SECURITY LOCK DISTRIBUTORS INC. has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan SECURITY LOCK DISTRIBUTORS INC. HEALTH & WELFARE BENEFITS PLAN
401k plan membership statisitcs for SECURITY LOCK DISTRIBUTORS INC. HEALTH & WELFARE BENEFITS PLAN
| Measure | Date | Value |
|---|
| 2022: SECURITY LOCK DISTRIBUTORS INC. HEALTH & WELFARE BENEFITS PLAN 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-09-15 | 217 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-09-15 | 218 |
| Number of retired or separated participants receiving benefits | 2022-09-15 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2022-09-15 | 0 |
| Total of all active and inactive participants | 2022-09-15 | 218 |
| Number of employers contributing to the scheme | 2022-09-15 | 0 |
| 2021: SECURITY LOCK DISTRIBUTORS INC. HEALTH & WELFARE BENEFITS PLAN 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-09-15 | 186 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-09-15 | 217 |
| Number of retired or separated participants receiving benefits | 2021-09-15 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2021-09-15 | 0 |
| Total of all active and inactive participants | 2021-09-15 | 217 |
| Number of employers contributing to the scheme | 2021-09-15 | 0 |
| 2020: SECURITY LOCK DISTRIBUTORS INC. HEALTH & WELFARE BENEFITS PLAN 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-09-15 | 168 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-09-15 | 186 |
| Number of retired or separated participants receiving benefits | 2020-09-15 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2020-09-15 | 0 |
| Total of all active and inactive participants | 2020-09-15 | 186 |
| Number of employers contributing to the scheme | 2020-09-15 | 0 |
| 2019: SECURITY LOCK DISTRIBUTORS INC. HEALTH & WELFARE BENEFITS PLAN 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-09-15 | 169 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-09-15 | 168 |
| Number of retired or separated participants receiving benefits | 2019-09-15 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2019-09-15 | 0 |
| Total of all active and inactive participants | 2019-09-15 | 168 |
| Number of employers contributing to the scheme | 2019-09-15 | 0 |
| 2018: SECURITY LOCK DISTRIBUTORS INC. HEALTH & WELFARE BENEFITS PLAN 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-09-15 | 151 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-09-15 | 169 |
| Number of retired or separated participants receiving benefits | 2018-09-15 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2018-09-15 | 0 |
| Total of all active and inactive participants | 2018-09-15 | 169 |
| Number of employers contributing to the scheme | 2018-09-15 | 0 |
| 2017: SECURITY LOCK DISTRIBUTORS INC. HEALTH & WELFARE BENEFITS PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-09-15 | 153 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-09-15 | 151 |
| Number of retired or separated participants receiving benefits | 2017-09-15 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2017-09-15 | 0 |
| Total of all active and inactive participants | 2017-09-15 | 151 |
| Number of employers contributing to the scheme | 2017-09-15 | 0 |
| 2016: SECURITY LOCK DISTRIBUTORS INC. HEALTH & WELFARE BENEFITS PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-09-15 | 131 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-09-15 | 153 |
| Number of retired or separated participants receiving benefits | 2016-09-15 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2016-09-15 | 0 |
| Total of all active and inactive participants | 2016-09-15 | 153 |
| Number of employers contributing to the scheme | 2016-09-15 | 0 |
| 2015: SECURITY LOCK DISTRIBUTORS INC. HEALTH & WELFARE BENEFITS PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-09-15 | 119 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-09-15 | 131 |
| Number of retired or separated participants receiving benefits | 2015-09-15 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2015-09-15 | 0 |
| Total of all active and inactive participants | 2015-09-15 | 131 |
| 2022: SECURITY LOCK DISTRIBUTORS INC. HEALTH & WELFARE BENEFITS PLAN 2022 form 5500 responses |
|---|
| 2022-09-15 | Type of plan entity | Single employer plan |
| 2022-09-15 | Plan funding arrangement – Insurance | Yes |
| 2022-09-15 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2022-09-15 | Plan benefit arrangement – Insurance | Yes |
| 2022-09-15 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2021: SECURITY LOCK DISTRIBUTORS INC. HEALTH & WELFARE BENEFITS PLAN 2021 form 5500 responses |
