NY CITY DISTRICT COUNCIL 37, AFSCME AFL- has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan WELFARE PLAN FOR EMPLOYEES OF DISTRICT COUNCIL 37
401k plan membership statisitcs for WELFARE PLAN FOR EMPLOYEES OF DISTRICT COUNCIL 37
STANDARD SECURITY LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 55247 ) |
Policy contract number | 11020521014 |
Policy instance | 4 |
Insurance contract or identification number | 11020521014 | Number of Individuals Covered | 559 | 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 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $5,593,835 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 ) |
Policy contract number | 11020521004 |
Policy instance | 3 |
Insurance contract or identification number | 11020521004 | Number of Individuals Covered | 82 | 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 | Welfare Benefit Premiums Paid to Carrier | USD $786,315 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 ) |
Policy contract number | 11020521015 |
Policy instance | 2 |
Insurance contract or identification number | 11020521015 | Number of Individuals Covered | 46 | 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 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $413,451 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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STANDARD SECURITY LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 55247 ) |
Policy contract number | 11DBL0695400 |
Policy instance | 1 |
Insurance contract or identification number | 11DBL0695400 | Number of Individuals Covered | 212 | Insurance policy start date | 2022-10-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $16,005 | Total amount of fees paid to insurance company | USD $0 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $173,468 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $16,005 | Insurance broker organization code? | 3 |
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EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 ) |
Policy contract number | 00001GYTK |
Policy instance | 6 |
Insurance contract or identification number | 00001GYTK | Number of Individuals Covered | 25 | 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 | Welfare Benefit Premiums Paid to Carrier | USD $194,451 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 ) |
Policy contract number | 00001GYN4 |
Policy instance | 2 |
Insurance contract or identification number | 00001GYN4 | Number of Individuals Covered | 46 | 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 | Welfare Benefit Premiums Paid to Carrier | USD $389,541 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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STANDARD SECURITY LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 55247 ) |
Policy contract number | 11DBL0695400 |
Policy instance | 1 |
Insurance contract or identification number | 11DBL0695400 | Number of Individuals Covered | 304 | Insurance policy start date | 2021-10-01 | 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 $15,916 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $170,678 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 15916 | Insurance broker organization code? | 3 |
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EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 ) |
Policy contract number | 00001GYP3 |
Policy instance | 3 |
Insurance contract or identification number | 00001GYP3 | Number of Individuals Covered | 131 | 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 | Welfare Benefit Premiums Paid to Carrier | USD $1,002,220 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 ) |
Policy contract number | 00001GYQ1 |
Policy instance | 4 |
Insurance contract or identification number | 00001GYQ1 | Number of Individuals Covered | 142 | 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 | Welfare Benefit Premiums Paid to Carrier | USD $1,287,691 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 ) |
Policy contract number | 00001GYTL |
Policy instance | 5 |
Insurance contract or identification number | 00001GYTL | Number of Individuals Covered | 7 | 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 | Welfare Benefit Premiums Paid to Carrier | USD $57,100 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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STANDARD SECURITY LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 55247 ) |
Policy contract number | 1102052014 |
Policy instance | 7 |
Insurance contract or identification number | 1102052014 | Number of Individuals Covered | 574 | 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 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,653,826 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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STANDARD SECURITY LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 55247 ) |
Policy contract number | 11DBL0695400 |
Policy instance | 1 |
Insurance contract or identification number | 11DBL0695400 | Number of Individuals Covered | 235 | Insurance policy start date | 2020-10-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $5,751 | Total amount of fees paid to insurance company | USD $0 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $142,622 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,751 | Insurance broker organization code? | 3 |
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EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 ) |
Policy contract number | 00001GYN4 |
Policy instance | 2 |
Insurance contract or identification number | 00001GYN4 | Number of Individuals Covered | 46 | 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 | Welfare Benefit Premiums Paid to Carrier | USD $389,541 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 ) |
Policy contract number | 00001GYP3 |
Policy instance | 3 |
Insurance contract or identification number | 00001GYP3 | Number of Individuals Covered | 131 | 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 | Welfare Benefit Premiums Paid to Carrier | USD $1,002,220 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 ) |
Policy contract number | 00001GYQ1 |
Policy instance | 4 |
Insurance contract or identification number | 00001GYQ1 | Number of Individuals Covered | 142 | 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 | Welfare Benefit Premiums Paid to Carrier | USD $1,287,691 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 ) |
Policy contract number | 00001GYTL |
Policy instance | 5 |
Insurance contract or identification number | 00001GYTL | Number of Individuals Covered | 7 | 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 | Welfare Benefit Premiums Paid to Carrier | USD $57,100 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 ) |
Policy contract number | 00001GYTK |
Policy instance | 6 |
