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FORTUNE BENEFITS SOLUTIONS GROUP HEALTH PLAN TRUST 401k Plan overview

Plan NameFORTUNE BENEFITS SOLUTIONS GROUP HEALTH PLAN TRUST
Plan identification number 501

FORTUNE BENEFITS SOLUTIONS GROUP HEALTH PLAN TRUST Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Long-term disability cover

401k Sponsoring company profile

TRUSTEES OF FORTUNE BENEFITS SOLUTIONS GROUP HEALTH PLAN TRUST has sponsored the creation of one or more 401k plans.

Company Name:TRUSTEES OF FORTUNE BENEFITS SOLUTIONS GROUP HEALTH PLAN TRUST
Employer identification number (EIN):266121186
NAIC Classification:561300

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FORTUNE BENEFITS SOLUTIONS GROUP HEALTH PLAN TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012017-01-01SARAH SMITH
5012016-01-01SARAH SMITH
5012016-01-01
5012015-01-01CARL GUIDICE
5012015-01-01CARL GUIDICE
5012014-01-01THOMAS NEWMAN
5012013-01-01THOMAS NEWMAN
5012012-01-01THOMAS NEWMAN
5012011-01-01THOMAS NEWMAN
5012010-01-01THOMAS NEWMAN
5012009-01-01THOMAS NEWMAN

Plan Statistics for FORTUNE BENEFITS SOLUTIONS GROUP HEALTH PLAN TRUST

401k plan membership statisitcs for FORTUNE BENEFITS SOLUTIONS GROUP HEALTH PLAN TRUST

Measure Date Value
2017: FORTUNE BENEFITS SOLUTIONS GROUP HEALTH PLAN TRUST 2017 401k membership
Total participants, beginning-of-year2017-01-013,228
Total number of active participants reported on line 7a of the Form 55002017-01-010
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-010
2016: FORTUNE BENEFITS SOLUTIONS GROUP HEALTH PLAN TRUST 2016 401k membership
Total participants, beginning-of-year2016-01-013,997
Total number of active participants reported on line 7a of the Form 55002016-01-013,186
Number of retired or separated participants receiving benefits2016-01-0142
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-013,228
2015: FORTUNE BENEFITS SOLUTIONS GROUP HEALTH PLAN TRUST 2015 401k membership
Total participants, beginning-of-year2015-01-015,615
Total number of active participants reported on line 7a of the Form 55002015-01-013,917
Number of retired or separated participants receiving benefits2015-01-0180
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-013,997
2014: FORTUNE BENEFITS SOLUTIONS GROUP HEALTH PLAN TRUST 2014 401k membership
Total participants, beginning-of-year2014-01-012,440
Total number of active participants reported on line 7a of the Form 55002014-01-015,599
Number of retired or separated participants receiving benefits2014-01-0116
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-015,615
2013: FORTUNE BENEFITS SOLUTIONS GROUP HEALTH PLAN TRUST 2013 401k membership
Total participants, beginning-of-year2013-01-012,044
Total number of active participants reported on line 7a of the Form 55002013-01-012,440
Total of all active and inactive participants2013-01-012,440
2012: FORTUNE BENEFITS SOLUTIONS GROUP HEALTH PLAN TRUST 2012 401k membership
Total participants, beginning-of-year2012-01-011,051
Total number of active participants reported on line 7a of the Form 55002012-01-012,044
Total of all active and inactive participants2012-01-012,044
2011: FORTUNE BENEFITS SOLUTIONS GROUP HEALTH PLAN TRUST 2011 401k membership
Total participants, beginning-of-year2011-01-012,200
Total number of active participants reported on line 7a of the Form 55002011-01-011,051
Total of all active and inactive participants2011-01-011,051
2010: FORTUNE BENEFITS SOLUTIONS GROUP HEALTH PLAN TRUST 2010 401k membership
Total participants, beginning-of-year2010-01-011,398
Total number of active participants reported on line 7a of the Form 55002010-01-012,200
Number of retired or separated participants receiving benefits2010-01-0150
Total of all active and inactive participants2010-01-012,250
2009: FORTUNE BENEFITS SOLUTIONS GROUP HEALTH PLAN TRUST 2009 401k membership
Total participants, beginning-of-year2009-01-01618
Total number of active participants reported on line 7a of the Form 55002009-01-011,719
Total of all active and inactive participants2009-01-011,719