|---|
| 2021-09-15 | Type of plan entity | Single employer plan |
| 2021-09-15 | Plan funding arrangement – Insurance | Yes |
| 2021-09-15 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2021-09-15 | Plan benefit arrangement – Insurance | Yes |
| 2021-09-15 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2020: SECURITY LOCK DISTRIBUTORS INC. HEALTH & WELFARE BENEFITS PLAN 2020 form 5500 responses |
|---|
| 2020-09-15 | Type of plan entity | Single employer plan |
| 2020-09-15 | Plan funding arrangement – Insurance | Yes |
| 2020-09-15 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2020-09-15 | Plan benefit arrangement – Insurance | Yes |
| 2020-09-15 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2019: SECURITY LOCK DISTRIBUTORS INC. HEALTH & WELFARE BENEFITS PLAN 2019 form 5500 responses |
|---|
| 2019-09-15 | Type of plan entity | Single employer plan |
| 2019-09-15 | Plan funding arrangement – Insurance | Yes |
| 2019-09-15 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2019-09-15 | Plan benefit arrangement – Insurance | Yes |
| 2019-09-15 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2018: SECURITY LOCK DISTRIBUTORS INC. HEALTH & WELFARE BENEFITS PLAN 2018 form 5500 responses |
|---|
| 2018-09-15 | Type of plan entity | Single employer plan |
| 2018-09-15 | Submission has been amended | Yes |
| 2018-09-15 | Plan funding arrangement – Insurance | Yes |
| 2018-09-15 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2018-09-15 | Plan benefit arrangement – Insurance | Yes |
| 2018-09-15 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2017: SECURITY LOCK DISTRIBUTORS INC. HEALTH & WELFARE BENEFITS PLAN 2017 form 5500 responses |
|---|
| 2017-09-15 | Type of plan entity | Single employer plan |
| 2017-09-15 | Submission has been amended | Yes |
| 2017-09-15 | Plan funding arrangement – Insurance | Yes |
| 2017-09-15 | Plan benefit arrangement – Insurance | Yes |
| 2016: SECURITY LOCK DISTRIBUTORS INC. HEALTH & WELFARE BENEFITS PLAN 2016 form 5500 responses |
|---|
| 2016-09-15 | Type of plan entity | Single employer plan |
| 2016-09-15 | Submission has been amended | Yes |
| 2016-09-15 | Plan funding arrangement – Insurance | Yes |
| 2016-09-15 | Plan benefit arrangement – Insurance | Yes |
| 2015: SECURITY LOCK DISTRIBUTORS INC. HEALTH & WELFARE BENEFITS PLAN 2015 form 5500 responses |
|---|
| 2015-09-15 | Type of plan entity | Single employer plan |
| 2015-09-15 | First time form 5500 has been submitted | Yes |
| 2015-09-15 | Submission has been amended | No |
| 2015-09-15 | This submission is the final filing | No |
| 2015-09-15 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-09-15 | Plan is a collectively bargained plan | No |
| 2015-09-15 | Plan funding arrangement – Insurance | Yes |
| 2015-09-15 | Plan benefit arrangement – Insurance | Yes |
| ALLONE HEALTH (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | EAP |
| Policy instance | 5 |
| Insurance contract or identification number | EAP | | Number of Individuals Covered | 182 | | Insurance policy start date | 2022-09-01 | | Insurance policy end date | 2023-08-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | EMPLOYEE ASSISTANCE PROGRAM | | Welfare Benefit Premiums Paid to Carrier | USD $5,321 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
| Policy contract number | E7595192 |
| Policy instance | 4 |
| Insurance contract or identification number | E7595192 | | Number of Individuals Covered | 46 | | Insurance policy start date | 2022-09-01 | | Insurance policy end date | 2023-08-31 | | Total amount of commissions paid to insurance broker | USD $5,927 | | Total amount of fees paid to insurance company | USD $255 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT, ACCIDENT, CRITICAL ILLNESS, CANCER | | Welfare Benefit Premiums Paid to Carrier | USD $44,425 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,379 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 | | Additional information about fees paid to insurance broker | FEES |
|
| BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 ) |
| Policy contract number | 4004030 |
| Policy instance | 3 |
| Insurance contract or identification number | 4004030 | | Number of Individuals Covered | 482 | | Insurance policy start date | 2022-09-01 | | Insurance policy end date | 2023-08-31 | | Total amount of commissions paid to insurance broker | USD $63,745 | | Total amount of fees paid to insurance company | USD $14,490 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | | Commission paid to Insurance Broker | USD $63,745 | | Amount paid for insurance broker fees | 14490 | | Additional information about fees paid to insurance broker | OTHER COMMISSION | | Insurance broker organization code? | 3 |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 241612 |
