CNB BANK has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan CNB BANK EMPLOYEE HEALTH PROTECTION PLAN
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 118586 |
Policy instance | 3 |
Insurance contract or identification number | 118586 | Number of Individuals Covered | 517 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 ) |
Policy contract number | 4066590010 |
Policy instance | 1 |
Insurance contract or identification number | 4066590010 | Number of Individuals Covered | 517 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $81,504 | Welfare Benefit Premiums Paid to Carrier | USD $815,036 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $81,504 | Insurance broker organization code? | 3 |
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AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 118586 |
Policy instance | 2 |
Insurance contract or identification number | 118586 | Number of Individuals Covered | 517 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | 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 | ACC-62084 |
Policy instance | 15 |
Insurance contract or identification number | ACC-62084 | Number of Individuals Covered | 200 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $6,044 | Total amount of fees paid to insurance company | USD $2,672 | Other welfare benefits provided | ACCIDENT | Welfare Benefit Premiums Paid to Carrier | USD $40,292 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,044 | Amount paid for insurance broker fees | 2289 | Additional information about fees paid to insurance broker | BROKER BONUS | Insurance broker organization code? | 3 |
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HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | ETB136014 |
Policy instance | 4 |
Insurance contract or identification number | ETB136014 | Number of Individuals Covered | 517 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Other welfare benefits provided | BUSINESS TRAVEL ACCIDENT | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 210769 0001 |
Policy instance | 5 |
Insurance contract or identification number | 210769 0001 | Number of Individuals Covered | 156 | Insurance policy start date | 2021-10-01 | Insurance policy end date | 2022-10-01 | Total amount of commissions paid to insurance broker | USD $3,677 | Other welfare benefits provided | LONG-TERM CARE | Welfare Benefit Premiums Paid to Carrier | USD $36,818 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,677 | Insurance broker organization code? | 3 |
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PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) |
Policy contract number | 148515 |
Policy instance | 6 |
Insurance contract or identification number | 148515 | Number of Individuals Covered | 12 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2023-01-01 | Total amount of commissions paid to insurance broker | USD $1,053 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $16,370 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $578 | Insurance broker organization code? | 3 |
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PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) |
Policy contract number | 156081 |
Policy instance | 7 |
Insurance contract or identification number | 156081 | Number of Individuals Covered | 59 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2023-01-01 | Total amount of commissions paid to insurance broker | USD $6,438 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $47,922 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,911 | Insurance broker organization code? | 3 |
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PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68209 ) |
Policy contract number | 163115 |
Policy instance | 8 |
Insurance contract or identification number | 163115 | Number of Individuals Covered | 13 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2023-01-01 | Total amount of commissions paid to insurance broker | USD $1,110 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $11,984 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $925 | Insurance broker organization code? | 3 |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | CI-62083 |
Policy instance | 14 |
Insurance contract or identification number | CI-62083 | Number of Individuals Covered | 212 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $8,496 | Total amount of fees paid to insurance company | USD $3,814 | Other welfare benefits provided | CRITICAL ILLNESS | Welfare Benefit Premiums Paid to Carrier | USD $56,642 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $8,496 | Amount paid for insurance broker fees | 3267 | Additional information about fees paid to insurance broker | BROKER BONUS | Insurance broker organization code? | 3 |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 62082 |
Policy instance | 13 |
Insurance contract or identification number | 62082 | Number of Individuals Covered | 337 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $8,776 | Total amount of fees paid to insurance company | USD $6,088 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $87,757 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $8,776 | Amount paid for insurance broker fees | 5215 | Additional information about fees paid to insurance broker | BROKER BONUS | Insurance broker organization code? | 3 |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 62079 |
Policy instance | 12 |
Insurance contract or identification number | 62079 | Number of Individuals Covered | 687 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $4,797 | Total amount of fees paid to insurance company | USD $5,481 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $79,699 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,797 | Amount paid for insurance broker fees | 4695 | Additional information about fees paid to insurance broker | BROKER BONUS | Insurance broker organization code? | 3 |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 62081 |
