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SAMUELS AND SON SEAFOOD CO WELFARE PLAN 401k Plan overview

Plan NameSAMUELS AND SON SEAFOOD CO WELFARE PLAN
Plan identification number 501

SAMUELS AND SON SEAFOOD CO WELFARE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover

401k Sponsoring company profile

SAMUELS & SON SEAFOOD COMPANY INC. has sponsored the creation of one or more 401k plans.

Company Name:SAMUELS & SON SEAFOOD COMPANY INC.
Employer identification number (EIN):232540626
NAIC Classification:445220
NAIC Description:Fish and Seafood Markets

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SAMUELS AND SON SEAFOOD CO WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-03-01JOHN HARTY2023-09-28
5012021-03-01JOHN HARTY2022-12-15
5012020-03-01JOHN HARTY2021-08-11
5012019-03-01JOHN HARTY2020-07-30
5012018-03-01JOHN HARTY2019-10-08
5012017-03-01
5012017-03-01JOHN HARTY2019-12-03
5012016-03-01
5012015-03-01
5012014-03-01
5012013-03-01
5012012-03-01
5012011-03-01
5012010-03-01
5012009-03-01
5012008-03-01

Plan Statistics for SAMUELS AND SON SEAFOOD CO WELFARE PLAN

401k plan membership statisitcs for SAMUELS AND SON SEAFOOD CO WELFARE PLAN

Measure Date Value
2022: SAMUELS AND SON SEAFOOD CO WELFARE PLAN 2022 401k membership
Total participants, beginning-of-year2022-03-01143
Total number of active participants reported on line 7a of the Form 55002022-03-01178
Number of retired or separated participants receiving benefits2022-03-010
Number of other retired or separated participants entitled to future benefits2022-03-010
Total of all active and inactive participants2022-03-01178
Number of employers contributing to the scheme2022-03-010
2021: SAMUELS AND SON SEAFOOD CO WELFARE PLAN 2021 401k membership
Total participants, beginning-of-year2021-03-01364
Total number of active participants reported on line 7a of the Form 55002021-03-01327
Number of retired or separated participants receiving benefits2021-03-010
Number of other retired or separated participants entitled to future benefits2021-03-010
Total of all active and inactive participants2021-03-01327
Number of employers contributing to the scheme2021-03-010
2020: SAMUELS AND SON SEAFOOD CO WELFARE PLAN 2020 401k membership
Total participants, beginning-of-year2020-03-01388
Total number of active participants reported on line 7a of the Form 55002020-03-01364
Number of retired or separated participants receiving benefits2020-03-010
Number of other retired or separated participants entitled to future benefits2020-03-010
Total of all active and inactive participants2020-03-01364
Number of employers contributing to the scheme2020-03-010
2019: SAMUELS AND SON SEAFOOD CO WELFARE PLAN 2019 401k membership
Total participants, beginning-of-year2019-03-01430
Total number of active participants reported on line 7a of the Form 55002019-03-01388
Number of retired or separated participants receiving benefits2019-03-010
Number of other retired or separated participants entitled to future benefits2019-03-010
Total of all active and inactive participants2019-03-01388
Number of employers contributing to the scheme2019-03-010
2018: SAMUELS AND SON SEAFOOD CO WELFARE PLAN 2018 401k membership
Total participants, beginning-of-year2018-03-01430
Total number of active participants reported on line 7a of the Form 55002018-03-01430
Number of retired or separated participants receiving benefits2018-03-010
Number of other retired or separated participants entitled to future benefits2018-03-010
Total of all active and inactive participants2018-03-01430
Number of employers contributing to the scheme2018-03-010
2017: SAMUELS AND SON SEAFOOD CO WELFARE PLAN 2017 401k membership
Total participants, beginning-of-year2017-03-01128
Total number of active participants reported on line 7a of the Form 55002017-03-01137
Number of retired or separated participants receiving benefits2017-03-010
Number of other retired or separated participants entitled to future benefits2017-03-010
Total of all active and inactive participants2017-03-01137
Number of employers contributing to the scheme2017-03-010
2016: SAMUELS AND SON SEAFOOD CO WELFARE PLAN 2016 401k membership
Total participants, beginning-of-year2016-03-01300
Total number of active participants reported on line 7a of the Form 55002016-03-01307
Total of all active and inactive participants2016-03-01307
2015: SAMUELS AND SON SEAFOOD CO WELFARE PLAN 2015 401k membership
Total participants, beginning-of-year2015-03-01300