Financial Data on FORTUNE BENEFITS SOLUTIONS GROUP HEALTH PLAN TRUST

Measure Date Value
2017 : FORTUNE BENEFITS SOLUTIONS GROUP HEALTH PLAN TRUST 2017 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$179,471
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$3,542,299
Total income from all sources (including contributions)2017-12-31$2,313,677
Total of all expenses incurred2017-12-31$95,959
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$2,313,213
Value of total assets at end of year2017-12-31$184,850
Value of total assets at beginning of year2017-12-31$1,329,960
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$95,959
Total interest from all sources2017-12-31$464
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Administrative expenses professional fees incurred2017-12-31$22,816
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$25,000,000
If this is an individual account plan, was there a blackout period2017-12-31No
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2017-12-31$384,526
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2017-12-31$142,500
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2017-12-31$142,500
Administrative expenses (other) incurred2017-12-31$73,143
Total non interest bearing cash at end of year2017-12-31$184,850
Total non interest bearing cash at beginning of year2017-12-31$794,637
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$2,217,718
Value of net assets at end of year (total assets less liabilities)2017-12-31$5,379
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$-2,212,339
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2017-12-31$150,797
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2017-12-31$150,797
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2017-12-31$464
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31No
Was there a failure to transmit to the plan any participant contributions2017-12-31No
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Contributions received in cash from employer2017-12-31$2,313,213
Liabilities. Value of benefit claims payable at end of year2017-12-31$36,971
Liabilities. Value of benefit claims payable at beginning of year2017-12-31$3,399,799
Did the plan have assets held for investment2017-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
2016 : FORTUNE BENEFITS SOLUTIONS GROUP HEALTH PLAN TRUST 2016 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$3,542,299
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$8,015,800
Total income from all sources (including contributions)2016-12-31$29,664,600
Total of all expenses incurred2016-12-31$27,186,522
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$20,771,662
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$29,663,546
Value of total assets at end of year2016-12-31$1,329,960
Value of total assets at beginning of year2016-12-31$3,325,383
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$6,414,860
Total interest from all sources2016-12-31$1,054
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Administrative expenses professional fees incurred2016-12-31$171,271
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$3,000,000
If this is an individual account plan, was there a blackout period2016-12-31No
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$8,358,229
Value of other receiveables (less allowance for doubtful accounts) at end of year2016-12-31$384,526
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2016-12-31$142,500
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2016-12-31$142,500
Liabilities. Value of operating payables at end of year2016-12-31$8,297
Total non interest bearing cash at end of year2016-12-31$794,637
Total non interest bearing cash at beginning of year2016-12-31$3,175,641
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$2,478,078
Value of net assets at end of year (total assets less liabilities)2016-12-31$-2,212,339
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$-4,690,417
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2016-12-31$150,797
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2016-12-31$149,742
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2016-12-31$149,742
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2016-12-31$1,054
Expenses. Payments to insurance carriers foe the provision of benefits2016-12-31$500,062
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31No
Was there a failure to transmit to the plan any participant contributions2016-12-31No
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Contributions received in cash from employer2016-12-31$21,305,317
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$20,771,662
Contract administrator fees2016-12-31$6,243,589
Liabilities. Value of benefit claims payable at end of year2016-12-31$3,399,799
Liabilities. Value of benefit claims payable at beginning of year2016-12-31$7,873,300
Did the plan have assets held for investment2016-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31No
Opinion of an independent qualified public accountant for this plan2016-12-31Unqualified
Accountancy firm name2016-12-31INFANTE & COMPANY
Accountancy firm EIN2016-12-31592115588
2015 : FORTUNE BENEFITS SOLUTIONS GROUP HEALTH PLAN TRUST 2015 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$8,015,800
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$4,606,263
Total income from all sources (including contributions)2015-12-31$31,092,622
Total of all expenses incurred2015-12-31$32,601,691
