN = 203260332]
• NEW YORK FIRE DETECTION, INC. 401(K) PLAN [EIN = 113145334]
• NEW YORK BLACK CAR FUND 401(K) PLAN [EIN = 134074646]
• NEW YORK STATE FENCE, INC. RETIREMENT SAVINGS PLAN [EIN = 161098453]
• NEW YORK STATE PSYCHOLOGICAL ASSOCIATION, INC. 401(K) PLAN [EIN = 131956620]
• NEW YORK RURAL WATER ASSOCIATION 401(K) PROFIT SHARING PLAN [EIN = 222257996]
• NEW YORK SPORTS AND PHYSICAL THERAPY INSTITUTE DEFINED BENEFIT [EIN = 112356557]
• NEW YORK & ATLANTIC RAILWAY UNION 401(K) PLAN [EIN = 133926500]
• NEW YORK FLAG & POLE CO., INC. PROFIT SHARING PLAN [EIN = 133132131]
• NEW YORK PAVING, INC. PROFIT SHARING PLAN [EIN = 112426065]
• NEW YORK PACKAGING II LLC CASH BALANCE PLAN [EIN = 043834351]
• NEW YORK REAL ESTATE INSTITUTE PENSION PLAN [EIN = 200484486]
• NEW YORK STATE PODIATRIC MEDICAL ASSOCIATION 401(K) PLAN [EIN = 131679614]
• NEW YORK STATE ASSOC OF ALCOHO 401 K PROFIT SHARING PLAN TRUST [EIN = 141793172]
• NEW YORK CARDIOLOGY GROUP, P.C. CASH BALANCE PENSION PLAN [EIN = 113339481]
• NEW YORK URGENT CARE, P.C. PROFIT SHARING 401(K) PENSION PLAN [EIN = 260250985]
• NEW YORK INTEGRATIVE RHEUMATOLOGY & ARTHRITIS CARE 401(K) PLAN [EIN = 270609949]
• NEW YORK CITY RENT GUIDELINES BOARD PROFIT SHARIN [EIN = 133026145]
• NEW YORK COOLING TOWERS INC 401 K PROFIT SHARING PLAN TRUST [EIN = 133266877]
• NEW YORK LAW JOURNAL UNION EMPLOYEES' PENSION PLAN [EIN = 133273851]
• NEW YORK RESIDENTIAL WORKS INC 401 K PROFIT SHARING PLAN TRUST [EIN = 112984526]
• NEW YORK ORAL, MAXILLOFACIAL AND IMPLANT SURGERY, P.C. DEFINED BENEFIT PLAN [EIN = 112621554]
• NEW YORK CITY RUNS, INC. 401(K) PLAN [EIN = 274480140]
• NEW YORK TYPOGRAPHICAL 401(K) P/S PLAN [EIN = 135276340]
• NEW YORK BIOTECHNOLOGY ASSOCIATION SAVINGS AND RETIREMENT PLAN [EIN = 113026494]
• NEW YORK GASTROENTEROLOGY ASSOCIATES, LLP 401(K) PLAN [EIN = 134056764]
• NEW YORK CHILD RESOURCE CENTER PROFIT SHARING PLAN [EIN = 133792985]
• NEW YORK SPINE PHYSICAL THERAPY, P.C. [EIN = 113497018]
• NEW YORK RHB, LLC 401K PLAN [EIN = 208104462]
• NEW YORK ORTHOPAEDIC HOSPITAL ASSOCIATES, P.C. RETIREMENT PLAN [EIN = 133297333]
• NEW YORK STATE DEFENDERS JUSTICE FUND, INC. 401(K) PLAN [EIN = 205311731]
• NEW YORK MILITARY ACADEMY [EIN = 140921372]
• NEW YORK STATE FORUM INC 401K PLAN [EIN = 263962887]
• NEW YORK CITY POLICE MUSEUM 401 K PROFIT SHARING PLAN TRUST [EIN = 134000578]
• NEW YORKER ELECTRONICS CO. INC. RETIREMENT PLAN [EIN = 131666917]