Insurance contract or identification number | 00001GYTK | Number of Individuals Covered | 25 | 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 | Welfare Benefit Premiums Paid to Carrier | USD $194,451 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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STANDARD SECURITY LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 55247 ) |
Policy contract number | 1102052014 |
Policy instance | 7 |
Insurance contract or identification number | 1102052014 | Number of Individuals Covered | 574 | 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 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,653,826 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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STANDARD SECURITY LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 55247 ) |
Policy contract number | 1102052-1004 |
Policy instance | 4 |
Insurance contract or identification number | 1102052-1004 | Number of Individuals Covered | 59 | 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 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $90,551 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 ) |
Policy contract number | 174667 |
Policy instance | 2 |
Insurance contract or identification number | 174667 | Number of Individuals Covered | 850 | 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 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $3,269,839 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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STANDARD SECURITY LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 55247 ) |
Policy contract number | 11DBL0695400 |
Policy instance | 1 |
Insurance contract or identification number | 11DBL0695400 | Number of Individuals Covered | 323 | Insurance policy start date | 2019-10-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $4,880 | Total amount of fees paid to insurance company | USD $0 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $116,425 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,880 | Insurance broker organization code? | 3 |
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EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 ) |
Policy contract number | IP1 IPX IPY IPZ |
Policy instance | 3 |
Insurance contract or identification number | IP1 IPX IPY IPZ | Number of Individuals Covered | 374 | 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 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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STANDARD SECURITY LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 55247 ) |
Policy contract number | 1102052-004 |
Policy instance | 4 |
Insurance contract or identification number | 1102052-004 | Number of Individuals Covered | 132 | 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 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $980,527 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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STANDARD SECURITY LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 55247 ) |
Policy contract number | 11DBL0695400 |
Policy instance | 1 |
Insurance contract or identification number | 11DBL0695400 | Number of Individuals Covered | 241 | Insurance policy start date | 2018-10-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $4,709 | Total amount of fees paid to insurance company | USD $0 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $104,650 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,709 | Insurance broker organization code? | 3 |
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EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 ) |
Policy contract number | 174667 |
Policy instance | 2 |
Insurance contract or identification number | 174667 | Number of Individuals Covered | 857 | 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 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $6,326,542 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 ) |
Policy contract number | 31D,675,7EY,7EX |
Policy instance | 3 |
Insurance contract or identification number | 31D,675,7EY,7EX | Number of Individuals Covered | 328 | 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 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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HIP HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 1004018-004 |
Policy instance | 4 |
Insurance contract or identification number | 1004018-004 | Number of Individuals Covered | 130 | 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 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $942,396 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 ) |
Policy contract number | 31D,675,7EY,7EX |
Policy instance | 3 |
Insurance contract or identification number | 31D,675,7EY,7EX | Number of Individuals Covered | 337 | 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 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 ) |
Policy contract number | 174667 |
Policy instance | 2 |
Insurance contract or identification number | 174667 | Number of Individuals Covered | 858 | 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 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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STANDARD SECURITY LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 55247 ) |
Policy contract number | 11DBL0695400 |
Policy instance | 1 |
Insurance contract or identification number | 11DBL0695400 | Number of Individuals Covered | 245 | Insurance policy start date | 2017-10-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $4,388 | Total amount of fees paid to insurance company | USD $0 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $97,515 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,388 | Insurance broker organization code? | 3 | Insurance broker name | MMG AGENCY |
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EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 ) |
Policy contract number | X00001948 |
Policy instance | 7 |
Insurance contract or identification number | X00001948 | Number of Individuals Covered | 172 | 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 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00931955 |
Policy instance | 8 |
Insurance contract or identification number | 00931955 | Number of Individuals Covered | 660 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $32,925 | Total amount of fees paid to insurance company | USD $0 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $164,623 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $32,925 | Insurance broker organization code? | 3 | Insurance broker name | MMG AGENCY INC |
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UNION SECURITY LIFE INSURANCE COMPANY OF NEW YORK 4D DENTAL (National Association of Insurance Commissioners NAIC id number: 81477 ) |