| Policy instance | 2 |
| Insurance contract or identification number | 241612 | | Number of Individuals Covered | 244 | | Insurance policy start date | 2022-09-15 | | Insurance policy end date | 2023-09-14 | | Total amount of commissions paid to insurance broker | USD $10,689 | | Total amount of fees paid to insurance company | USD $3,703 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $181,440 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $10,689 | | Amount paid for insurance broker fees | 3703 | | Insurance broker organization code? | 3 |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 10016751001 |
| Policy instance | 1 |
| Insurance contract or identification number | 10016751001 | | Number of Individuals Covered | 346 | | Insurance policy start date | 2021-10-01 | | Insurance policy end date | 2022-09-30 | | Total amount of commissions paid to insurance broker | USD $3,034 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $24,071 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,034 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 10016751001 |
| Policy instance | 1 |
| Insurance contract or identification number | 10016751001 | | Number of Individuals Covered | 287 | | Insurance policy start date | 2020-10-01 | | Insurance policy end date | 2021-09-30 | | Total amount of commissions paid to insurance broker | USD $3,590 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $36,034 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,590 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 241612 |
| Policy instance | 2 |
| Insurance contract or identification number | 241612 | | Number of Individuals Covered | 235 | | Insurance policy start date | 2021-09-15 | | Insurance policy end date | 2022-09-14 | | Total amount of commissions paid to insurance broker | USD $9,170 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $145,391 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $9,170 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 ) |
| Policy contract number | 4004030 |
| Policy instance | 3 |
| Insurance contract or identification number | 4004030 | | Number of Individuals Covered | 487 | | Insurance policy start date | 2021-09-01 | | Insurance policy end date | 2022-08-31 | | Total amount of commissions paid to insurance broker | USD $61,935 | | Total amount of fees paid to insurance company | USD $10,464 | | Health Insurance Welfare Benefit | Yes | | Dental 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? | Yes | | Commission paid to Insurance Broker | USD $61,935 | | Amount paid for insurance broker fees | 10464 | | Additional information about fees paid to insurance broker | BONUS AND PERSISTENCY COMMISSIONS | | Insurance broker organization code? | 3 |
|
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
| Policy contract number | E7595192 |
| Policy instance | 4 |
| Insurance contract or identification number | E7595192 | | Number of Individuals Covered | 44 | | Insurance policy start date | 2021-09-01 | | Insurance policy end date | 2022-08-31 | | Total amount of commissions paid to insurance broker | USD $5,025 | | Total amount of fees paid to insurance company | USD $82 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT, ACCIDENT, CRITICAL ILLNESS, CANCER | | Welfare Benefit Premiums Paid to Carrier | USD $43,801 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,186 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 | | Additional information about fees paid to insurance broker | FEES |
|
| ALLONE HEALTH (National Association of Insurance Commissioners NAIC id number: 8741 ) |
| Policy contract number | EAP |
| Policy instance | 5 |
| Insurance contract or identification number | EAP | | Number of Individuals Covered | 160 | | Insurance policy start date | 2021-09-01 | | Insurance policy end date | 2022-08-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | EMPLOYEE ASSISTANCE PROGRAM | | Welfare Benefit Premiums Paid to Carrier | USD $4,382 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| ALLONE HEALTH (National Association of Insurance Commissioners NAIC id number: 8741 ) |
| Policy contract number | EAP |
| Policy instance | 5 |