Total number of active participants reported on line 7a of the Form 55002015-03-01310
Total of all active and inactive participants2015-03-01310
2014: SAMUELS AND SON SEAFOOD CO WELFARE PLAN 2014 401k membership
Total participants, beginning-of-year2014-03-01270
Total number of active participants reported on line 7a of the Form 55002014-03-01300
Total of all active and inactive participants2014-03-01300
2013: SAMUELS AND SON SEAFOOD CO WELFARE PLAN 2013 401k membership
Total participants, beginning-of-year2013-03-01270
Total number of active participants reported on line 7a of the Form 55002013-03-01270
Total of all active and inactive participants2013-03-01270
2012: SAMUELS AND SON SEAFOOD CO WELFARE PLAN 2012 401k membership
Total participants, beginning-of-year2012-03-01241
Total number of active participants reported on line 7a of the Form 55002012-03-01270
Total of all active and inactive participants2012-03-01270
2011: SAMUELS AND SON SEAFOOD CO WELFARE PLAN 2011 401k membership
Total participants, beginning-of-year2011-03-01243
Total number of active participants reported on line 7a of the Form 55002011-03-01241
Total of all active and inactive participants2011-03-01241
2010: SAMUELS AND SON SEAFOOD CO WELFARE PLAN 2010 401k membership
Total participants, beginning-of-year2010-03-01235
Total number of active participants reported on line 7a of the Form 55002010-03-01243
Total of all active and inactive participants2010-03-01243
2009: SAMUELS AND SON SEAFOOD CO WELFARE PLAN 2009 401k membership
Total participants, beginning-of-year2009-03-01234
Total number of active participants reported on line 7a of the Form 55002009-03-01235
Total of all active and inactive participants2009-03-01235
2008: SAMUELS AND SON SEAFOOD CO WELFARE PLAN 2008 401k membership
Total participants, beginning-of-year2008-03-01234
Total number of active participants reported on line 7a of the Form 55002008-03-01234
Total of all active and inactive participants2008-03-01234

Form 5500 Responses for SAMUELS AND SON SEAFOOD CO WELFARE PLAN

2022: SAMUELS AND SON SEAFOOD CO WELFARE PLAN 2022 form 5500 responses
2022-03-01Type of plan entitySingle employer plan
2022-03-01Plan funding arrangement – InsuranceYes
2022-03-01Plan benefit arrangement – InsuranceYes
2021: SAMUELS AND SON SEAFOOD CO WELFARE PLAN 2021 form 5500 responses
2021-03-01Type of plan entitySingle employer plan
2021-03-01Plan funding arrangement – InsuranceYes
2021-03-01Plan benefit arrangement – InsuranceYes
2020: SAMUELS AND SON SEAFOOD CO WELFARE PLAN 2020 form 5500 responses
2020-03-01Type of plan entitySingle employer plan
2020-03-01Plan funding arrangement – InsuranceYes
2020-03-01Plan benefit arrangement – InsuranceYes
2019: SAMUELS AND SON SEAFOOD CO WELFARE PLAN 2019 form 5500 responses
2019-03-01Type of plan entitySingle employer plan
2019-03-01Plan funding arrangement – InsuranceYes
2019-03-01Plan benefit arrangement – InsuranceYes
2018: SAMUELS AND SON SEAFOOD CO WELFARE PLAN 2018 form 5500 responses
2018-03-01Type of plan entitySingle employer plan
2018-03-01Plan funding arrangement – InsuranceYes
2018-03-01Plan benefit arrangement – InsuranceYes
2017: SAMUELS AND SON SEAFOOD CO WELFARE PLAN 2017 form 5500 responses
2017-03-01Type of plan entitySingle employer plan
2017-03-01Submission has been amendedYes
2017-03-01Plan funding arrangement – InsuranceYes
2017-03-01Plan benefit arrangement – InsuranceYes
2016: SAMUELS AND SON SEAFOOD CO WELFARE PLAN 2016 form 5500 responses
2016-03-01Type of plan entitySingle employer plan
2016-03-01Plan funding arrangement – InsuranceYes
2016-03-01Plan benefit arrangement – InsuranceYes
2015: SAMUELS AND SON SEAFOOD CO WELFARE PLAN 2015 form 5500 responses
2015-03-01Type of plan entitySingle employer plan
2015-03-01Plan funding arrangement – InsuranceYes
2015-03-01Plan benefit arrangement – InsuranceYes
2014: SAMUELS AND SON SEAFOOD CO WELFARE PLAN 2014 form 5500 responses
2014-03-01Type of plan entitySingle employer plan
2014-03-01Plan funding arrangement – InsuranceYes
2014-03-01Plan benefit arrangement – InsuranceYes
2013: SAMUELS AND SON SEAFOOD CO WELFARE PLAN 2013 form 5500 responses
2013-03-01Type of plan entitySingle employer plan
2013-03-01Plan funding arrangement – InsuranceYes
2013-03-01Plan benefit arrangement – InsuranceYes
2012: SAMUELS AND SON SEAFOOD CO WELFARE PLAN 2012 form 5500 responses
2012-03-01Type of plan entitySingle employer plan
2012-03-01Plan funding arrangement – InsuranceYes
2012-03-01Plan benefit arrangement – InsuranceYes