• NEW YORK CITY CENTER FOR CHARTER SCHOOL EXCELLENCE 403(B) PLAN [EIN = 200759687]
• NEW YORK STATE HISTORICAL ASSOCIATION AND THE FARMERS MUSEUM [EIN = 150539110]
• NEW YORK STATE WEATHERIZATION DIRECTORS' ASSOCIATION 401(K) PLAN [EIN = 222712338]
• NEW YORK LAW INSTITUTE 403(B) PLAN [EIN = 135600417]
• NEW YORK FOUNDATION FOR THE ARTS, INC. ANNUITY PLAN [EIN = 237129564]
• NEW YORK ASIAN WOMEN'S CENTER 403(B)(7) PLAN [EIN = 133286250]
• NEW YORK PLASTIC SURGERY, P.C. PROFIT-SHARING PLA [EIN = 133651645]
• NEW YORK PREMIER WINES, INC. PROFIT SHARING PLAN [EIN = 203705744]
• NEW YORK CENTER FOR CIVIL JUSTICE TOLERANCE & VALUES DEFINED BENEFIT PENSION PLAN [EIN = 010701804]
• NEW YORK PATHWAYS 401K PROFIT SHARING PLAN [EIN = 300667649]
• NEW YORK FARM VIABILITY INSTIT 401 K PROFIT SHARING PLAN TRUST [EIN = 134295807]
• NEW YORK FILM ACADEMY LTD 401(K) PROFIT SHARING PLAN & TRUST [EIN = 133723331]
• NEW YORK ENGINEERS 401(K) PLAN [EIN = 454064575]
• NEW YORK LOAN EXCHANGE 401K PLAN [EIN = 383717882]
• NEW YORK HAND REHABILITATION, O.T., P.C. 401(K) PLAN [EIN = 133671130]
• NEW YORK OBSTETRICS & GYNECOLOGY PC 401(K) PROFIT SHARING PLAN [EIN = 133890271]
• NEW YORK ANESTHESIOLOGY MEDICAL SPECIALTIES, PC PENSION PLAN [EIN = 161592210]
• NEW YORK DENTAL GROUP LLP 401(K) PLAN [EIN = 331130608]
• NEW YORK HEALTH PURCHASING ALLIANCE, INC. 401(K) PLAN [EIN = 134019932]
• NEW YORK RISK SOLUTIONS, INC. 401(K) PLAN [EIN = 364697668]
• NEW YORK FOLDING BOX CO. PROFIT SHARING PLAN [EIN = 221662323]
• NEW YORK EHEALTH COLLABORATIVE (NYEC) 401(K) PLAN [EIN = 208022336]
• NEW YORK SPEAKERS BUREAU, INC. DEFINED BENEFIT PLAN [EIN = 133793535]
• NEW YORK ORTHOPEDIC SPECIALISTS, PC 401K PROFIT SHARING PLAN AND TRUST [EIN = 132795179]
• NEW YORK BITUMINOUS PRODUCTS C 401 K PROFIT SHARING PLAN TRUST [EIN = 061069341]
• NEW YORK PELVIC PAIN AND MINIMALLY INVASIVE GYNECOLOGIC SURGERY, P.C. CASH BALANCE PENSION PLAN [EIN = 205706671]
• NEW YORK ACADEMY OF ART 403B RETIREMENT PLAN [EIN = 133643485]
• NEW YORK REPUBLICAN STATE COMMITTEE 401(K) PLAN [EIN = 131214350]
• NEW YORK HOME X-RAY LLC 401 K PROFIT SHARING PLAN TRUST [EIN = 200975541]
• NEW YORK DESIGN ARCHITECTS LLP 401K PLAN [EIN = 113338348]
• NEW YORK RESTORATION PROJECT 401(K) RETIREMENT PLAN [EIN = 133959056]
• NEW YORK EXPORT CO., INC. EMPLOYEES PROFIT SHARING PLAN [EIN = 135516850]
• NEW YORK PULMONARY & SLEEP MEDICINE, PC PROFIT SHARING [EIN = 462712332]