| Insurance contract or identification number | EAP | | Number of Individuals Covered | 160 | | Insurance policy start date | 2020-09-01 | | Insurance policy end date | 2021-08-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | EMPLOYEE ASSISTANCE PROGRAM | | Welfare Benefit Premiums Paid to Carrier | USD $5,976 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
|
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
| Policy contract number | E7595192 |
| Policy instance | 4 |
| Insurance contract or identification number | E7595192 | | Number of Individuals Covered | 42 | | Insurance policy start date | 2020-09-01 | | Insurance policy end date | 2021-08-31 | | Total amount of commissions paid to insurance broker | USD $6,646 | | Total amount of fees paid to insurance company | USD $173 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT, ACCIDENT, CRITICAL ILLNESS, CANCER | | Welfare Benefit Premiums Paid to Carrier | USD $42,168 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,969 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 | | Additional information about fees paid to insurance broker | FEES |
|
| BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 ) |
| Policy contract number | 4004030 |
| Policy instance | 3 |
| Insurance contract or identification number | 4004030 | | Number of Individuals Covered | 438 | | Insurance policy start date | 2020-09-01 | | Insurance policy end date | 2021-08-31 | | Total amount of commissions paid to insurance broker | USD $54,552 | | Total amount of fees paid to insurance company | USD $12,871 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Were dividends or retroactive rate refunds paid as a credit? | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | | Commission paid to Insurance Broker | USD $54,552 | | Amount paid for insurance broker fees | 12871 | | Additional information about fees paid to insurance broker | OTHER COMMISSION | | Insurance broker organization code? | 3 |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 241612 |
| Policy instance | 2 |
| Insurance contract or identification number | 241612 | | Number of Individuals Covered | 191 | | Insurance policy start date | 2020-09-15 | | Insurance policy end date | 2021-09-14 | | Total amount of commissions paid to insurance broker | USD $11,200 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $157,807 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | | Commission paid to Insurance Broker | USD $11,200 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 10016751001 |
| Policy instance | 1 |
| Insurance contract or identification number | 10016751001 | | Number of Individuals Covered | 250 | | Insurance policy start date | 2019-10-01 | | Insurance policy end date | 2020-09-30 | | Total amount of commissions paid to insurance broker | USD $972 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $6,642 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $972 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| ALLONE HEALTH (National Association of Insurance Commissioners NAIC id number: 8741 ) |
| Policy contract number | EAP |
| Policy instance | 5 |
| Insurance contract or identification number | EAP | | Number of Individuals Covered | 160 | | Insurance policy start date | 2019-09-01 | | Insurance policy end date | 2020-08-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | EMPLOYEE ASSISTANCE PROGRAM | | Welfare Benefit Premiums Paid to Carrier | USD $4,781 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
| Policy contract number | E7595192 |
| Policy instance | 4 |
| Insurance contract or identification number | E7595192 | | Number of Individuals Covered | 41 | | Insurance policy start date | 2019-09-01 | | Insurance policy end date | 2020-08-31 | | Total amount of commissions paid to insurance broker | USD $4,948 | | Total amount of fees paid to insurance company | USD $127 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT, ACCIDENT, CRITICAL ILLNESS, CANCER | | Welfare Benefit Premiums Paid to Carrier | USD $40,789 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,873 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 | | Additional information about fees paid to insurance broker | FEES |
|
| BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 ) |
| Policy contract number | 4004030 |
| Policy instance | 3 |
