PORT-A-COOL, LLC has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan PORT-A-COOL, LLC INSURANCE PLAN
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | 10940 |
Policy instance | 1 |
Insurance contract or identification number | 10940 | Number of Individuals Covered | 472 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $49,367 | Total amount of fees paid to insurance company | USD $4,305 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $481,731 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $42,905 | Amount paid for insurance broker fees | 4305 | Additional information about fees paid to insurance broker | SPECIAL PROGRAMS | Insurance broker organization code? | 3 |
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BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | 010940 |
Policy instance | 6 |
Insurance contract or identification number | 010940 | Number of Individuals Covered | 461 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $15,223 | Total amount of fees paid to insurance company | USD $4,305 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $148,122 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $15,223 | Amount paid for insurance broker fees | 4305 | Additional information about fees paid to insurance broker | SPECIAL PROGRAMS |
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HEALTH SMART (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | POR |
Policy instance | 2 |
Insurance contract or identification number | POR | Number of Individuals Covered | 100 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Other welfare benefits provided | FSA/DCA | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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TELADOC, INC. (National Association of Insurance Commissioners NAIC id number: 62199 ) |
Policy contract number | 36668 |
Policy instance | 3 |
Insurance contract or identification number | 36668 | Number of Individuals Covered | 386 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $2,343 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $15,622 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,343 | Insurance broker organization code? | 3 |
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NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 ) |
Policy contract number | 29513 |
Policy instance | 4 |
Insurance contract or identification number | 29513 | Number of Individuals Covered | 258 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $5,709 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $52,250 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,011 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000B94X |
Policy instance | 5 |
Insurance contract or identification number | G000B94X | Number of Individuals Covered | 410 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $24,267 | Total amount of fees paid to insurance company | USD $8,109 | 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 $161,778 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $24,267 | Amount paid for insurance broker fees | 8109 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 |
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HEALTH SMART (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | POR |
Policy instance | 2 |
Insurance contract or identification number | POR | Number of Individuals Covered | 81 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Other welfare benefits provided | FSA/DCA | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 ) |
Policy contract number | 29513 |
Policy instance | 4 |
Insurance contract or identification number | 29513 | Number of Individuals Covered | 241 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $4,553 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $45,533 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,553 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000B94X |
Policy instance | 5 |
Insurance contract or identification number | G000B94X | Number of Individuals Covered | 274 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $26,531 | Total amount of fees paid to insurance company | USD $8,001 | 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 $176,877 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $26,531 | Amount paid for insurance broker fees | 8001 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 |
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BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | 010940 |
Policy instance | 6 |
Insurance contract or identification number | 010940 | Number of Individuals Covered | 472 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $16,293 | Total amount of fees paid to insurance company | USD $6,715 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $167,305 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $16,293 | Amount paid for insurance broker fees | 6715 | Additional information about fees paid to insurance broker | SPECIAL PROGRAMS |
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BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | 10940 |
Policy instance | 1 |
Insurance contract or identification number | 10940 | Number of Individuals Covered | 468 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $50,090 | Total amount of fees paid to insurance company | USD $6,715 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $462,175 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $43,533 | Amount paid for insurance broker fees | 6715 | Additional information about fees paid to insurance broker | SPECIAL PROGRAMS | Insurance broker organization code? | 3 |
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TELADOC, INC. (National Association of Insurance Commissioners NAIC id number: 62199 ) |
Policy contract number | 136298 |
Policy instance | 3 |
Insurance contract or identification number | 136298 | Number of Individuals Covered | 513 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $2,517 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $16,783 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,517 | Insurance broker organization code? | 3 |
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NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 ) |
Policy contract number | 29513 |
Policy instance | 4 |
Insurance contract or identification number | 29513 | Number of Individuals Covered | 253 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $4,828 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $48,279 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,828 |