Policy instance | 11 |
Insurance contract or identification number | 62081 | Number of Individuals Covered | 685 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $1,427 | Total amount of fees paid to insurance company | USD $8,217 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $104,056 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,427 | Amount paid for insurance broker fees | 7038 | Additional information about fees paid to insurance broker | BROKER BONUS | Insurance broker organization code? | 3 |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 1D041546 |
Policy instance | 10 |
Insurance contract or identification number | 1D041546 | Number of Individuals Covered | 621 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of fees paid to insurance company | USD $2,369 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $33,661 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 2029 | Additional information about fees paid to insurance broker | BROKER BONUS | Insurance broker organization code? | 3 |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 10267999 |
Policy instance | 9 |
Insurance contract or identification number | 10267999 | Number of Individuals Covered | 617 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $5,189 | Total amount of fees paid to insurance company | USD $3,920 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $103,778 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,189 | Amount paid for insurance broker fees | 3358 | Additional information about fees paid to insurance broker | BROKER BONUS | Insurance broker organization code? | 3 |
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AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 118586 |
Policy instance | 2 |
Insurance contract or identification number | 118586 | Number of Individuals Covered | 484 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 118586 |
Policy instance | 3 |
Insurance contract or identification number | 118586 | Number of Individuals Covered | 484 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | ETB136014 |
Policy instance | 4 |
Insurance contract or identification number | ETB136014 | Number of Individuals Covered | 488 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $1,065 | Other welfare benefits provided | BUSINESS TRAVEL ACCIDENT | Welfare Benefit Premiums Paid to Carrier | USD $7,103 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,065 |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 210769 0001 |
Policy instance | 5 |
Insurance contract or identification number | 210769 0001 | Number of Individuals Covered | 119 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2022-01-01 | Total amount of commissions paid to insurance broker | USD $2,480 | Other welfare benefits provided | LONG-TERM CARE | Welfare Benefit Premiums Paid to Carrier | USD $24,805 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,480 | Insurance broker organization code? | 3 |
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PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) |
Policy contract number | 148515 |
Policy instance | 6 |
Insurance contract or identification number | 148515 | Number of Individuals Covered | 13 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2022-01-01 | Total amount of commissions paid to insurance broker | USD $1,230 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $16,472 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $710 | Insurance broker organization code? | 3 |
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PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) |
Policy contract number | 156081 |
Policy instance | 7 |
Insurance contract or identification number | 156081 | Number of Individuals Covered | 65 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2022-01-01 | Total amount of commissions paid to insurance broker | USD $7,063 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $46,327 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,097 | Insurance broker organization code? | 3 |
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PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68209 ) |
Policy contract number | 163115 |
Policy instance | 8 |
Insurance contract or identification number | 163115 | Number of Individuals Covered | 16 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2022-01-01 | Total amount of commissions paid to insurance broker | USD $1,953 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $11,676 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,690 | Insurance broker organization code? | 3 |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00544982 |
Policy instance | 9 |
Insurance contract or identification number | 00544982 | Number of Individuals Covered | 626 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $99,926 | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | VOLUNTARY CRITICAL ILLNESS | Welfare Benefit Premiums Paid to Carrier | USD $475,497 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $69,929 | Insurance broker organization code? | 3 |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 210769 0800 |
Policy instance | 10 |
Insurance contract or identification number | 210769 0800 | Number of Individuals Covered | 1 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2022-01-01 | Total amount of commissions paid to insurance broker | USD $927 | Other welfare benefits provided | LONG-TERM CARE | Welfare Benefit Premiums Paid to Carrier | USD $9,268 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $927 | Insurance broker organization code? | 3 |