| Insurance contract or identification number | 4004030 | | Number of Individuals Covered | 394 | | Insurance policy start date | 2019-09-01 | | Insurance policy end date | 2020-08-31 | | Total amount of commissions paid to insurance broker | USD $54,947 | | Total amount of fees paid to insurance company | USD $11,220 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | | Commission paid to Insurance Broker | USD $54,947 | | Amount paid for insurance broker fees | 11220 | | Additional information about fees paid to insurance broker | OTHER COMMISSION | | Insurance broker organization code? | 3 |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 241612 |
| Policy instance | 2 |
| Insurance contract or identification number | 241612 | | Number of Individuals Covered | 176 | | Insurance policy start date | 2019-09-15 | | Insurance policy end date | 2020-09-14 | | Total amount of commissions paid to insurance broker | USD $8,682 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $127,889 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,682 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 10016751001 |
| Policy instance | 1 |
| Insurance contract or identification number | 10016751001 | | Number of Individuals Covered | 242 | | Insurance policy start date | 2018-10-01 | | Insurance policy end date | 2019-09-30 | | Total amount of commissions paid to insurance broker | USD $1,785 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $17,852 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,785 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 10016751001 |
| Policy instance | 1 |
| Insurance contract or identification number | 10016751001 | | Number of Individuals Covered | 221 | | Insurance policy start date | 2018-09-15 | | Insurance policy end date | 2019-09-14 | | Total amount of commissions paid to insurance broker | USD $1,785 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $17,852 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,478 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 241612 |
| Policy instance | 2 |
| Insurance contract or identification number | 241612 | | Number of Individuals Covered | 184 | | Insurance policy start date | 2018-09-15 | | Insurance policy end date | 2019-09-14 | | Total amount of commissions paid to insurance broker | USD $9,004 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $109,459 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $9,004 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 ) |
| Policy contract number | 4004030 |
| Policy instance | 3 |
| Insurance contract or identification number | 4004030 | | Number of Individuals Covered | 400 | | Insurance policy start date | 2018-09-01 | | Insurance policy end date | 2019-08-31 | | Total amount of commissions paid to insurance broker | USD $53,822 | | Total amount of fees paid to insurance company | USD $12,480 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $53,822 | | Amount paid for insurance broker fees | 12480 | | Additional information about fees paid to insurance broker | OTHER COMMISSION | | Insurance broker organization code? | 3 |
|
| ALLONE HEALTH (National Association of Insurance Commissioners NAIC id number: 8741 ) |
| Policy contract number | EAP |
| Policy instance | 5 |
| Insurance contract or identification number | EAP | | Number of Individuals Covered | 160 | | Insurance policy start date | 2018-09-01 | | Insurance policy end date | 2019-08-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | EMPLOYEE ASSISTANCE PROGRAM | | Welfare Benefit Premiums Paid to Carrier | USD $4,781 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
| Policy contract number | E7595192 |
| Policy instance | 4 |
| Insurance contract or identification number | E7595192 | | Number of Individuals Covered | 42 | | Insurance policy start date | 2018-09-01 | | Insurance policy end date | 2019-08-31 | | Total amount of commissions paid to insurance broker | USD $7,189 | | Total amount of fees paid to insurance company | USD $140 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT, ACCIDENT, CRITICAL ILLNESS, CANCER | | Welfare Benefit Premiums Paid to Carrier | USD $42,323 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,677 | | Amount paid for insurance broker fees | 100 | | Additional information about fees paid to insurance broker | FEES | | Insurance broker organization code? | 3 |
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| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
| Policy contract number | E7595192 |
| Policy instance | 4 |