• NEW YORK WOMEN IN FILM & TELEVISION, INC. 401(K) RETIREMENT PLAN [EIN = 132983705]
• NEW YORK CENTER FOR LIVING INC 401K PLAN [EIN = 202323022]
• NEW YORK AFFORDABLE RELIABLE ELECTR [EIN = 205860747]
• NEW YORK ORTHODONTICS GROUP PLLC 401(K) PROFIT SHARING PLAN [EIN = 271447761]
• NEW YORK OTOLARYNGOLOGY GROUP, P.C. CASH BALANCE PENSION PLAN [EIN = 133295335]
• NEW YORK URGENT CARE, P.C. DEFINED BENEFIT PLAN [EIN = 260250985]
• NEW YORK STATE ASSOCIATION OF COUNTY HEALTH OFFICIALS RETIREMENT TRUST [EIN = 141747742]
• NEW YORK UROLOGICAL ASSOCIATES PC RETIREMENT PLAN [EIN = 133548722]
• NEW YORK GOLD MART MONEY PURCHASE PLAN [EIN = 133427970]
• NEW YORK CARDIOVASCULAR ANESTHESIOLOGISTS PC DEFINED BENEFIT PLAN [EIN = 113027215]
• NEW YORK HOTEL AND MOTEL TRADES COUNCIL, AFL-CIO MONEY PURCHASE PLAN [EIN = 131098484]
• NEW YORK LEAK DETECTION, INC. 401(K) PROFIT SHARING PLAN [EIN = 161299328]
• NEW YORK PULMONARY & SLEEP MEDICINE PC PENSION PLAN [EIN = 462712332]
• NEW YORK LEGAL ASSISTANCE GROUP SAVINGS PLAN [EIN = 133505428]
• NEW YORK METRO TRUCK, INC. 401(K) PLAN [EIN = 113057170]
• NEW YORK EYE SAVINGS PLAN [EIN = 132686866]
• NEW YORK INSTITUTE OF BUSINESS TECHNOLOGY 401(K) PLAN [EIN = 133903957]
• NEW YORK STATE RESTAURANT ASSOCIATION 401(K) PLAN [EIN = 131101544]
• NEW YORK LEAGUE OF CONSERVATION VOTERS 401(K) PLAN [EIN = 113095033]
• NEW YORK AERIAL SERVICES 401(K) PLAN [EIN = 161613650]
• NEW YORK INSURANCE ASSOCIATION 401K SAVINGS PLAN [EIN = 161521843]
• NEW YORK NETWORK MANAGEMENT LLC CASH BALANCE PLAN [EIN = 113347168]
• NEW YORK MINT LTD. 401(K) PLAN [EIN = 411840859]
• NEW YORK DISTRICT COUNCIL OF CARPENTERS ANNUITY FUND [EIN = 364660775]
• NEW YORK BAKERY 401(K) PROFIT SHARING PLAN & TRUST [EIN = 300886210]
• NEW YORK STATE REHABILITATION ASSOCIATION, INC. 401(K) PROFIT SHARING PLAN [EIN = 141596108]
• NEW YORK GRAPHIC SOCEITY 401(K) PLAN [EIN = 060834793]
• NEW YORK PEACE INSTITUTE, INC. 401(K) PROFIT SHARING PLAN [EIN = 451964622]
• NEW YORK E COMMERCE ADVISORY, INC. PENSION PLAN [EIN = 453950113]
• NEW YORK COSMETIC AND [EIN = 464096493]
• NEW YORK INTERNATIONAL SCHOOL, INC. 401K PLAN [EIN = 463640492]
• NEW YORK TRUCK & EQUIPMENT, INC. PROFIT SHARING 401(K) PLAN [EIN = 900915971]
• NEW YORK URBAN PROFESSIONALS ATHLETIC LEAGUE, INC. PROFIT SHARING PLAN [EIN = 133975259]
• NEW YORK SPORTS CHIROPRACTIC 401(K) PLAN [EIN = 271115776]