Policy contract number | G# 84804 |
Policy instance | 1 |
Insurance contract or identification number | G# 84804 | Number of Individuals Covered | 58 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $4,226 | Total amount of fees paid to insurance company | USD $103 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $52,421 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,226 | Amount paid for insurance broker fees | 103 | Additional information about fees paid to insurance broker | NON-MONETARY COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | WINSTON FINANCIAL SERVICES |
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EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 ) |
Policy contract number | N00003907 |
Policy instance | 6 |
Insurance contract or identification number | N00003907 | Number of Individuals Covered | 114 | 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 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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HIP HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 1004018-004 |
Policy instance | 5 |
Insurance contract or identification number | 1004018-004 | Number of Individuals Covered | 127 | 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 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $893,541 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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AMALGAMATED LIFE INSURANCE (National Association of Insurance Commissioners NAIC id number: 60216 ) |
Policy contract number | 260B68 |
Policy instance | 4 |
Insurance contract or identification number | 260B68 | Number of Individuals Covered | 204 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-04-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $6,281 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 ) |
Policy contract number | 174667 |
Policy instance | 3 |
Insurance contract or identification number | 174667 | Number of Individuals Covered | 851 | 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 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 ) |
Policy contract number | N00002591 |
Policy instance | 2 |
Insurance contract or identification number | N00002591 | Number of Individuals Covered | 65 | 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 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 ) |
Policy contract number | 174667-696 |
Policy instance | 3 |
Insurance contract or identification number | 174667-696 | Number of Individuals Covered | 164 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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AMALGAMATED LIFE INSURANCE (National Association of Insurance Commissioners NAIC id number: 60216 ) |
Policy contract number | 260B68 |
Policy instance | 4 |
Insurance contract or identification number | 260B68 | Number of Individuals Covered | 214 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $26,210 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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HIP HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 1004018-004 |
Policy instance | 5 |
Insurance contract or identification number | 1004018-004 | Number of Individuals Covered | 136 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $932,798 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 ) |
Policy contract number | N00002591 |
Policy instance | 2 |
Insurance contract or identification number | N00002591 | Number of Individuals Covered | 70 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNION SECURITY LIFE INSURANCE COMPANY OF NEW YORK 4D DENTAL (National Association of Insurance Commissioners NAIC id number: 81477 ) |
Policy contract number | G# 84804 |
Policy instance | 1 |
Insurance contract or identification number | G# 84804 | Number of Individuals Covered | 67 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $4,429 | Total amount of fees paid to insurance company | USD $0 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $61,505 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,429 | Insurance broker organization code? | 3 | Insurance broker name | WINSTON FINANCIAL SERVICES |
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STANDARD SECURITY LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 55247 ) |
Policy contract number | R04160-002 |
Policy instance | 7 |
Insurance contract or identification number | R04160-002 | Number of Individuals Covered | 193 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-09-30 | Total amount of commissions paid to insurance broker | USD $915 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | NY DBL | Welfare Benefit Premiums Paid to Carrier | USD $30,510 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $915 | Insurance broker organization code? | 3 | Insurance broker name | EG BOWMAN |
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EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 ) |
Policy contract number | 174667-000 |
Policy instance | 8 |
Insurance contract or identification number | 174667-000 | Number of Individuals Covered | 530 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Were dividends or retroactive rate refunds paid in cash? | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 ) |
Policy contract number | X00001948 |
Policy instance | 9 |
Insurance contract or identification number | X00001948 | Number of Individuals Covered | 180 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00931955 |
Policy instance | 10 |
Insurance contract or identification number | 00931955 | Number of Individuals Covered | 685 | Insurance policy start date | 2014-10-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $0 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 ) |
Policy contract number | N00003907 |
Policy instance | 6 |
Insurance contract or identification number | N00003907 | Number of Individuals Covered | 100 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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STANDARD SECURITY LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 55247 ) |
Policy contract number | R04160-003 |
Policy instance | 11 |
Insurance contract or identification number | R04160-003 | Number of Individuals Covered | 88 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-09-30 | Total amount of commissions paid to insurance broker | USD $624 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | NYS DISABILITY | Welfare Benefit Premiums Paid to Carrier | USD $20,976 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $624 | Insurance broker organization code? | 3 | Insurance broker name | EG BOWMAN |
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STANDARD SECURITY LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 55247 ) |
Policy contract number | R04160-003 |
Policy instance | 10 |