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TELADOC, INC. (National Association of Insurance Commissioners NAIC id number: 62199 ) |
Policy contract number | 136298 |
Policy instance | 3 |
Insurance contract or identification number | 136298 | Number of Individuals Covered | 384 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Welfare Benefit Premiums Paid to Carrier | USD $17,184 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | 010940 |
Policy instance | 6 |
Insurance contract or identification number | 010940 | Number of Individuals Covered | 498 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $16,989 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $188,024 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $16,989 |
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HEALTH SMART (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | POR |
Policy instance | 2 |
Insurance contract or identification number | POR | Number of Individuals Covered | 97 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Other welfare benefits provided | FSA/DCA | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | 10940 |
Policy instance | 1 |
Insurance contract or identification number | 10940 | Number of Individuals Covered | 477 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $51,049 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $439,876 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $44,367 | Insurance broker organization code? | 3 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000B94X |
Policy instance | 5 |
Insurance contract or identification number | G000B94X | Number of Individuals Covered | 360 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $24,004 | Total amount of fees paid to insurance company | USD $5,340 | 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 $160,025 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $24,004 | Amount paid for insurance broker fees | 5340 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 |
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BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | 10940 |
Policy instance | 1 |
Insurance contract or identification number | 10940 | Number of Individuals Covered | 458 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $45,093 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $426,575 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $45,093 | Insurance broker organization code? | 3 |
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BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | 010940 |
Policy instance | 6 |
Insurance contract or identification number | 010940 | Number of Individuals Covered | 480 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $16,683 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $168,159 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $16,683 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000B94X |
Policy instance | 5 |
Insurance contract or identification number | G000B94X | Number of Individuals Covered | 341 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $22,886 | Total amount of fees paid to insurance company | USD $6,245 | 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 $152,575 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $22,886 | Amount paid for insurance broker fees | 6245 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 |
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NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 ) |
Policy contract number | 29513 |
Policy instance | 4 |
Insurance contract or identification number | 29513 | Number of Individuals Covered | 89 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $1,517 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $15,165 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,517 |
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HEALTH SMART (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | POR |
Policy instance | 2 |
Insurance contract or identification number | POR | Number of Individuals Covered | 74 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Other welfare benefits provided | FSA/DCA | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 30011696 |
Policy instance | 3 |
Insurance contract or identification number | 30011696 | Number of Individuals Covered | 162 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $1,469 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $32,528 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,469 | Insurance broker organization code? | 3 |
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VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 30011696 |
Policy instance | 3 |
Insurance contract or identification number | 30011696 | Number of Individuals Covered | 139 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $1,471 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $32,796 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,471 | Insurance broker organization code? | 3 |
|
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000B94X |
Policy instance | 5 |
Insurance contract or identification number | G000B94X | Number of Individuals Covered | 330 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $21,972 | 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 $146,476 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $21,972 | Insurance broker organization code? | 3 |
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HEALTH SMART (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | POR |
Policy instance | 2 |
Insurance contract or identification number | POR | Number of Individuals Covered | 93 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Other welfare benefits provided | FSA/DCA | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | 10940 |
Policy instance | 1 |
Insurance contract or identification number | 10940 | Number of Individuals Covered | 463 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $40,123 | Total amount of fees paid to insurance company | USD $2,875 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $369,811 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $26,443 | Amount paid for insurance broker fees | 2871 | Additional information about fees paid to insurance broker | MISC | Insurance broker organization code? | 3 |
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NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 ) |