2011: SAMUELS AND SON SEAFOOD CO WELFARE PLAN 2011 form 5500 responses
2011-03-01Type of plan entitySingle employer plan
2011-03-01Plan funding arrangement – InsuranceYes
2011-03-01Plan benefit arrangement – InsuranceYes
2010: SAMUELS AND SON SEAFOOD CO WELFARE PLAN 2010 form 5500 responses
2010-03-01Type of plan entitySingle employer plan
2010-03-01Plan funding arrangement – InsuranceYes
2010-03-01Plan benefit arrangement – InsuranceYes
2009: SAMUELS AND SON SEAFOOD CO WELFARE PLAN 2009 form 5500 responses
2009-03-01Type of plan entitySingle employer plan
2009-03-01Plan funding arrangement – InsuranceYes
2009-03-01Plan benefit arrangement – InsuranceYes
2008: SAMUELS AND SON SEAFOOD CO WELFARE PLAN 2008 form 5500 responses
2008-03-01Type of plan entitySingle employer plan
2008-03-01First time form 5500 has been submittedYes
2008-03-01Plan funding arrangement – InsuranceYes
2008-03-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number176202
Policy instance 2
Insurance contract or identification number176202
Number of Individuals Covered316
Insurance policy start date2022-03-01
Insurance policy end date2023-02-28
Total amount of commissions paid to insurance brokerUSD $75,249
Total amount of fees paid to insurance companyUSD $7,500
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,401,785
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $51,736
Amount paid for insurance broker fees7500
Additional information about fees paid to insurance broker2022 Q1 GROW WITH US NEW BUSINESS INCENTIVE RISK
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number876843G
Policy instance 1
Insurance contract or identification number876843G
Number of Individuals Covered360
Insurance policy start date2022-03-01
Insurance policy end date2023-02-28
Total amount of commissions paid to insurance brokerUSD $28,528
Total amount of fees paid to insurance companyUSD $3,139
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $145,454
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $28,579
Amount paid for insurance broker fees3139
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number876843G
Policy instance 3
Insurance contract or identification number876843G
Number of Individuals Covered327
Insurance policy start date2021-03-01
Insurance policy end date2022-02-28
Total amount of commissions paid to insurance brokerUSD $8,670
Total amount of fees paid to insurance companyUSD $4,175
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $52,651
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,670
Amount paid for insurance broker fees4175
Additional information about fees paid to insurance brokerFEE, BONUS
Insurance broker organization code?3
UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 )
Policy contract numberA19083 ET AL
Policy instance 2
Insurance contract or identification numberA19083 ET AL
Number of Individuals Covered305
Insurance policy start date2021-03-01
Insurance policy end date2022-02-28
Total amount of commissions paid to insurance brokerUSD $10,397
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $75,882
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $10,397
Amount paid for insurance broker fees0
Insurance broker organization code?3
INDEPENDENCE BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 93688 )
Policy contract number572273
Policy instance 1
Insurance contract or identification number572273
Number of Individuals Covered292
Insurance policy start date2021-03-01
Insurance policy end date2022-02-28
Total amount of commissions paid to insurance brokerUSD $44,068
Total amount of fees paid to insurance companyUSD $2,842
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $44,068
Amount paid for insurance broker fees2842
Additional information about fees paid to insurance brokerOVERRIDE/NON-MONETARY COMPENSATION
Insurance broker organization code?3
INDEPENDENCE BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 93688 )
Policy contract number572273
Policy instance 1
Insurance contract or identification number572273
Number of Individuals Covered279
Insurance policy start date2020-03-01
Insurance policy end date2021-02-28
Total amount of commissions paid to insurance brokerUSD $52,237
Total amount of fees paid to insurance companyUSD $11,232
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $52,237
Amount paid for insurance broker fees11232
Additional information about fees paid to insurance brokerOVERRIDE NON-MONETARY COMPENSATION
Insurance broker organization code?3
UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 )