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HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 ) |
Policy contract number | 4066590010 |
Policy instance | 1 |
Insurance contract or identification number | 4066590010 | Number of Individuals Covered | 488 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $69,466 | Welfare Benefit Premiums Paid to Carrier | USD $694,660 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $69,466 | Insurance broker organization code? | 3 |
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HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | ETB136014 |
Policy instance | 4 |
Insurance contract or identification number | ETB136014 | Number of Individuals Covered | 542 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2020-12-31 | Other welfare benefits provided | BUSINESS TRAVEL ACCIDENT | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 118586 |
Policy instance | 3 |
Insurance contract or identification number | 118586 | Number of Individuals Covered | 448 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 118586 |
Policy instance | 2 |
Insurance contract or identification number | 118586 | Number of Individuals Covered | 448 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 ) |
Policy contract number | 4066590010 |
Policy instance | 1 |
Insurance contract or identification number | 4066590010 | Number of Individuals Covered | 456 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $62,663 | Welfare Benefit Premiums Paid to Carrier | USD $626,627 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $62,663 | Insurance broker organization code? | 3 |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 210769 0001 |
Policy instance | 5 |
Insurance contract or identification number | 210769 0001 | Number of Individuals Covered | 98 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2021-01-01 | Total amount of commissions paid to insurance broker | USD $2,078 | Other welfare benefits provided | LONG-TERM CARE | Welfare Benefit Premiums Paid to Carrier | USD $20,776 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,078 | Insurance broker organization code? | 3 |
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PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) |
Policy contract number | 148515 |
Policy instance | 6 |
Insurance contract or identification number | 148515 | Number of Individuals Covered | 13 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2021-01-01 | Total amount of commissions paid to insurance broker | USD $2,319 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $16,221 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,695 | Insurance broker organization code? | 3 |
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PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) |
Policy contract number | 156081 |
Policy instance | 7 |
Insurance contract or identification number | 156081 | Number of Individuals Covered | 53 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2021-01-01 | Total amount of commissions paid to insurance broker | USD $8,620 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $43,071 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,287 | Insurance broker organization code? | 3 |
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PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68209 ) |
Policy contract number | 163115 |
Policy instance | 8 |
Insurance contract or identification number | 163115 | Number of Individuals Covered | 14 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2021-01-01 | Total amount of commissions paid to insurance broker | USD $1,897 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $10,817 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,547 | Insurance broker organization code? | 3 |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00544982 |
Policy instance | 9 |
Insurance contract or identification number | 00544982 | Number of Individuals Covered | 572 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $61,902 | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | VOLUNTARY CRITICAL ILLNESS | Welfare Benefit Premiums Paid to Carrier | USD $410,037 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $35,250 | Insurance broker organization code? | 3 |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 210769 0800 |
Policy instance | 10 |
Insurance contract or identification number | 210769 0800 | Number of Individuals Covered | 1 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2021-01-01 | Total amount of commissions paid to insurance broker | USD $933 | Other welfare benefits provided | LONG-TERM CARE | Welfare Benefit Premiums Paid to Carrier | USD $8,780 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $933 | Insurance broker organization code? | 3 |
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HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 ) |
Policy contract number | 4066590010 |
Policy instance | 1 |
Insurance contract or identification number | 4066590010 | Number of Individuals Covered | 421 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $61,884 | Welfare Benefit Premiums Paid to Carrier | USD $618,838 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $61,859 | Insurance broker organization code? | 3 |
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AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 118586 |
Policy instance | 2 |
Insurance contract or identification number | 118586 | Number of Individuals Covered | 421 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Insurance broker organization code? | 3 |