Policy contract number | 29513 |
Policy instance | 4 |
Insurance contract or identification number | 29513 | Number of Individuals Covered | 179 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $2,004 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $20,044 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,004 |
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BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | 010940 |
Policy instance | 6 |
Insurance contract or identification number | 010940 | Number of Individuals Covered | 487 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $16,027 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $164,124 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $10,617 |
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BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | 10940 |
Policy instance | 1 |
Insurance contract or identification number | 10940 | Number of Individuals Covered | 496 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $41,246 | Total amount of fees paid to insurance company | USD $2,045 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $369,110 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $27,566 | Amount paid for insurance broker fees | 2029 | Additional information about fees paid to insurance broker | SPECIAL PROGRAMS / MISC | Insurance broker organization code? | 3 | Insurance broker name | PORTACOOL LLC |
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HEALTH SMART (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | POR |
Policy instance | 2 |
Insurance contract or identification number | POR | Number of Individuals Covered | 86 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Other welfare benefits provided | FSA/DCA | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 30011696 |
Policy instance | 3 |
Insurance contract or identification number | 30011696 | Number of Individuals Covered | 162 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $2,561 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $32,922 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,473 | Insurance broker organization code? | 3 | Insurance broker name | HIGGINBOTHAM INSURANCE AGENCY |
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NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 ) |
Policy contract number | 29513 |
Policy instance | 4 |
Insurance contract or identification number | 29513 | Number of Individuals Covered | 123 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $1,226 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $12,126 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,226 | Insurance broker name | USI INSURANCE SERVICES NATIONAL INC |
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DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
Policy contract number | F014510 |
Policy instance | 5 |
Insurance contract or identification number | F014510 | Number of Individuals Covered | 332 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $25,654 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | ADD, ADDSUP1,C,S, DEPSUBC,S, LIFESU | Welfare Benefit Premiums Paid to Carrier | USD $161,953 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $25,626 | Insurance broker name | HIGGINBOTHAM INSURANCE AGENCY INC |
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BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | 10940 |
Policy instance | 3 |
Insurance contract or identification number | 10940 | Number of Individuals Covered | 464 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $40,025 | Total amount of fees paid to insurance company | USD $3,240 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $292,642 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $40,025 | Amount paid for insurance broker fees | 3240 | Additional information about fees paid to insurance broker | SPECIAL PROGRAMS | Insurance broker organization code? | 3 | Insurance broker name | WELLS FARGO INSURANCE |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 000010123229 |
Policy instance | 4 |
Insurance contract or identification number | 000010123229 | Number of Individuals Covered | 336 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $6,298 | Total amount of fees paid to insurance company | USD $1,731 | Other welfare benefits provided | WEEKLY INCOME | Welfare Benefit Premiums Paid to Carrier | USD $41,985 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,298 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 1731 | Additional information about fees paid to insurance broker | BROKER BONUS | Insurance broker name | WELLS FARGO INS SVCS USA INC |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 000010096571 |
Policy instance | 5 |
Insurance contract or identification number | 000010096571 | Number of Individuals Covered | 339 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $5,546 | Total amount of fees paid to insurance company | USD $1,584 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $36,973 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,546 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 1584 | Additional information about fees paid to insurance broker | BROKER BONUS | Insurance broker name | WELLS FARGO INS SVCS USA INC |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 000010096572 |
Policy instance | 6 |
Insurance contract or identification number | 000010096572 | Number of Individuals Covered | 339 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $6,982 | Total amount of fees paid to insurance company | USD $1,929 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $46,547 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,982 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 1929 | Additional information about fees paid to insurance broker | BROKER BONUS | Insurance broker name | WELLS FARGO INS SVCS USA INC |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 00001D015699 |
Policy instance | 7 |
Insurance contract or identification number | 00001D015699 | Number of Individuals Covered | 275 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $15,787 | Total amount of fees paid to insurance company | USD $2,940 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $157,866 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $15,787 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 2940 | Additional information about fees paid to insurance broker | BROKER BONUS | Insurance broker name | WELLS FARGO INS SVCS USA INC |