Insurance contract or identification number | R04160-003 | Number of Individuals Covered | 88 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $843 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | NYS DISABILITY | Welfare Benefit Premiums Paid to Carrier | USD $28,091 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $843 | Insurance broker organization code? | 3 | Insurance broker name | EG BOWMAN |
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EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 ) |
Policy contract number | X00001948 |
Policy instance | 9 |
Insurance contract or identification number | X00001948 | Number of Individuals Covered | 189 | 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 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 ) |
Policy contract number | 174667-000 |
Policy instance | 8 |
Insurance contract or identification number | 174667-000 | Number of Individuals Covered | 535 | 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 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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STANDARD SECURITY LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 55247 ) |
Policy contract number | R04160-002 |
Policy instance | 7 |
Insurance contract or identification number | R04160-002 | Number of Individuals Covered | 193 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $1,241 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | NY DBL | Welfare Benefit Premiums Paid to Carrier | USD $41,367 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,241 | Insurance broker organization code? | 3 | Insurance broker name | EG BOWMAN |
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EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 ) |
Policy contract number | N00003907 |
Policy instance | 6 |
Insurance contract or identification number | N00003907 | Number of Individuals Covered | 89 | 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 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 ) |
Policy contract number | N00002591 |
Policy instance | 2 |
Insurance contract or identification number | N00002591 | Number of Individuals Covered | 74 | 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 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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HIP HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 1004018-004 |
Policy instance | 5 |
Insurance contract or identification number | 1004018-004 | Number of Individuals Covered | 71 | 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 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $881,382 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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AMALGAMATED LIFE INSURANCE (National Association of Insurance Commissioners NAIC id number: 60216 ) |
Policy contract number | 260B68 |
Policy instance | 4 |
Insurance contract or identification number | 260B68 | Number of Individuals Covered | 96 | 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 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $27,325 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 ) |
Policy contract number | 174667-696 |
Policy instance | 3 |
Insurance contract or identification number | 174667-696 | Number of Individuals Covered | 168 | 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 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNION SECURITY LIFE INSURANCE COMPANY OF NEW YORK 4D DENTAL (National Association of Insurance Commissioners NAIC id number: 81477 ) |
Policy contract number | G# 84804 |
Policy instance | 1 |
Insurance contract or identification number | G# 84804 | Number of Individuals Covered | 73 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $4,679 | Total amount of fees paid to insurance company | USD $0 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $67,882 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,679 | Insurance broker organization code? | 3 | Insurance broker name | WINSTON FINANCIAL SERVICES |
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EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 ) |
Policy contract number | X00001948 |
Policy instance | 9 |
Insurance contract or identification number | X00001948 | Number of Individuals Covered | 192 | 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 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 ) |
Policy contract number | 174667-000 |
Policy instance | 8 |
Insurance contract or identification number | 174667-000 | Number of Individuals Covered | 541 | 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 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 ) |
Policy contract number | N00003907 |
Policy instance | 6 |
Insurance contract or identification number | N00003907 | Number of Individuals Covered | 85 | 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 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 ) |
Policy contract number | 53-57-661 |
Policy instance | 7 |
Insurance contract or identification number | 53-57-661 | Number of Individuals Covered | 792 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $5,022 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | NY DBL | Welfare Benefit Premiums Paid to Carrier | USD $167,409 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,022 | Insurance broker organization code? | 3 | Insurance broker name | EG BOWMAN AND CO |
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HIP HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 1004018-004 |
Policy instance | 5 |
Insurance contract or identification number | 1004018-004 | Number of Individuals Covered | 73 | 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 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $844,848 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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AMALGAMATED LIFE INSURANCE (National Association of Insurance Commissioners NAIC id number: 60216 ) |
Policy contract number | 260B68 |
Policy instance | 4 |
Insurance contract or identification number | 260B68 | Number of Individuals Covered | 142 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $17,095 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 ) |
Policy contract number | 174667-696 |
Policy instance | 3 |
Insurance contract or identification number | 174667-696 | Number of Individuals Covered | 174 | 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 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 ) |
Policy contract number | N00002591 |
Policy instance | 2 |
Insurance contract or identification number | N00002591 | Number of Individuals Covered | 78 | 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 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNION SECURITY LIFE INSURANCE COMPANY OF NEW YORK 4D DENTAL (National Association of Insurance Commissioners NAIC id number: 81477 ) |