Policy contract numberA19083 ET AL
Policy instance 2
Insurance contract or identification numberA19083 ET AL
Number of Individuals Covered294
Insurance policy start date2020-03-01
Insurance policy end date2021-02-28
Total amount of commissions paid to insurance brokerUSD $12,628
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $77,620
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $12,628
Amount paid for insurance broker fees0
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number876843G
Policy instance 3
Insurance contract or identification number876843G
Number of Individuals Covered364
Insurance policy start date2020-03-01
Insurance policy end date2021-02-28
Total amount of commissions paid to insurance brokerUSD $9,598
Total amount of fees paid to insurance companyUSD $5,248
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $55,234
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,598
Amount paid for insurance broker fees4229
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number766152-0287503
Policy instance 1
Insurance contract or identification number766152-0287503
Number of Individuals Covered388
Insurance policy start date2019-03-01
Insurance policy end date2020-02-29
Total amount of commissions paid to insurance brokerUSD $7,463
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $49,672
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,463
Amount paid for insurance broker fees0
Insurance broker organization code?3
INDEPENDENCE BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 93688 )
Policy contract number572273
Policy instance 2
Insurance contract or identification number572273
Number of Individuals Covered328
Insurance policy start date2019-03-01
Insurance policy end date2020-02-29
Total amount of commissions paid to insurance brokerUSD $48,277
Total amount of fees paid to insurance companyUSD $17,300
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $48,277
Amount paid for insurance broker fees17300
Additional information about fees paid to insurance brokerOVERRIDE NON-MONETARY COMPENSATION
Insurance broker organization code?3
DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 )
Policy contract number18316
Policy instance 3
Insurance contract or identification number18316
Number of Individuals Covered346
Insurance policy start date2019-03-01
Insurance policy end date2020-02-28
Total amount of commissions paid to insurance brokerUSD $9,124
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Welfare Benefit Premiums Paid to CarrierUSD $91,238
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $9,124
Amount paid for insurance broker fees0
Insurance broker organization code?3
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0766152
Policy instance 1
Insurance contract or identification number0766152
Number of Individuals Covered388
Insurance policy start date2018-03-01
Insurance policy end date2019-02-28
Total amount of commissions paid to insurance brokerUSD $7,455
Total amount of fees paid to insurance companyUSD $48,382
Health Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $1,212,993
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $7,455
Amount paid for insurance broker fees48348
Additional information about fees paid to insurance brokerDIRECT COMPENSATION
Insurance broker organization code?3
DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 )
Policy contract number18316
Policy instance 2
Insurance contract or identification number18316
Number of Individuals Covered287
Insurance policy start date2018-03-01
Insurance policy end date2019-02-28
Total amount of commissions paid to insurance brokerUSD $8,563
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Welfare Benefit Premiums Paid to CarrierUSD $85,630
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $8,563
Amount paid for insurance broker fees0
Insurance broker organization code?3
DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 )
Policy contract number18316
Policy instance 3
Insurance contract or identification number18316
Number of Individuals Covered266
Insurance policy start date2018-01-01
Insurance policy end date2018-02-28
Total amount of commissions paid to insurance brokerUSD $1,306
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Welfare Benefit Premiums Paid to CarrierUSD $13,061
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 )
Policy contract number18316
Policy instance 2
Insurance contract or identification number18316
Number of Individuals Covered306