• NEW YORK-CONNECTICUT DEVELOPME 401 K PROFIT SHARING PLAN TRUST [EIN = 134042619]
• NEW YORK VETERINARY SPECIALTY CENTER DEFINED BENEFIT PLAN [EIN = 364530633]
• NEW YORK RESTORATION PROJECT 401(K) RETIREMENT PLAN [EIN = 133959056]
• NEW YORK DIGITAL CORP. 401(K) PROFIT SHARING PLAN [EIN = 870789932]
• NEW YORK STATE RESTAURANT 401(K) PROFIT SHARING PLAN & TRUST [EIN = 141817369]
• NEW YORK BEACON, INC. 401(K) PLAN [EIN = 113449447]
• NEW YORK ACHIEVEMENT LLC 401 K PROFIT SHARING PLAN TRUST [EIN = 232834912]
• NEW YORK DOG SPA & HOTEL INC 401K PROFIT SHARING PLAN [EIN = 133995305]
• NEW YORK CITY SOCIAL SPORTS CLUB, INC. 401(K)/PROFIT SHARING PLAN [EIN = 205774314]
• NEW YORK FRENCH AMERICAN CHARTER SCHOOL 401(K) PLAN [EIN = 800518737]
• NEW YORK HOMTOWN STORES SEARS [EIN = 461661511]
• NEW YORK EYE CANCER CENTER 401(K) PROFIT SHARING PLAN & TRUST [EIN = 134166365]
• NEW YORK TECH INDUSTRIES INC 401K PLAN [EIN = 020587191]
• NEW YORK CENTER FOR ADDICTION TREATMENT 401(K) PLAN [EIN = 133704138]
• NEW YORK CENTER FOR LIVER TRAN 401 K PROFIT SHARING PLAN TRUST [EIN = 133510056]
• NEW YORK PRODUCTS DISTRIBUTORS INC 401(K) PROFIT SHARING PLAN [EIN = 113213359]
• NEW YORK CITY ENVIRONMENTAL JU 401 K PROFIT SHARING PLAN TRUST [EIN = 133779250]
• NEW YORK PHYSICAL MEDICINE CENTER 401(K) PROFIT SHARING PLAN [EIN = 204226416]
• NEW YORK GASTROENTEROLOGY & HEPATOLOGY 401(K) PLAN [EIN = 364698047]
• NEW YORK STATE RESTAURANT ASSN 401(K) PROFIT SHARING PLAN & TRUST [EIN = 131101544]
• NEW YORK GASTROENTEROLOGY ASSOCIATES DEFINED BENEFIT PLAN [EIN = 134056764]
• NEW YORK NECK & BACK CENTER 401(K) PLAN [EIN = 900893068]
• NEW YORK STATE HEALTH FOUNDATION TAX DEFERRED ANNUITY PLAN [EIN = 300127892]
• NEW YORK MEDICAL & DIAGNOSTIC CENTER, INC. EMPLOYEES PROFIT SHARING PLAN & TRUST [EIN = 113405167]
• NEW YORK HOUSING CONFERENCE IN 401(K) PROFIT SHARING PLAN & TRUST [EIN = 263846042]
• NEW YORK, NEW YORK SALON INC 401K PLAN [EIN = 521529495]
• NEW YORK STATEWIDE SENIOR ACTION COUNCIL, INC. 403(B) TDA PLAN [EIN = 222233947]
• NEW YORK STOCK EXCHANGE INC., AND SUBSIDIARY COMPANIES EMPLOYEE SAVINGS PLAN - MASTER TRUST [EIN = 203783862]
• NEW YORK STATE BANKERS RETIREMENT SYSTEM VOLUME SUBMITTER PLAN [EIN = 111380045]
• NEW YORK CARDIAC DIAGNOSTIC CENTER DEFINED BENEFIT PLAN [EIN = 133413929]
• NEW YORK CAROLINA EXPRESS, INC. 401(K) RETIREMENT PLAN [EIN = 161236489]
• NEW YORK DIALYSIS SERVICES, INC. SECTION 125 CAFETERIA PLAN [EIN = 043267217]