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$26,665,816
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$31,091,577
Value of total assets at end of year2015-12-31$3,325,383
Value of total assets at beginning of year2015-12-31$1,424,915
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$5,935,875
Total interest from all sources2015-12-31$1,045
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Administrative expenses professional fees incurred2015-12-31$192,334
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$1,000,000
If this is an individual account plan, was there a blackout period2015-12-31No
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$9,139,787
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2015-12-31$142,500
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2015-12-31$142,500
Total non interest bearing cash at end of year2015-12-31$3,175,641
Total non interest bearing cash at beginning of year2015-12-31$1,101,218
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$-1,509,069
Value of net assets at end of year (total assets less liabilities)2015-12-31$-4,690,417
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$-3,181,348
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2015-12-31$149,742
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2015-12-31$148,697
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2015-12-31$148,697
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2015-12-31$1,045
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31Yes
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Contributions received in cash from employer2015-12-31$21,951,790
Employer contributions (assets) at beginning of year2015-12-31$175,000
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$26,665,816
Contract administrator fees2015-12-31$5,743,541
Liabilities. Value of benefit claims payable at end of year2015-12-31$7,873,300
Liabilities. Value of benefit claims payable at beginning of year2015-12-31$4,463,763
Did the plan have assets held for investment2015-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31No
Opinion of an independent qualified public accountant for this plan2015-12-31Unqualified
Accountancy firm name2015-12-31INFANTE & COMPANY
Accountancy firm EIN2015-12-31592115588
2014 : FORTUNE BENEFITS SOLUTIONS GROUP HEALTH PLAN TRUST 2014 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$4,606,263
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$3,070,509
Total income from all sources (including contributions)2014-12-31$19,834,544
Total of all expenses incurred2014-12-31$21,435,607
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$17,382,831
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$19,833,802
Value of total assets at end of year2014-12-31$1,424,915
Value of total assets at beginning of year2014-12-31$1,490,224
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$4,052,776
Total interest from all sources2014-12-31$742
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Administrative expenses professional fees incurred2014-12-31$44,343
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$2,000,000
If this is an individual account plan, was there a blackout period2014-12-31No
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$6,660,394
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2014-12-31$239,151
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2014-12-31$142,500
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2014-12-31$142,500
Total non interest bearing cash at end of year2014-12-31$1,101,218
Total non interest bearing cash at beginning of year2014-12-31$605,456
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net income/loss2014-12-31$-1,601,063
Value of net assets at end of year (total assets less liabilities)2014-12-31$-3,181,348
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$-1,580,285
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2014-12-31$148,697
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2014-12-31$147,955
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2014-12-31$147,955
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2014-12-31$742
Expenses. Payments to insurance carriers foe the provision of benefits2014-12-31$17,382,831
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31Yes
Was there a failure to transmit to the plan any participant contributions2014-12-31No
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Contributions received in cash from employer2014-12-31$13,173,408
Employer contributions (assets) at end of year2014-12-31$175,000
Employer contributions (assets) at beginning of year2014-12-31$497,662
Contract administrator fees2014-12-31$4,008,433
Liabilities. Value of benefit claims payable at end of year2014-12-31$4,463,763
Liabilities. Value of benefit claims payable at beginning of year2014-12-31$2,928,009
Did the plan have assets held for investment2014-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31No
Opinion of an independent qualified public accountant for this plan2014-12-31Unqualified
Accountancy firm name2014-12-31INFANTE & COMPANY
Accountancy firm EIN2014-12-31592115588
2013 : FORTUNE BENEFITS SOLUTIONS GROUP HEALTH PLAN TRUST 2013 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$3,070,509
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$1,948,261
Total income from all sources (including contributions)2013-12-31$14,188,178
Total of all expenses incurred2013-12-31$14,244,754
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$11,784,681