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $7,682
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Welfare Benefit Premiums Paid to CarrierUSD $76,816
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $7,682
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameEMPLOYEE BENEFIT SPECIALIST INC.
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0766152
Policy instance 1
Insurance contract or identification number0766152
Number of Individuals Covered378
Insurance policy start date2017-03-01
Insurance policy end date2018-02-28
Total amount of commissions paid to insurance brokerUSD $5,701
Total amount of fees paid to insurance companyUSD $45,393
Health Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $1,044,267
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,701
Amount paid for insurance broker fees45393
Additional information about fees paid to insurance brokerDIRECT COMPENSATION
Insurance broker organization code?3
Insurance broker nameEMPLOYEE BENEFIT SPECIALIST
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number419179
Policy instance 3
Insurance contract or identification number419179
Number of Individuals Covered310
Insurance policy start date2015-03-01
Insurance policy end date2016-02-29
Total amount of commissions paid to insurance brokerUSD $2,252
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $24,476
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,252
Insurance broker organization code?3
Insurance broker nameEMPLOYEE BENEFIT SPECIALIST INC
AMERIHEALTH HMO, INC. (National Association of Insurance Commissioners NAIC id number: 95044 )
Policy contract number0000572273
Policy instance 2
Insurance contract or identification number0000572273
Number of Individuals Covered3
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $380
Total amount of fees paid to insurance companyUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $380
Insurance broker organization code?3
Insurance broker nameEMERSON REID DBA TRA BENEFIT
UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 26921 )
Policy contract number900510-099,9005
Policy instance 1
Insurance contract or identification number900510-099,9005
Number of Individuals Covered171
Insurance policy start date2015-03-01
Insurance policy end date2016-02-29
Total amount of commissions paid to insurance brokerUSD $7,061
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $54,644
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,061
Insurance broker organization code?3
Insurance broker nameEMERSON REID DBA TRA BENEFIT
UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 26921 )
Policy contract number900510-099,9005
Policy instance 4
Insurance contract or identification number900510-099,9005
Number of Individuals Covered155
Insurance policy start date2014-03-01
Insurance policy end date2015-02-28
Total amount of commissions paid to insurance brokerUSD $4,275
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $42,705
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,912
Insurance broker organization code?3
Insurance broker nameEMERSON REID DBA TRA BENEFIT
INDEPENDENCE BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 93688 )
Policy contract number0000572273
Policy instance 3
Insurance contract or identification number0000572273
Number of Individuals Covered199
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $32,084
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $32,084
Insurance broker organization code?3
Insurance broker nameFLEXIBLE BENEFIT PLANS INC
KEYSTONE HEALTH PLAN EAST (National Association of Insurance Commissioners NAIC id number: 95056 )
Policy contract number0000572273
Policy instance 2
Insurance contract or identification number0000572273
Number of Individuals Covered73
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $21,178
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $21,178
Insurance broker organization code?3
Insurance broker nameFLEXIBLE BENEFIT PLANS INC
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0476800
Policy instance 1
Insurance contract or identification number0476800
Number of Individuals Covered300
Insurance policy start date2014-03-01
Insurance policy end date2015-01-31
Total amount of commissions paid to insurance brokerUSD $2,742
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $21,177
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,742
Insurance broker organization code?3
Insurance broker nameKATZ-PIERZ INC
INDEPENDENCE BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 93688 )