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VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 30011696 |
Policy instance | 2 |
Insurance contract or identification number | 30011696 | Number of Individuals Covered | 142 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $1,367 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $28,700 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,367 | Insurance broker organization code? | 3 | Insurance broker name | WELLS FARGO INS SVCS USA INC |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 00040F001000143 |
Policy instance | 1 |
Insurance contract or identification number | 00040F001000143 | 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 $6,428 | Total amount of fees paid to insurance company | USD $1,637 | Other welfare benefits provided | VOLUNTARY AD&D, VOLUNTARY LIFE | Welfare Benefit Premiums Paid to Carrier | USD $42,850 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,428 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 1637 | Additional information about fees paid to insurance broker | BROKER BONUS | Insurance broker name | WELLS FARGO INS SVCS USA |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 000010123229 |
Policy instance | 4 |
Insurance contract or identification number | 000010123229 | Number of Individuals Covered | 304 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $6,110 | Total amount of fees paid to insurance company | USD $1,458 | Other welfare benefits provided | WEEKLY INCOME | Welfare Benefit Premiums Paid to Carrier | USD $40,735 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,110 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 1458 | Additional information about fees paid to insurance broker | BROKER BONUS | Insurance broker name | WELLS FARGO INS SVCS |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 000010096571 |
Policy instance | 5 |
Insurance contract or identification number | 000010096571 | Number of Individuals Covered | 306 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $5,592 | Total amount of fees paid to insurance company | USD $1,261 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $37,280 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,592 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 1261 | Additional information about fees paid to insurance broker | BROKER BONUS | Insurance broker name | WELLS FARGO INS SVCS USA INC |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 00040F001000143 |
Policy instance | 1 |
Insurance contract or identification number | 00040F001000143 | Number of Individuals Covered | 95 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $5,777 | Total amount of fees paid to insurance company | USD $1,331 | Other welfare benefits provided | VOLUNTARY AD&D, VOLUNTARY LIFE | Welfare Benefit Premiums Paid to Carrier | USD $38,510 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,777 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 1331 | Additional information about fees paid to insurance broker | BROKER BONUS | Insurance broker name | WELLS FARGO INS SVCS USA |
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BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | 10940 |
Policy instance | 3 |
Insurance contract or identification number | 10940 | Number of Individuals Covered | 419 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $35,730 | Total amount of fees paid to insurance company | USD $2,538 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $243,052 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $35,730 | Amount paid for insurance broker fees | 2538 | Additional information about fees paid to insurance broker | SPECIAL PROGRAMS | Insurance broker organization code? | 3 | Insurance broker name | WELLS FARGO INSURANCE |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 00001D015699 |
Policy instance | 7 |
Insurance contract or identification number | 00001D015699 | Number of Individuals Covered | 253 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $13,837 | Total amount of fees paid to insurance company | USD $1,146 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $138,373 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $13,837 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 1146 | Additional information about fees paid to insurance broker | BROKER BONUS | Insurance broker name | WELLS FARGO INS SVCS USA INC |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 000010096572 |
Policy instance | 6 |
Insurance contract or identification number | 000010096572 | Number of Individuals Covered | 304 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $6,809 | Total amount of fees paid to insurance company | USD $1,559 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $45,392 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,809 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 1559 | Additional information about fees paid to insurance broker | BROKER BONUS | Insurance broker name | WELLS FARGO INS SVCS USA INC |
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VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 30011696 |
Policy instance | 2 |
Insurance contract or identification number | 30011696 | Number of Individuals Covered | 111 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $1,105 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $19,973 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,105 | Insurance broker organization code? | 3 | Insurance broker name | WELLS FARGO INSURANCE SERVICES USA |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 000010096571 |
Policy instance | 5 |
Insurance contract or identification number | 000010096571 | Number of Individuals Covered | 275 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $4,450 | Total amount of fees paid to insurance company | USD $355 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $29,665 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,450 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 355 | Additional information about fees paid to insurance broker | BROKER BONUS | Insurance broker name | WELLS FARGO INS SVCS |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 00040F001000143 |
Policy instance | 1 |