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$14,187,438
Value of total assets at end of year2013-12-31$1,490,224
Value of total assets at beginning of year2013-12-31$424,552
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$2,460,073
Total interest from all sources2013-12-31$740
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Administrative expenses professional fees incurred2013-12-31$57,030
Was this plan covered by a fidelity bond2013-12-31No
If this is an individual account plan, was there a blackout period2013-12-31No
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Contributions received from participants2013-12-31$4,733,063
Value of other receiveables (less allowance for doubtful accounts) at end of year2013-12-31$239,151
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2013-12-31$60,750
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2013-12-31$142,500
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2013-12-31$142,500
Total non interest bearing cash at end of year2013-12-31$605,456
Total non interest bearing cash at beginning of year2013-12-31$196,362
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Value of net income/loss2013-12-31$-56,576
Value of net assets at end of year (total assets less liabilities)2013-12-31$-1,580,285
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$-1,523,709
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2013-12-31$147,955
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2013-12-31$147,215
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2013-12-31$147,215
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2013-12-31$740
Expenses. Payments to insurance carriers foe the provision of benefits2013-12-31$11,784,681
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31Yes
Was there a failure to transmit to the plan any participant contributions2013-12-31No
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Contributions received in cash from employer2013-12-31$9,454,375
Employer contributions (assets) at end of year2013-12-31$497,662
Employer contributions (assets) at beginning of year2013-12-31$20,225
Contract administrator fees2013-12-31$2,403,043
Liabilities. Value of benefit claims payable at end of year2013-12-31$2,928,009
Liabilities. Value of benefit claims payable at beginning of year2013-12-31$1,805,761
Did the plan have assets held for investment2013-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31No
Opinion of an independent qualified public accountant for this plan2013-12-31Unqualified
Accountancy firm name2013-12-31INFANTE & COMPANY
Accountancy firm EIN2013-12-31592115588
2012 : FORTUNE BENEFITS SOLUTIONS GROUP HEALTH PLAN TRUST 2012 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$1,948,261
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$779,802
Total income from all sources (including contributions)2012-12-31$10,852,282
Total of all expenses incurred2012-12-31$12,214,031
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$10,085,232
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$10,851,179
Value of total assets at end of year2012-12-31$424,552
Value of total assets at beginning of year2012-12-31$617,842
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$2,128,799
Total interest from all sources2012-12-31$1,103
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Administrative expenses professional fees incurred2012-12-31$22,981
Was this plan covered by a fidelity bond2012-12-31No
If this is an individual account plan, was there a blackout period2012-12-31No
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Contributions received from participants2012-12-31$3,298,927
Value of other receiveables (less allowance for doubtful accounts) at end of year2012-12-31$60,750
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2012-12-31$142,500
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2012-12-31$202,068
Total non interest bearing cash at end of year2012-12-31$196,362
Total non interest bearing cash at beginning of year2012-12-31$471,730
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Value of net income/loss2012-12-31$-1,361,749
Value of net assets at end of year (total assets less liabilities)2012-12-31$-1,523,709
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$-161,960
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
Were any leases to which the plan was party in default or uncollectible2012-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2012-12-31$147,215
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2012-12-31$146,112
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2012-12-31$146,112
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2012-12-31$1,103
Expenses. Payments to insurance carriers foe the provision of benefits2012-12-31$10,085,232
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31Yes
Was there a failure to transmit to the plan any participant contributions2012-12-31No
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Contributions received in cash from employer2012-12-31$7,552,252
Employer contributions (assets) at end of year2012-12-31$20,225
Contract administrator fees2012-12-31$2,105,818
Liabilities. Value of benefit claims payable at end of year2012-12-31$1,805,761
Liabilities. Value of benefit claims payable at beginning of year2012-12-31$577,734
Did the plan have assets held for investment2012-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-12-31No
Opinion of an independent qualified public accountant for this plan2012-12-31Unqualified