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AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 118586 |
Policy instance | 3 |
Insurance contract or identification number | 118586 | Number of Individuals Covered | 421 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Insurance broker organization code? | 3 |
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HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | ETB136014 |
Policy instance | 4 |
Insurance contract or identification number | ETB136014 | Number of Individuals Covered | 542 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2019-12-31 | Other welfare benefits provided | BUSINESS TRAVEL ACCIDENT | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 210769 |
Policy instance | 5 |
Insurance contract or identification number | 210769 | Number of Individuals Covered | 101 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2020-01-01 | Total amount of commissions paid to insurance broker | USD $2,782 | Other welfare benefits provided | LONG-TERM CARE | Welfare Benefit Premiums Paid to Carrier | USD $27,859 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,782 | Insurance broker organization code? | 3 |
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PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) |
Policy contract number | 156081 |
Policy instance | 7 |
Insurance contract or identification number | 156081 | Number of Individuals Covered | 51 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2020-01-01 | Total amount of commissions paid to insurance broker | USD $6,250 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $35,659 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,353 | Insurance broker organization code? | 3 |
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PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) |
Policy contract number | 148515 |
Policy instance | 6 |
Insurance contract or identification number | 148515 | Number of Individuals Covered | 16 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2020-01-01 | Total amount of commissions paid to insurance broker | USD $1,836 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $17,561 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,255 | Insurance broker organization code? | 3 |
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PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68209 ) |
Policy contract number | 163115 |
Policy instance | 8 |
Insurance contract or identification number | 163115 | Number of Individuals Covered | 10 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2020-01-01 | Total amount of commissions paid to insurance broker | USD $950 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $8,491 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $595 | Insurance broker organization code? | 3 |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00544982 |
Policy instance | 9 |
Insurance contract or identification number | 00544982 | Number of Individuals Covered | 527 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $37,727 | Total amount of fees paid to insurance company | USD $2,920 | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | VOLUNTARY CRITICAL ILLNESS | Welfare Benefit Premiums Paid to Carrier | USD $346,547 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $27,329 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 2920 | Additional information about fees paid to insurance broker | CLAIM ADMINISTRATION |
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RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
Policy contract number | VCI 800560 |
Policy instance | 11 |
Insurance contract or identification number | VCI 800560 | Number of Individuals Covered | 15 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $418 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,784 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $418 | Insurance broker organization code? | 3 | Insurance broker name | C H REAMS & ASSOCIATES INC |
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RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
Policy contract number | VG 185308 |
Policy instance | 12 |
Insurance contract or identification number | VG 185308 | Number of Individuals Covered | 21 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $1,128 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $11,283 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,128 | Insurance broker organization code? | 3 | Insurance broker name | C H REAMS & ASSOCIATES INC. |
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PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) |
Policy contract number | 148515 |
Policy instance | 13 |
Insurance contract or identification number | 148515 | Number of Individuals Covered | 19 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2018-01-01 | Total amount of commissions paid to insurance broker | USD $1,668 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $17,206 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,668 | Insurance broker organization code? | 3 | Insurance broker name | C H REAMS & ASSOCIATES INC. |
|
PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) |
Policy contract number | 156081 |
Policy instance | 14 |
Insurance contract or identification number | 156081 | Number of Individuals Covered | 45 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2018-01-01 | Total amount of commissions paid to insurance broker | USD $8,199 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $30,537 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $8,199 | Insurance broker organization code? | 3 | Insurance broker name | C H REAMS & ASSOCIATES INC. |
|
PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68209 ) |