Policy contract number0000572273
Policy instance 2
Insurance contract or identification number0000572273
Number of Individuals Covered208
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $32,779
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $32,779
Insurance broker organization code?3
Insurance broker nameADVANCED INSURANCE CONCEPTS INC
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0476800
Policy instance 1
Insurance contract or identification number0476800
Number of Individuals Covered270
Insurance policy start date2013-03-01
Insurance policy end date2014-02-28
Total amount of commissions paid to insurance brokerUSD $3,244
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $21,427
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,554
Insurance broker organization code?3
Insurance broker nameKATZ-PIERZ INC
KEYSTONE HEALTH PLAN EAST (National Association of Insurance Commissioners NAIC id number: 95056 )
Policy contract number0000572273
Policy instance 3
Insurance contract or identification number0000572273
Number of Individuals Covered68
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $18,321
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $18,321
Insurance broker organization code?3
Insurance broker nameADVANCED INSURANCE CONCEPTS INC
UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 26921 )
Policy contract number900510-099,9005
Policy instance 4
Insurance contract or identification number900510-099,9005
Number of Individuals Covered149
Insurance policy start date2013-03-01
Insurance policy end date2014-02-28
Total amount of commissions paid to insurance brokerUSD $5,836
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $42,880
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,637
Insurance broker organization code?3
Insurance broker nameFLEXIBLE BENEFIT PLANS INC
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number476800
Policy instance 2
Insurance contract or identification number476800
Number of Individuals Covered270
Insurance policy start date2012-03-01
Insurance policy end date2013-02-28
Total amount of commissions paid to insurance brokerUSD $6,172
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $78,917
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,172
Insurance broker organization code?3
Insurance broker nameKATZ-PIERZ INC
AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95109 )
Policy contract numberUS385630
Policy instance 1
Insurance contract or identification numberUS385630
Number of Individuals Covered304
Insurance policy start date2012-03-01
Insurance policy end date2013-02-28
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $1,088,406
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95109 )
Policy contract numberUS385630
Policy instance 1
Insurance contract or identification numberUS385630
Number of Individuals Covered260
Insurance policy start date2011-03-01
Insurance policy end date2012-02-29
Total amount of commissions paid to insurance brokerUSD $3,925
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $1,025,495
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,925
Insurance broker organization code?3
Insurance broker nameKATZ-PIERZ INC
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number476800
Policy instance 2
Insurance contract or identification number476800
Number of Individuals Covered241
Insurance policy start date2011-03-01
Insurance policy end date2012-02-29
Total amount of commissions paid to insurance brokerUSD $5,980
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $75,737
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,980
Insurance broker organization code?3
Insurance broker nameKATZ-PIERZ INC
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number476800
Policy instance 2
Insurance contract or identification number476800
Number of Individuals Covered243
Insurance policy start date2010-03-01
Insurance policy end date2011-02-28
Total amount of commissions paid to insurance brokerUSD $5,617
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $71,010
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,617
Insurance broker organization code?3
Insurance broker nameKATZ-PIERZ INC
AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95109 )
Policy contract numberUS385630
Policy instance 1
Insurance contract or identification numberUS385630
Number of Individuals Covered282
Insurance policy start date2010-03-01
Insurance policy end date2011-02-28
Total amount of commissions paid to insurance brokerUSD $45,634