| Insurance contract or identification number | E7595192 | | Number of Individuals Covered | 38 | | Insurance policy start date | 2017-09-01 | | Insurance policy end date | 2018-08-31 | | Total amount of commissions paid to insurance broker | USD $9,687 | | Total amount of fees paid to insurance company | USD $648 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT, ACCIDENT, CRITICAL ILLNESS, CANCER | | Welfare Benefit Premiums Paid to Carrier | USD $41,590 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,606 | | Amount paid for insurance broker fees | 78 | | Additional information about fees paid to insurance broker | FEES | | Insurance broker organization code? | 3 |
|
| BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 ) |
| Policy contract number | 4004030 |
| Policy instance | 3 |
| Insurance contract or identification number | 4004030 | | Number of Individuals Covered | 356 | | Insurance policy start date | 2017-09-01 | | Insurance policy end date | 2018-08-31 | | Total amount of commissions paid to insurance broker | USD $52,610 | | Total amount of fees paid to insurance company | USD $10,295 | | Health Insurance Welfare Benefit | Yes | | Dental 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? | Yes | | Commission paid to Insurance Broker | USD $52,610 | | Amount paid for insurance broker fees | 10295 | | Additional information about fees paid to insurance broker | BONUS AND PERSISTENCY COMMISSIONS | | Insurance broker organization code? | 3 |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 241612 |
| Policy instance | 2 |
| Insurance contract or identification number | 241612 | | Number of Individuals Covered | 171 | | Insurance policy start date | 2017-09-15 | | Insurance policy end date | 2018-09-14 | | Total amount of commissions paid to insurance broker | USD $7,080 | | Total amount of fees paid to insurance company | USD $0 | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $78,218 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $7,080 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 10016751001 |
| Policy instance | 1 |
| Insurance contract or identification number | 10016751001 | | Number of Individuals Covered | 189 | | Insurance policy start date | 2017-09-15 | | Insurance policy end date | 2018-09-14 | | Total amount of commissions paid to insurance broker | USD $2,478 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $32,129 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
| Policy contract number | 1001675 |
| Policy instance | 1 |
| Insurance contract or identification number | 1001675 | | Number of Individuals Covered | 183 | | Insurance policy start date | 2016-09-15 | | Insurance policy end date | 2017-09-14 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,224 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 241612 |
| Policy instance | 2 |
| Insurance contract or identification number | 241612 | | Number of Individuals Covered | 153 | | Insurance policy start date | 2016-09-15 | | Insurance policy end date | 2017-09-14 | | Total amount of commissions paid to insurance broker | USD $5,230 | | Total amount of fees paid to insurance company | USD $0 | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $68,463 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,230 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 ) |
| Policy contract number | 4004030 |
| Policy instance | 3 |
| Insurance contract or identification number | 4004030 | | Number of Individuals Covered | 334 | | Insurance policy start date | 2016-09-01 | | Insurance policy end date | 2017-08-31 | | Total amount of commissions paid to insurance broker | USD $50,513 | | Total amount of fees paid to insurance company | USD $12,635 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | | Commission paid to Insurance Broker | USD $50,513 | | Amount paid for insurance broker fees | 12635 | | Additional information about fees paid to insurance broker | FEES | | Insurance broker organization code? | 3 |
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| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
| Policy contract number | E7595192 |
| Policy instance | 4 |
| Insurance contract or identification number | E7595192 | | Number of Individuals Covered | 36 | | Insurance policy start date | 2016-09-01 | | Insurance policy end date | 2017-08-31 | | Total amount of commissions paid to insurance broker | USD $9,981 | | Total amount of fees paid to insurance company | USD $1,117 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT, ACCIDENT, CRITICAL ILLNESS, CANCER | | Welfare Benefit Premiums Paid to Carrier | USD $30,113 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,741 | | Amount paid for insurance broker fees | 62 | | Additional information about fees paid to insurance broker | FEES | | Insurance broker organization code? | 3 |
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