Policy contract number | 163115 |
Policy instance | 15 |
Insurance contract or identification number | 163115 | Number of Individuals Covered | 7 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2018-01-01 | Total amount of commissions paid to insurance broker | USD $2,078 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $4,897 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,078 | Insurance broker organization code? | 3 | Insurance broker name | C H REAMS & ASSOCIATES INC. |
|
FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71005 ) |
Policy contract number | DBL252135 |
Policy instance | 10 |
Insurance contract or identification number | DBL252135 | Number of Individuals Covered | 2 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $105 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $959 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $105 | Insurance broker organization code? | 3 | Insurance broker name | C H REAMS & ASSOCIATES INC. |
|
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 210769 |
Policy instance | 9 |
Insurance contract or identification number | 210769 | Number of Individuals Covered | 51 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $2,633 | Other welfare benefits provided | LONG-TERM CARE | Welfare Benefit Premiums Paid to Carrier | USD $26,640 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,633 | Insurance broker organization code? | 3 | Insurance broker name | C H REAMS & ASSOCIATES INC. |
|
HIGHMARK CASUALTY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 35599 ) |
Policy contract number | 990066 0010 |
Policy instance | 1 |
Insurance contract or identification number | 990066 0010 | Number of Individuals Covered | 371 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $58,842 | Welfare Benefit Premiums Paid to Carrier | USD $588,425 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $58,842 | Insurance broker organization code? | 3 | Insurance broker name | C H REAMS & ASSOCIATES INC |
|
DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 ) |
Policy contract number | 02559 |
Policy instance | 2 |
Insurance contract or identification number | 02559 | Number of Individuals Covered | 1105 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $1,312 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $241,402 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,312 | Insurance broker organization code? | 3 | Insurance broker name | C H REAMS & ASSOCIATES INC |
|
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
Policy contract number | 061655 |
Policy instance | 3 |
Insurance contract or identification number | 061655 | Number of Individuals Covered | 1068 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $64,308 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Insurance broker organization code? | 3 | Insurance broker name | C H REAMS & ASSOCIATES INC. |
|
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
Policy contract number | 01320200.01.02. |
Policy instance | 4 |
Insurance contract or identification number | 01320200.01.02. | Number of Individuals Covered | 3416 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Insurance broker organization code? | 3 | Insurance broker name | C H REAMS & ASSOCIATES INC. |
|
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
Policy contract number | 01320200.01.02. |
Policy instance | 5 |
Insurance contract or identification number | 01320200.01.02. | Number of Individuals Covered | 4385 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Insurance broker organization code? | 3 | Insurance broker name | C H REAMS & ASSOCIATES INC. |
|
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
Policy contract number | GL 155497 |
Policy instance | 6 |
Insurance contract or identification number | GL 155497 | Number of Individuals Covered | 444 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $3,337 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D/DEPENDENT RETIREE/GROUP LIFE | Welfare Benefit Premiums Paid to Carrier | USD $78,677 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,337 | Insurance broker organization code? | 3 | Insurance broker name | C H REAMS & ASSOCIATES INC. |
|
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | ETB136014 |
Policy instance | 7 |
Insurance contract or identification number | ETB136014 | Number of Individuals Covered | 542 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2018-01-01 | Other welfare benefits provided | BUSINESS TRAVEL ACCIDENT | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Insurance broker organization code? | 3 | Insurance broker name | C H REAMS & ASSOCIATES INC. |
|
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
Policy contract number | LTD 127244 |
Policy instance | 8 |
Insurance contract or identification number | LTD 127244 | 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 $4,011 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $40,217 | 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 | Insurance broker organization code? | 3 | Insurance broker name | C H REAMS & ASSOCIATES INC. |
|
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
Policy contract number | 01320200.01.02. |
Policy instance | 4 |
Insurance contract or identification number | 01320200.01.02. | Number of Individuals Covered | 3055 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Insurance broker organization code? | 3 | Insurance broker name | C H REAMS & ASSOCIATES INC. |
|
DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 ) |
Policy contract number | 02559 |
Policy instance | 2 |
Insurance contract or identification number | 02559 | Number of Individuals Covered | 996 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $1,141 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $211,352 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,141 | Insurance broker organization code? | 3 | Insurance broker name | C H REAMS & ASSOCIATES INC |