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $922,484
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $45,634
Insurance broker organization code?3
Insurance broker nameKATZ-PIERZ INC
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number476800
Policy instance 2
Insurance contract or identification number476800
Number of Individuals Covered235
Insurance policy start date2009-03-01
Insurance policy end date2010-02-28
Total amount of commissions paid to insurance brokerUSD $5,471
Total amount of fees paid to insurance companyUSD $56
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $69,808
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,471
Amount paid for insurance broker fees56
Additional information about fees paid to insurance brokerPM CROSS-SALE
Insurance broker organization code?3
Insurance broker nameKATZ-PIERZ INC
AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95109 )
Policy contract numberUS385630
Policy instance 1
Insurance contract or identification numberUS385630
Number of Individuals Covered253
Insurance policy start date2009-03-01
Insurance policy end date2010-02-28
Total amount of commissions paid to insurance brokerUSD $38,747
Total amount of fees paid to insurance companyUSD $657
Welfare Benefit Premiums Paid to CarrierUSD $773,495
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $38,747
Amount paid for insurance broker fees657
Additional information about fees paid to insurance brokerPM CROSS-SALE
Insurance broker organization code?3
Insurance broker nameKATZ-PIERZ INC
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number476800
Policy instance 2
Insurance contract or identification number476800
Number of Individuals Covered234
Insurance policy start date2008-03-01
Insurance policy end date2009-02-28
Total amount of commissions paid to insurance brokerUSD $5,314
Total amount of fees paid to insurance companyUSD $578
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $63,277
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,314
Amount paid for insurance broker fees578
Additional information about fees paid to insurance brokerPM CROS-SALE
Insurance broker organization code?3
Insurance broker nameKATZ-PIERZ INC
INDEPENDENCE BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 93688 )
Policy contract number572273
Policy instance 3
Insurance contract or identification number572273
Number of Individuals Covered11
Insurance policy start date2008-01-01
Insurance policy end date2008-12-31
Total amount of commissions paid to insurance brokerUSD $-2,379
Total amount of fees paid to insurance companyUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $-2,379
Insurance broker organization code?3
Insurance broker nameBROWN & BROWN OF PENNA LP
KEYSTONE HEALTH PLAN EAST (National Association of Insurance Commissioners NAIC id number: 95056 )
Policy contract number572273
Policy instance 4
Insurance contract or identification number572273
Number of Individuals Covered128
Insurance policy start date2008-01-01
Insurance policy end date2008-12-31
Total amount of commissions paid to insurance brokerUSD $5,906
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,848
Insurance broker organization code?3
Insurance broker nameBROKERAGE CONCEPTS INC
AMERIHEALTH HMO, INC. (National Association of Insurance Commissioners NAIC id number: 95044 )
Policy contract number572273
Policy instance 5
Insurance contract or identification number572273
Number of Individuals Covered1
Insurance policy start date2008-01-01
Insurance policy end date2008-12-31
Total amount of commissions paid to insurance brokerUSD $39
Total amount of fees paid to insurance companyUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $39
Insurance broker organization code?3
Insurance broker nameBROWN & BROWN OF PENNA LP
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract numberUS385630
Policy instance 1
Insurance contract or identification numberUS385630
Number of Individuals Covered268
Insurance policy start date2008-03-01
Insurance policy end date2009-02-28
Total amount of commissions paid to insurance brokerUSD $33,974
Total amount of fees paid to insurance companyUSD $6,795
Welfare Benefit Premiums Paid to CarrierUSD $741,880
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $33,974
Amount paid for insurance broker fees6795
Additional information about fees paid to insurance brokerPM CROSS-SALE
Insurance broker organization code?3
Insurance broker nameKATZ-PIERZ INC

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