Insurance contract or identification number | 4601800 |
Number of Individuals Covered | 112 |
Insurance policy start date | 2021-12-01 |
Insurance policy end date | 2022-11-30 |
Total amount of commissions paid to insurance broker | USD $37,523 |
Total amount of fees paid to insurance company | USD $0 |
Health Insurance Welfare Benefit | Yes |
Dental Insurance Welfare Benefit | Yes |
Vision Insurance Welfare Benefit | Yes |
Life Insurance Welfare Benefit | No |
Temporary Disability Insurance Welfare Benefit | No |
Long Term Disability Insurance Welfare Benefit | No |
Unemployment Insurance Welfare Benefit | No |
Welfare Benefit Premiums Paid to Carrier | USD $688,370 |
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
Commission paid to Insurance Broker | USD $26,622 |
Amount paid for insurance broker fees | 0 |
Insurance broker organization code? | 3 |