|
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 215776 |
Policy instance | 6 |
Insurance contract or identification number | 215776 | Number of Individuals Covered | 380 | Total amount of commissions paid to insurance broker | USD $7,738 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D/DEPENDENT RETIREE/GROUP LIFE | Welfare Benefit Premiums Paid to Carrier | USD $114,759 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $7,738 | Insurance broker organization code? | 3 | Insurance broker name | C H REAMS & ASSOCIATES INC. |
|
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | ETB136014 |
Policy instance | 7 |
Insurance contract or identification number | ETB136014 | Number of Individuals Covered | 432 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Other welfare benefits provided | BUSINESS TRAVEL ACCIDENT | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Insurance broker organization code? | 3 | Insurance broker name | C H REAMS & ASSOCIATES INC. |
|
HIGHMARK CASUALTY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 35599 ) |
Policy contract number | 990066 0010 |
Policy instance | 1 |
Insurance contract or identification number | 990066 0010 | Number of Individuals Covered | 328 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $46,630 | Welfare Benefit Premiums Paid to Carrier | USD $466,299 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $46,630 | Insurance broker organization code? | 3 | Insurance broker name | C H REAMS & ASSOCIATES INC |
|
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
Policy contract number | 01320200.01.02. |
Policy instance | 5 |
Insurance contract or identification number | 01320200.01.02. | Number of Individuals Covered | 3807 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Insurance broker organization code? | 3 | Insurance broker name | C H REAMS & ASSOCIATES INC. |
|
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
Policy contract number | 061655 |
Policy instance | 3 |
Insurance contract or identification number | 061655 | Number of Individuals Covered | 987 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $59,245 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Insurance broker organization code? | 3 | Insurance broker name | C H REAMS & ASSOCIATES INC. |
|
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 215776 |
Policy instance | 6 |
Insurance contract or identification number | 215776 | Number of Individuals Covered | 360 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $7,523 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D, DEPENDENT RETIREE& GROUP LIFE | Welfare Benefit Premiums Paid to Carrier | USD $115,284 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $7,523 | Insurance broker organization code? | 3 | Insurance broker name | C H REAMS & ASSOCIATES INC. |
|
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
Policy contract number | 01320200.01.02. |
Policy instance | 4 |
Insurance contract or identification number | 01320200.01.02. | Number of Individuals Covered | 3663 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Insurance broker organization code? | 3 | Insurance broker name | C H REAMS & ASSOCIATES INC. |
|
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
Policy contract number | 01320200.01.02. |
Policy instance | 5 |
Insurance contract or identification number | 01320200.01.02. | Number of Individuals Covered | 3664 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $206,620 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $206,620 | Insurance broker organization code? | 3 | Insurance broker name | C H REAMS & ASSOCIATES INC. |
|
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
Policy contract number | 061655 |
Policy instance | 3 |
Insurance contract or identification number | 061655 | Number of Individuals Covered | 915 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $60,516 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Insurance broker organization code? | 3 | Insurance broker name | C H REAMS & ASSOCIATES INC. |
|
DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 ) |
Policy contract number | 02559 |
Policy instance | 2 |
Insurance contract or identification number | 02559 | Number of Individuals Covered | 365 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $631 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $205,694 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $631 | Insurance broker organization code? | 3 | Insurance broker name | C H REAMS & ASSOCIATES INC |
|
HIGHMARK CASUALTY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 35599 ) |
Policy contract number | 990066 0010 |
Policy instance | 1 |
Insurance contract or identification number | 990066 0010 | Number of Individuals Covered | 305 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $36,227 | Welfare Benefit Premiums Paid to Carrier | USD $362,269 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $36,227 | Insurance broker organization code? | 3 | Insurance broker name | C H REAMS & ASSOCIATES INC |
|
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
Policy contract number | 01320200.01.02. |
Policy instance | 5 |
Insurance contract or identification number | 01320200.01.02. | Number of Individuals Covered | 3035 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $173,390 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $173,390 | Insurance broker organization code? | 3 | Insurance broker name | C H REAMS & ASSOCIATES INC. |
|
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
Policy contract number | 01320200.01.02. |
Policy instance | 4 |