Accountancy firm name2012-12-31INFANTE & COMPANY
Accountancy firm EIN2012-12-31592115588
2011 : FORTUNE BENEFITS SOLUTIONS GROUP HEALTH PLAN TRUST 2011 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$779,802
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$863,391
Total income from all sources (including contributions)2011-12-31$7,072,029
Total of all expenses incurred2011-12-31$6,654,790
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$5,388,526
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$7,070,575
Value of total assets at end of year2011-12-31$617,842
Value of total assets at beginning of year2011-12-31$284,192
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$1,266,264
Total interest from all sources2011-12-31$1,454
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Administrative expenses professional fees incurred2011-12-31$12,341
Was this plan covered by a fidelity bond2011-12-31No
If this is an individual account plan, was there a blackout period2011-12-31No
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$2,309,568
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2011-12-31$202,068
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2011-12-31$287,793
Administrative expenses (other) incurred2011-12-31$4,000
Total non interest bearing cash at end of year2011-12-31$471,730
Total non interest bearing cash at beginning of year2011-12-31$118,855
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$417,239
Value of net assets at end of year (total assets less liabilities)2011-12-31$-161,960
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$-579,199
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2011-12-31$146,112
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2011-12-31$144,658
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2011-12-31$144,658
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2011-12-31$1,454
Expenses. Payments to insurance carriers foe the provision of benefits2011-12-31$5,388,526
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31Yes
Was there a failure to transmit to the plan any participant contributions2011-12-31No
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Contributions received in cash from employer2011-12-31$4,761,007
Employer contributions (assets) at beginning of year2011-12-31$20,679
Contract administrator fees2011-12-31$1,249,923
Liabilities. Value of benefit claims payable at end of year2011-12-31$577,734
Liabilities. Value of benefit claims payable at beginning of year2011-12-31$575,598
Did the plan have assets held for investment2011-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31No
Opinion of an independent qualified public accountant for this plan2011-12-31Unqualified
Accountancy firm name2011-12-31INFANTE & COMPANY
Accountancy firm EIN2011-12-31592115588
2010 : FORTUNE BENEFITS SOLUTIONS GROUP HEALTH PLAN TRUST 2010 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$863,391
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$1,137,741
Total income from all sources (including contributions)2010-12-31$8,578,322
Total of all expenses incurred2010-12-31$8,940,625
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$7,146,877
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$8,576,040
Value of total assets at end of year2010-12-31$284,192
Value of total assets at beginning of year2010-12-31$920,845
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$1,793,748
Total interest from all sources2010-12-31$2,282
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Administrative expenses professional fees incurred2010-12-31$21,106
Was this plan covered by a fidelity bond2010-12-31No
If this is an individual account plan, was there a blackout period2010-12-31No
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$1,686,359
Income. Received or receivable in cash from other sources (including rollovers)2010-12-31$831,813
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2010-12-31$287,793
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2010-12-31$142,500
Total non interest bearing cash at end of year2010-12-31$118,855
Total non interest bearing cash at beginning of year2010-12-31$653,085
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$-362,303
Value of net assets at end of year (total assets less liabilities)2010-12-31$-579,199
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$-216,896
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2010-12-31$144,658
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2010-12-31$142,377
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2010-12-31$142,377
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2010-12-31$2,282
Expenses. Payments to insurance carriers foe the provision of benefits2010-12-31$7,146,877
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31Yes
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Contributions received in cash from employer2010-12-31$6,057,868
Employer contributions (assets) at end of year2010-12-31$20,679
Employer contributions (assets) at beginning of year2010-12-31$125,383
Contract administrator fees2010-12-31$1,772,642
Liabilities. Value of benefit claims payable at end of year2010-12-31$575,598
Liabilities. Value of benefit claims payable at beginning of year2010-12-31$995,241
Did the plan have assets held for investment2010-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31No
Opinion of an independent qualified public accountant for this plan2010-12-31Unqualified
Accountancy firm name2010-12-31INFANTE & COMPANY