• NEW YORK CORPORATE OFFICE/FAMS DISABILITY PLAN [EIN = 133324058]
• NEW YORK STATE BANKERS RETIREMENT SYSTEM VOLUME SUBMITTER PLAN [EIN = 141454232]
• NEW YORK EYE & EAR INFIRMARY SHORT TERM DISABILITY PLAN [EIN = 135562304]
• NEW YORK ORTHOPEDIC & SPINE SV PLLC 401K PLAN [EIN = 113433664]
• NEW YORK NEWSPAPER SAVINGS PLUS PLAN [EIN = 141772204]
• NEW YORK COMPENSATION INSURANCE RATING BOARD LTD PLAN [EIN = 130594020]
• NEW YORK LOCKSMITH SUPPLY, INC. RETIREMENT TRUST [EIN = 133146769]
• NEW YORK STOCK EXCHANGE INC., AND SUBSIDIARY COMPANIES OPERATIONS LEVEL EMPLOYEE SAVINGS PLAN [EIN = 203783862]
• NEW YORK MINUTE MANAGEMENT, INC. 401(K) PLAN [EIN = 113628783]
• NEW YORK CENTER HEALTH PLAN [EIN = 113626586]
• NEW YORK ORTHOPAEDICS AND SPORTS MEDICINE, P.C. PROFIT SHARING PLAN [EIN = 133955151]
• NEW YORK WELFARE FUND [EIN = 204285629]
• NEW YORK STATE BANKERS RETIREMENT SYSTEM VOLUME SUBMITTER PLAN [EIN = 160341550]
• NEW YORK BOTANICAL GARDEN PENSION BENEFIT PLAN [EIN = 131693134]
• NEW YORK GENEALOGICAL & BIOGRAPHICAL SOCIETY DEFINED CONTRIBUTION MONEY PURCHASE RETIREMENT PLA [EIN = 135596870]
• NEW YORK STATE BAR ASSOCIATION TERMINATION PAY PLAN [EIN = 140923640]
• NEW YORK DISABILITY BENEFITS LAW PLAN [EIN = 010085930]
• NEW YORK TRAP ROCK-HOURLY RETIREE GROUP HEALTH PLAN [EIN = 061032119]
• NEW YORK WESTCHESTER SQUARE MEDICAL CENTER INC. PROFIT SHARING PLAN [EIN = 131732601]
• NEW YORK STATE BANKERS RETIREMENT SYSTEM VOLUME SUBMITTER PLAN [EIN = 110804410]
• NEW YORK COLLEGE OF TRADITIONAL CHINESE MEDICINE 401(K) PROFIT SHARING PLAN & TRUST [EIN = 113358541]
• NEW YORK WATER SERVICE CORPORATION POST RETIREMENT HEALTHCARE PLAN [EIN = 550823550]
• NEW YORK ISLANDERS HOCKEY CLUB DENTAL PLAN [EIN = 112254417]
• NEW YORK STOCK EXCHANGE INC., AND SUBSIDIARY COMPANIES EMPLOYEE SAVINGS PLAN [EIN = 203783862]
• NEW YORK STATE AFL-CIO [EIN = 140923720]
• NEW YORK CARDIOLOGY PC DEFINED BENEFIT PENSION PLAN [EIN = 113638015]
• NEW YORK GROUP ADMINISTRATORS INC PENSION PLAN AND TRUST [EIN = 161160566]
• NEW YORK LIFE INSURANCE COMPANY EMPLOYEE PROGRESS-SHARING INVESTMENT PLAN [EIN = 135582869]
• NEW YORK MERCANTILE EXCHANGE [EIN = 135274360]
• NEW YORK STATE TEAMSTERS COUNCIL HEALTH & HOSPITAL FUND [EIN = 150551885]
• NEW YORK MEDIA LLC 401(K) PLAN [EIN = 320101978]
• NEW YORK INDEPENDENT SYSTEM OPERATOR, INC. CAFETERIA PLAN [EIN = 141815612]
• NEW YORK PRESBYTERIAN HOSPITAL MASTER TRUST - NYP DREYFUS [EIN = 134011699]