Insurance contract or identification number | 01320200.01.02. | Number of Individuals Covered | 3035 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Insurance broker organization code? | 3 | Insurance broker name | C H REAMS & ASSOCIATES INC. |
|
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
Policy contract number | 061655 |
Policy instance | 3 |
Insurance contract or identification number | 061655 | Number of Individuals Covered | 777 | 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 $48,557 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Insurance broker organization code? | 3 | Insurance broker name | C H REAMS & ASSOCIATES INC. |
|
HIGHMARK CASUALTY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 35599 ) |
Policy contract number | 990066 0010 |
Policy instance | 1 |
Insurance contract or identification number | 990066 0010 | Number of Individuals Covered | 249 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $26,873 | Welfare Benefit Premiums Paid to Carrier | USD $268,725 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $26,873 | Insurance broker organization code? | 3 | Insurance broker name | C H REAMS & ASSOCIATES INC |
|
DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 ) |
Policy contract number | 02559 |
Policy instance | 2 |
Insurance contract or identification number | 02559 | Number of Individuals Covered | 316 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $926 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $166,273 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $926 | Insurance broker organization code? | 3 | Insurance broker name | C H REAMS & ASSOCIATES INC |
|
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 215776 |
Policy instance | 7 |
Insurance contract or identification number | 215776 | Number of Individuals Covered | 291 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $6,996 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D, DEPENDENT RETIREE& GROUP LIFE | Welfare Benefit Premiums Paid to Carrier | USD $91,023 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,996 | Insurance broker organization code? | 3 | Insurance broker name | C H REAMS & ASSOCIATES INC. |
|
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
Policy contract number | 53896 |
Policy instance | 6 |
Insurance contract or identification number | 53896 | Number of Individuals Covered | 77 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-11-30 | Total amount of commissions paid to insurance broker | USD $1,498 | Other welfare benefits provided | SPECIAL RISK | Welfare Benefit Premiums Paid to Carrier | USD $19,738 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,498 | Insurance broker organization code? | 3 | Insurance broker name | C H REAMS & ASSOCIATES INC. |
|
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | ETB136014 |
Policy instance | 2 |
Insurance contract or identification number | ETB136014 | Number of Individuals Covered | 99 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $350 | Other welfare benefits provided | SPECIAL RISK | Welfare Benefit Premiums Paid to Carrier | USD $2,300 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $350 | Insurance broker organization code? | 3 | Insurance broker name | C H REAMS & ASSOCIATES INC. |
|
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
Policy contract number | 01320200.01.02. |
Policy instance | 3 |
Insurance contract or identification number | 01320200.01.02. | Number of Individuals Covered | 2807 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $157,108 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $157,108 | Insurance broker organization code? | 3 | Insurance broker name | C H REAMS & ASSOCIATES INC. |
|
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
Policy contract number | 01320200.01.02. |
Policy instance | 4 |
Insurance contract or identification number | 01320200.01.02. | Number of Individuals Covered | 2807 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Insurance broker organization code? | 3 | Insurance broker name | C H REAMS & ASSOCIATES INC. |
|
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
Policy contract number | 061655 |
Policy instance | 5 |
Insurance contract or identification number | 061655 | Number of Individuals Covered | 736 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $45,207 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Insurance broker organization code? | 3 | Insurance broker name | C H REAMS & ASSOCIATES INC. |
|
DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 ) |
Policy contract number | 02559 |
Policy instance | 6 |
Insurance contract or identification number | 02559 | Number of Individuals Covered | 299 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $858 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $161,058 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $858 | Insurance broker organization code? | 3 | Insurance broker name | C H REAMS & ASSOCIATES INC |
|
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 215776 |
Policy instance | 1 |
Insurance contract or identification number | 215776 | Number of Individuals Covered | 275 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $6,726 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D, DEPENDENT RETIREE& GROUP LIFE | Welfare Benefit Premiums Paid to Carrier | USD $80,145 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,726 | Insurance broker organization code? | 3 | Insurance broker name | C H REAMS & ASSOCIATES INC. |
|
HIGHMARK CASUALTY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 35599 ) |
Policy contract number | 990066 0010 |
Policy instance | 7 |