Accountancy firm EIN2010-12-31592115588
2008 : FORTUNE BENEFITS SOLUTIONS GROUP HEALTH PLAN TRUST 2008 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2008-12-31$536,013
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2008-12-31$143,644
Total income from all sources (including contributions)2008-12-31$1,651,296
Total of all expenses incurred2008-12-31$1,457,764
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2008-12-31$1,051,750
Total contributions o plan (from employers,participants, others, non cash contrinutions)2008-12-31$1,643,251
Value of total assets at end of year2008-12-31$723,706
Value of total assets at beginning of year2008-12-31$137,805
Total of administrative expenses incurred including professional, contract, advisory and management fees2008-12-31$406,014
Total interest from all sources2008-12-31$8,045
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2008-12-31No
Administrative expenses professional fees incurred2008-12-31$4,556
If this is an individual account plan, was there a blackout period2008-12-31No
Were there any nonexempt tranactions with any party-in-interest2008-12-31No
Contributions received from participants2008-12-31$522,865
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2008-12-31$142,500
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2008-12-31$142,500
Administrative expenses (other) incurred2008-12-31$3,054
Total non interest bearing cash at end of year2008-12-31$564,545
Total non interest bearing cash at beginning of year2008-12-31$2,805
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2008-12-31No
Value of net income/loss2008-12-31$193,532
Value of net assets at end of year (total assets less liabilities)2008-12-31$187,693
Value of net assets at beginning of year (total assets less liabilities)2008-12-31$-5,839
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2008-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2008-12-31No
Were any leases to which the plan was party in default or uncollectible2008-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2008-12-31$140,949
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2008-12-31$135,000
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2008-12-31$135,000
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2008-12-31$8,045
Expenses. Payments to insurance carriers foe the provision of benefits2008-12-31$1,051,750
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2008-12-31Yes
Was there a failure to transmit to the plan any participant contributions2008-12-31No
Has the plan failed to provide any benefit when due under the plan2008-12-31No
Contributions received in cash from employer2008-12-31$1,120,386
Employer contributions (assets) at end of year2008-12-31$18,212
Contract administrator fees2008-12-31$398,404
Liabilities. Value of benefit claims payable at end of year2008-12-31$393,513
Liabilities. Value of benefit claims payable at beginning of year2008-12-31$1,144
Did the plan have assets held for investment2008-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2008-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2008-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2008-12-31No
Opinion of an independent qualified public accountant for this plan2008-12-31Unqualified
Accountancy firm name2008-12-31INFANTE & COMPANY
Accountancy firm EIN2008-12-31592115588
2007 : FORTUNE BENEFITS SOLUTIONS GROUP HEALTH PLAN TRUST 2007 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2007-12-31$143,644
Total income from all sources (including contributions)2007-12-31$3,421
Total of all expenses incurred2007-12-31$9,260
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2007-12-31$1,144
Total contributions o plan (from employers,participants, others, non cash contrinutions)2007-12-31$3,421
Value of total assets at end of year2007-12-31$137,805
Total of administrative expenses incurred including professional, contract, advisory and management fees2007-12-31$8,116
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2007-12-31No
Was this plan covered by a fidelity bond2007-12-31No
If this is an individual account plan, was there a blackout period2007-12-31No
Were there any nonexempt tranactions with any party-in-interest2007-12-31No
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2007-12-31$142,500
Administrative expenses (other) incurred2007-12-31$7,566
Total non interest bearing cash at end of year2007-12-31$2,805
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2007-12-31No
Value of net income/loss2007-12-31$-5,839
Value of net assets at end of year (total assets less liabilities)2007-12-31$-5,839
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2007-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2007-12-31No
Were any leases to which the plan was party in default or uncollectible2007-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2007-12-31$135,000
Expenses. Payments to insurance carriers foe the provision of benefits2007-12-31$1,144
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2007-12-31Yes
Was there a failure to transmit to the plan any participant contributions2007-12-31No
Has the plan failed to provide any benefit when due under the plan2007-12-31No
Contributions received in cash from employer2007-12-31$3,421
Contract administrator fees2007-12-31$550
Liabilities. Value of benefit claims payable at end of year2007-12-31$1,144
Did the plan have assets held for investment2007-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2007-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2007-12-31No