Insurance contract or identification number | 00040F001000143 | Number of Individuals Covered | 87 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $4,697 | Total amount of fees paid to insurance company | USD $385 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $31,314 | 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 | Amount paid for insurance broker fees | 385 | Additional information about fees paid to insurance broker | BROKER BONUS | Insurance broker name | WELLS FARGO INS SVCS USA |
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VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 30011696 |
Policy instance | 2 |
Insurance contract or identification number | 30011696 | Number of Individuals Covered | 108 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $20,572 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | 10940 |
Policy instance | 3 |
Insurance contract or identification number | 10940 | Number of Individuals Covered | 398 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $34,629 | Total amount of fees paid to insurance company | USD $2,988 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $283,452 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $34,629 | Amount paid for insurance broker fees | 2988 | Additional information about fees paid to insurance broker | SPECIAL PROGRAMS | Insurance broker organization code? | 3 | Insurance broker name | WELLS FARGO INSURANCE |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 000010123229 |
Policy instance | 4 |
Insurance contract or identification number | 000010123229 | Number of Individuals Covered | 274 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $5,144 | Total amount of fees paid to insurance company | USD $403 | Other welfare benefits provided | WEEKLY INCOME | Welfare Benefit Premiums Paid to Carrier | USD $34,295 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,144 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 403 | Additional information about fees paid to insurance broker | BROKER BONUS | Insurance broker name | WELLS FARGO INS SVCS USA INC |
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NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 ) |
Policy contract number | 29513 |
Policy instance | 6 |
Insurance contract or identification number | 29513 | Number of Individuals Covered | 58 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $664 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $6,098 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $664 | Insurance broker organization code? | 3 | Insurance broker name | WELLS FARGO INSURANCE SERVICES USA |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 00001D015699 |
Policy instance | 8 |
Insurance contract or identification number | 00001D015699 | Number of Individuals Covered | 215 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $10,785 | Total amount of fees paid to insurance company | USD $306 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $107,849 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $10,785 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 306 | Additional information about fees paid to insurance broker | BROKER BONUS | Insurance broker name | WELLS FARGO INS SVCS USA INC |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 000010096572 |
Policy instance | 7 |
Insurance contract or identification number | 000010096572 | Number of Individuals Covered | 274 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $5,504 | Total amount of fees paid to insurance company | USD $438 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $36,691 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,504 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 438 | Additional information about fees paid to insurance broker | BROKER BONUS | Insurance broker name | WELLS FARGO INS SVCS USA INC |
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NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 ) |
Policy contract number | 29513 |
Policy instance | 1 |
Insurance contract or identification number | 29513 | Number of Individuals Covered | 57 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $548 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $5,825 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $548 | Insurance broker organization code? | 3 | Insurance broker name | WELLS FARGO INSURANCE SERVICES USA |
|
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 00040F001000143 |
Policy instance | 6 |
Insurance contract or identification number | 00040F001000143 | Number of Individuals Covered | 217 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $4,624 | Total amount of fees paid to insurance company | USD $955 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $30,827 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 955 | Additional information about fees paid to insurance broker | BROKER BONUS | Insurance broker organization code? | 3 | Commission paid to Insurance Broker | USD $4,624 | Insurance broker name | WELLS FARGO INS SVCS |
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VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 30011696 |
Policy instance | 5 |
Insurance contract or identification number | 30011696 | Number of Individuals Covered | 77 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $999 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $17,002 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $999 | Insurance broker organization code? | 3 | Insurance broker name | WELLS FARGO INSURANCE SERVICES USA |
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BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | 10940 |
Policy instance | 4 |
Insurance contract or identification number | 10940 | Number of Individuals Covered | 324 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $32,940 | Total amount of fees paid to insurance company | USD $2,748 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $257,458 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $32,940 | Amount paid for insurance broker fees | 2748 | Additional information about fees paid to insurance broker | SPECIAL PROGRAMS | Insurance broker organization code? | 3 | Insurance broker name | WELLS FARGO INSURANCE |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 000010096571 |
Policy instance | 2 |
Insurance contract or identification number | 000010096571 | Number of Individuals Covered | 270 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $4,258 | Total amount of fees paid to insurance company | USD $687 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $28,384 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 687 | Additional information about fees paid to insurance broker | BROKER BONUS | Insurance broker organization code? | 3 | Commission paid to Insurance Broker | USD $4,258 | Insurance broker name | WELLS FARGO INS SVCS USA INC |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 000010123229 |