Insurance contract or identification number | 990066 0010 | Number of Individuals Covered | 244 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $27,541 | Welfare Benefit Premiums Paid to Carrier | USD $275,407 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $27,541 | Insurance broker organization code? | 3 | Insurance broker name | C H REAMS & ASSOCIATES INC |
|
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 215776 |
Policy instance | 1 |
Insurance contract or identification number | 215776 | Number of Individuals Covered | 260 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $6,512 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D, DEPENDENT RETIREE& GROUP LIFE | Welfare Benefit Premiums Paid to Carrier | USD $68,705 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
Policy contract number | 061655 |
Policy instance | 5 |
Insurance contract or identification number | 061655 | Number of Individuals Covered | 683 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $41,631 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
HIGHMARK CASUALTY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 35599 ) |
Policy contract number | 990066 0010 |
Policy instance | 7 |
Insurance contract or identification number | 990066 0010 | Number of Individuals Covered | 224 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $30,265 | Welfare Benefit Premiums Paid to Carrier | USD $302,648 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 ) |
Policy contract number | 02559 |
Policy instance | 6 |
Insurance contract or identification number | 02559 | Number of Individuals Covered | 282 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $752 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $148,140 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
Policy contract number | 01320200.01.02. |
Policy instance | 4 |
Insurance contract or identification number | 01320200.01.02. | Number of Individuals Covered | 2677 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
Policy contract number | 01320200.01.02. |
Policy instance | 3 |
Insurance contract or identification number | 01320200.01.02. | Number of Individuals Covered | 2667 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $165,439 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | ETB136014 |
Policy instance | 2 |
Insurance contract or identification number | ETB136014 | Number of Individuals Covered | 99 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $345 | Other welfare benefits provided | SPECIAL RISK | Welfare Benefit Premiums Paid to Carrier | USD $2,300 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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HIGHMARK CASUALTY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 35599 ) |
Policy contract number | 990066 0010 |
Policy instance | 7 |
Insurance contract or identification number | 990066 0010 | Number of Individuals Covered | 217 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $29,698 | Welfare Benefit Premiums Paid to Carrier | USD $296,976 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $29,698 | Insurance broker organization code? | 3 | Insurance broker name | C H REAMS & ASSOCIATES INC |
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HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
Policy contract number | 061655 |
Policy instance | 5 |
Insurance contract or identification number | 061655 | Number of Individuals Covered | 642 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $45,684 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Insurance broker organization code? | 3 | Insurance broker name | C H REAMS & ASSOCIATES INC. |
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HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
Policy contract number | |
Policy instance | 3 |
Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Insurance broker organization code? | 3 | Insurance broker name | C H REAMS & ASSOCIATES INC. |
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HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) |
Policy contract number | |
Policy instance | 4 |
Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Insurance broker organization code? | 3 | Insurance broker name | C H REAMS & ASSOCIATES INC. |
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HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | ETB136014 |
Policy instance | 2 |
Insurance contract or identification number | ETB136014 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $350 | Other welfare benefits provided | SPECIAL RISK | Welfare Benefit Premiums Paid to Carrier | USD $2,300 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $350 | Insurance broker organization code? | 3 | Insurance broker name | C H REAMS & ASSOCIATES INC. |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 215776 |
Policy instance | 1 |
Insurance contract or identification number | 215776 | Number of Individuals Covered | 256 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $6,334 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D, DEPENDENT RETIREE& GROUP LIFE | Welfare Benefit Premiums Paid to Carrier | USD $76,298 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,334 | Insurance broker organization code? | 3 | Insurance broker name | C H REAMS & ASSOCIATES INC. |
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DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 ) |
Policy contract number | 2559 |
Policy instance | 6 |
Insurance contract or identification number | 2559 | Number of Individuals Covered | 269 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $799 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $137,832 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $799 | Insurance broker organization code? | 3 | Insurance broker name | C H REAMS & ASSOCIATES INC |
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