Insurance contract or identification number | 756327 |
Number of Individuals Covered | 169 |
Insurance policy start date | 2022-07-01 |
Insurance policy end date | 2023-06-30 |
Total amount of commissions paid to insurance broker | USD $12,272 |
Total amount of fees paid to insurance company | USD $3,540 |
Health Insurance Welfare Benefit | No |
Dental Insurance Welfare Benefit | Yes |
Vision Insurance Welfare Benefit | No |
Life Insurance Welfare Benefit | Yes |
Temporary Disability Insurance Welfare Benefit | No |
Long Term Disability Insurance Welfare Benefit | Yes |
Unemployment Insurance Welfare Benefit | No |
Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT |
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
Commission paid to Insurance Broker | USD $6,447 |
Amount paid for insurance broker fees | 1380 |
Additional information about fees paid to insurance broker | CONTINGENT COMPENSATION |
Insurance broker organization code? | 3 |