Policy instance | 3 |
Insurance contract or identification number | 000010123229 | Number of Individuals Covered | 268 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $4,839 | Total amount of fees paid to insurance company | USD $740 | Other welfare benefits provided | WEEKLY INCOME | Welfare Benefit Premiums Paid to Carrier | USD $32,258 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 740 | Additional information about fees paid to insurance broker | BROKER BONUS | Insurance broker organization code? | 3 | Commission paid to Insurance Broker | USD $4,839 | Insurance broker name | WELLS FARGO INS SVCS USA INC |
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NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 ) |
Policy contract number | 29513 |
Policy instance | 1 |
Insurance contract or identification number | 29513 | Number of Individuals Covered | 46 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $397 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $4,091 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 00040F001000 |
Policy instance | 2 |
Insurance contract or identification number | 00040F001000 | Number of Individuals Covered | 230 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $4,881 | Other welfare benefits provided | VOL LIFE, VOL AD&D, CHILD & SPOUSE | Welfare Benefit Premiums Paid to Carrier | USD $32,538 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 000010123229 |
Policy instance | 3 |
Insurance contract or identification number | 000010123229 | Number of Individuals Covered | 263 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $3,783 | Other welfare benefits provided | WEEKLY INCOME | Welfare Benefit Premiums Paid to Carrier | USD $25,222 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | 10940 |
Policy instance | 6 |
Insurance contract or identification number | 10940 | Number of Individuals Covered | 300 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $26,280 | Total amount of fees paid to insurance company | USD $2,028 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $173,956 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 30011696 |
Policy instance | 7 |
Insurance contract or identification number | 30011696 | Number of Individuals Covered | 72 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $860 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $13,084 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 00001D015699 |
Policy instance | 8 |
Insurance contract or identification number | 00001D015699 | Number of Individuals Covered | 209 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $7,286 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $72,855 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 000010096572 |
Policy instance | 4 |
Insurance contract or identification number | 000010096572 | Number of Individuals Covered | 266 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $4,142 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $27,615 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 000010096571 |
Policy instance | 5 |
Insurance contract or identification number | 000010096571 | Number of Individuals Covered | 265 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $3,511 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $23,408 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 ) |
Policy contract number | 29513 |
Policy instance | 1 |
Insurance contract or identification number | 29513 | Number of Individuals Covered | 14 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $292 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $3,442 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 00040F001000 |
Policy instance | 2 |
Insurance contract or identification number | 00040F001000 | Number of Individuals Covered | 210 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $4,865 | Total amount of fees paid to insurance company | USD $411 | Other welfare benefits provided | VOL LIFE, VOL AD&D, CHILD & SPOUSE | Welfare Benefit Premiums Paid to Carrier | USD $32,434 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 000010096572 |
Policy instance | 4 |
Insurance contract or identification number | 000010096572 | Number of Individuals Covered | 179 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $3,542 | Total amount of fees paid to insurance company | USD $202 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $23,616 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 000010096571 |
Policy instance | 5 |
Insurance contract or identification number | 000010096571 | Number of Individuals Covered | 177 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $3,159 | Total amount of fees paid to insurance company | USD $286 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $21,062 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | 10940 |
Policy instance | 6 |
Insurance contract or identification number | 10940 | Number of Individuals Covered | 226 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $21,102 | Total amount of fees paid to insurance company | USD $1,848 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $93,636 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 30011696 |
Policy instance | 7 |
Insurance contract or identification number | 30011696 | Number of Individuals Covered | 45 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $643 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $7,864 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 00001D015699 |
Policy instance | 8 |
Insurance contract or identification number | 00001D015699 | Number of Individuals Covered | 141 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $5,743 | Total amount of fees paid to insurance company | USD $268 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $57,432 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 000010123229 |
Policy instance | 3 |
Insurance contract or identification number | 000010123229 | Number of Individuals Covered | 175 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $3,494 | Other welfare benefits provided | WEEKLY INCOME | Welfare Benefit Premiums Paid to Carrier | USD $23,295 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|