Policy contract number | G# 84804 |
Policy instance | 1 |
Insurance contract or identification number | G# 84804 | Number of Individuals Covered | 76 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $4,697 | Total amount of fees paid to insurance company | USD $0 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $69,692 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,697 | Insurance broker organization code? | 3 | Insurance broker name | WINSTON FINANCIAL SERVICES |
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EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 ) |
Policy contract number | 174667-696 |
Policy instance | 3 |
Insurance contract or identification number | 174667-696 | Number of Individuals Covered | 179 | 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 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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AMALGAMATED LIFE INSURANCE (National Association of Insurance Commissioners NAIC id number: 60216 ) |
Policy contract number | 260B68 |
Policy instance | 4 |
Insurance contract or identification number | 260B68 | Number of Individuals Covered | 94 | 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 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $11,316 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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HIP HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 1004018-004 |
Policy instance | 5 |
Insurance contract or identification number | 1004018-004 | Number of Individuals Covered | 77 | 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 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $901,074 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 ) |
Policy contract number | N00003907 |
Policy instance | 6 |
Insurance contract or identification number | N00003907 | Number of Individuals Covered | 82 | 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 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 ) |
Policy contract number | 174667-000 |
Policy instance | 8 |
Insurance contract or identification number | 174667-000 | Number of Individuals Covered | 551 | 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 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 ) |
Policy contract number | X00001948 |
Policy instance | 9 |
Insurance contract or identification number | X00001948 | Number of Individuals Covered | 193 | 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 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 ) |
Policy contract number | N00002591 |
Policy instance | 2 |
Insurance contract or identification number | N00002591 | Number of Individuals Covered | 77 | 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 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $0 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNION SECURITY LIFE INSURANCE COMPANY OF NEW YORK 4D DENTAL (National Association of Insurance Commissioners NAIC id number: 81477 ) |
Policy contract number | G# 84804 |
Policy instance | 1 |
Insurance contract or identification number | G# 84804 | Number of Individuals Covered | 74 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $4,685 | Total amount of fees paid to insurance company | USD $0 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $68,520 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 ) |
Policy contract number | 53-57-661 |
Policy instance | 7 |
Insurance contract or identification number | 53-57-661 | Number of Individuals Covered | 531 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $5,669 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | NY DBL | Welfare Benefit Premiums Paid to Carrier | USD $188,952 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 ) |
Policy contract number | X00001948 |
Policy instance | 9 |
Insurance contract or identification number | X00001948 | Number of Individuals Covered | 190 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 ) |
Policy contract number | N00002591 |
Policy instance | 2 |
Insurance contract or identification number | N00002591 | Number of Individuals Covered | 76 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 ) |
Policy contract number | 174667-696 |
Policy instance | 3 |
Insurance contract or identification number | 174667-696 | Number of Individuals Covered | 174 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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AMALGAMATED LIFE INSURANCE (National Association of Insurance Commissioners NAIC id number: 60216 ) |
Policy contract number | 260B68 |
Policy instance | 4 |
Insurance contract or identification number | 260B68 | Number of Individuals Covered | 145 | 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 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $17,577 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 ) |
Policy contract number | N00003907 |
Policy instance | 6 |
Insurance contract or identification number | N00003907 | Number of Individuals Covered | 86 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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HIP HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 1004018-004 |
Policy instance | 5 |
Insurance contract or identification number | 1004018-004 | Number of Individuals Covered | 81 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $714,556 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 ) |
Policy contract number | 53-57-661 |
Policy instance | 7 |
Insurance contract or identification number | 53-57-661 | Number of Individuals Covered | 531 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $6,188 | Other welfare benefits provided | NY DBL | Welfare Benefit Premiums Paid to Carrier | USD $206,267 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,188 | Insurance broker organization code? | 3 | Insurance broker name | EG BOWMAN AND CO |
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EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 ) |
Policy contract number | 174667-000 |
Policy instance | 8 |
Insurance contract or identification number | 174667-000 | Number of Individuals Covered | 532 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNION SECURITY LIFE INSURANCE COMPANY OF NEW YORK 4D DENTAL (National Association of Insurance Commissioners NAIC id number: 81477 ) |
Policy contract number | G# 84804 |
Policy instance | 1 |
Insurance contract or identification number | G# 84804 | Number of Individuals Covered | 74 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $4,687 | Total amount of fees paid to insurance company | USD $0 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $67,281 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,687 | Insurance broker organization code? | 3 | Insurance broker name | WINSTON FINANCIAL SERVICES |
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