• NEW YORK LEAGUE FOR EARLY LEARNING WELFARE BENEFITS PLAN [EIN = 112513824]
• NEW YORK PRESBYTERIAN HOSPITAL MASTER TRUST - LONG TERM POOL [EIN = 134011699]
• NEW YORK ANESTHESIOLOGY MEDICAL SPECIALTIES, P.C. HEALTH AND WELFARE BENEFITS PLAN [EIN = 161592210]
• NEW YORK KIDS CLUB 401(K) AND PROFIT SHARING PLAN [EIN = 474552493]
• NEW YORK CRUISE LINES RETIREMENT AND 401(K) PLAN [EIN = 133082308]
• NEW YORK CITY ACOUSTICS INC 401K PLAN [EIN = 133564989]
• NEW YORK INSTITUTE OF TECHNOLOGY GROUP LIFE AND ACCIDENT INSURANCE PLAN [EIN = 111788788]
• NEW YORK ISLANDERS HOCKEY CLUB, LP 401(K) PLAN [EIN = 112254417]
• NEW YORK MARINE T/T INDUSTRY PLAN I [EIN = 205336063]
• NEW YORK STATE UNITED TEACHERS MEMBER BENEFITS TRUST [EIN = 222480854]
• NEW YORK COMMUNITY BANCORP, INC. GROUP BENEFITS PLAN [EIN = 061377322]
• NEW YORK THERAPY PLACEMENT INC. 401(K) PROFIT SHARING PLAN III [EIN = 113139640]
• NEW YORK FARM BUREAU, INC. 401(K) PLAN [EIN = 150539109]
• NEW YORK LEGAL ASSISTANCE GROUP HEALTH AND WELFARE BENEFITS PLAN [EIN = 133505428]
• NEW YORK LIFE INSURANCE COMPANY JOB ELIMINATION SEVERANCE BENEFIT PLAN [EIN = 135582869]
• NEW YORK CITY ACOUSTICS INC. DEFINED BENEFIT PENSION PLAN [EIN = 133564989]
• NEW YORK PRESBYTERIAN HOSPITAL MASTER TRUST - WESTCHESTER DREYFUS [EIN = 134011699]
• NEW YORK STATE AFL-CIO 401(K) PROFIT SHARING PLAN [EIN = 140923720]
• NEW YORK COUNCIL OF NONPROFITS, INC. HEALTH PLAN [EIN = 141343047]
• NEW YORK COUNCIL FOR THE HUMANITIES TAX-SHELTERED ANNUITY PLAN [EIN = 510152266]
• NEW YORK PUBLIC RADIO RETIREMENT PLAN [EIN = 133015230]
• NEW YORK LIFE INSURANCE COMPANY PENSION PLAN [EIN = 135582869]
• NEW YORK LAW SCHOOL DEFINED CONTRIBUTION RET. PLAN [EIN = 135645885]
• NEW YORK TRANSIT, INC 401(K) [EIN = 942956194]
• NEW YORK STATE TECHNOLOGY ENTERPRISE CORPORATION LIFE & LTD PLAN [EIN = 161521105]
• NEW YORK ISLANDERS HOCKEY CLUB LIFE & LTD PLAN [EIN = 112254417]
• NEW YORK PRESBYTERIAN HOSPITAL MASTER TRUST - LEGACY POOL [EIN = 134011699]
• NEW YORK THERAPY PLACEMENT INC. 401(K) PROFIT SHARING PLAN II [EIN = 113139640]
• NEW YORK CITY Q-CARDS, INC. 401(K) PROFIT SHARING PLAN [EIN = 201115600]
• NEW YORK SHIPPING ASSOCIATION 401(K) PLAN [EIN = 135637319]
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• NEW YORK DOWNTOWN HOSPITAL HEALTH AND WELFARE PLAN [EIN = 133049852]
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