Form 5500 Responses for FORTUNE BENEFITS SOLUTIONS GROUP HEALTH PLAN TRUST

2017: FORTUNE BENEFITS SOLUTIONS GROUP HEALTH PLAN TRUST 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – General assets of the sponsorYes
2016: FORTUNE BENEFITS SOLUTIONS GROUP HEALTH PLAN TRUST 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedYes
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – General assets of the sponsorYes
2015: FORTUNE BENEFITS SOLUTIONS GROUP HEALTH PLAN TRUST 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedYes
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – General assets of the sponsorYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – General assets of the sponsorYes
2014: FORTUNE BENEFITS SOLUTIONS GROUP HEALTH PLAN TRUST 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – General assets of the sponsorYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – General assets of the sponsorYes
2013: FORTUNE BENEFITS SOLUTIONS GROUP HEALTH PLAN TRUST 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – General assets of the sponsorYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – General assets of the sponsorYes
2012: FORTUNE BENEFITS SOLUTIONS GROUP HEALTH PLAN TRUST 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – General assets of the sponsorYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – General assets of the sponsorYes
2011: FORTUNE BENEFITS SOLUTIONS GROUP HEALTH PLAN TRUST 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – General assets of the sponsorYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – General assets of the sponsorYes
2010: FORTUNE BENEFITS SOLUTIONS GROUP HEALTH PLAN TRUST 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedYes
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan funding arrangement – General assets of the sponsorYes
2010-01-01Plan benefit arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – General assets of the sponsorYes
2009: FORTUNE BENEFITS SOLUTIONS GROUP HEALTH PLAN TRUST 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – General assets of the sponsorYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number001006277900000
Policy instance 4
Insurance contract or identification number001006277900000
Number of Individuals Covered53
Insurance policy start date2017-01-01
Insurance policy end date2017-06-30
Total amount of commissions paid to insurance brokerUSD $362
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,615
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $362
Insurance broker organization code?3
Insurance broker nameREGIONS INSURANCE INC
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number001006277800000
Policy instance 3
Insurance contract or identification number001006277800000
Number of Individuals Covered53
Insurance policy start date2017-01-01
Insurance policy end date2017-06-30
Total amount of commissions paid to insurance brokerUSD $258
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD & D
Welfare Benefit Premiums Paid to CarrierUSD $2,575
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $258
Insurance broker organization code?3
Insurance broker nameREGIONS INSURANCE INC.
BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 95089 )
Policy contract number64885
Policy instance 2
Insurance contract or identification number64885
Number of Individuals Covered629
Insurance policy start date2016-09-01
Insurance policy end date2017-06-30
Total amount of commissions paid to insurance brokerUSD $83,985
Other welfare benefits providedCOMPREHENSIVE
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $83,985
Insurance broker nameCOMPASS CONSULTING GROUP
BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 )
Policy contract number64885
Policy instance 1
Insurance contract or identification number64885
Number of Individuals Covered1218
Insurance policy start date2016-09-01
Insurance policy end date2017-06-30
Total amount of commissions paid to insurance brokerUSD $172,047
Other welfare benefits providedCOMPREHENSIVE
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $172,047
Insurance broker nameCOMPASS CONSULTING GROUP
SIRIUS AMERICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 38776 )
Policy contract numberIAT-SA0097
Policy instance 3
Insurance contract or identification numberIAT-SA0097
Number of Individuals Covered2263
Insurance policy start date2014-09-01
Insurance policy end date2015-08-31
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 95089 )
Policy contract number64885
Policy instance 2
Insurance contract or identification number64885
Number of Individuals Covered831
Insurance policy start date2014-09-01
Insurance policy end date2015-08-31
Total amount of commissions paid to insurance brokerUSD $138,600
Other welfare benefits providedCOMPREHENSIVE
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 )
Policy contract number64885
Policy instance 1
Insurance contract or identification number64885
Number of Individuals Covered888
Insurance policy start date2014-09-01
Insurance policy end date2015-08-31
Total amount of commissions paid to insurance brokerUSD $160,215
Other welfare benefits providedCOMPREHENSIVE
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 95089 )
Policy contract number64885
Policy instance 2
Insurance contract or identification number64885
Number of Individuals Covered748
Insurance policy start date2013-09-01
Insurance policy end date2014-08-31
Total amount of commissions paid to insurance brokerUSD $124,740
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 $124,740
Insurance broker organization code?3
Insurance broker nameFORTUNE INSURANCE SOLUTIONS LLC
GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 )
Policy contract numberIAT-G0562
Policy instance 3
Insurance contract or identification numberIAT-G0562
Number of Individuals Covered1624
Insurance policy start date2013-09-01
Insurance policy end date2014-08-31
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 )
Policy contract number64885
Policy instance 1
Insurance contract or identification number64885
Number of Individuals Covered748
Insurance policy start date2013-09-01
Insurance policy end date2014-08-31
Total amount of commissions paid to insurance brokerUSD $114,690
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 $114,690
Insurance broker organization code?3
Insurance broker nameFORTUNE INSURANCE SOLUTIONS LLC
GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 )
Policy contract numberIAT-G0562
Policy instance 3
Insurance contract or identification numberIAT-G0562
Number of Individuals Covered707
Insurance policy start date2012-09-01
Insurance policy end date2013-08-31
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 95089 )
Policy contract number64885
Policy instance 2
Insurance contract or identification number64885
Number of Individuals Covered556
Insurance policy start date2012-09-01
Insurance policy end date2013-08-31
Total amount of commissions paid to insurance brokerUSD $89,790
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 $89,790
Additional information about fees paid to insurance brokerCOMMISSIONS
Insurance broker nameFORTUNE INSURANCE SOLUTIONS, LLC 13
BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 )
Policy contract number64885
Policy instance 1
Insurance contract or identification number64885
Number of Individuals Covered575
Insurance policy start date2012-09-01
Insurance policy end date2013-08-31
Total amount of commissions paid to insurance brokerUSD $82,170
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 $82,170
Insurance broker nameFORTUNE INSURANCE SOLUTIONS, LLC
BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 95089 )
Policy contract number64885
Policy instance 2
Insurance contract or identification number64885
Number of Individuals Covered195
Insurance policy start date2011-09-01
Insurance policy end date2012-08-31
Total amount of commissions paid to insurance brokerUSD $56,198
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 $38,649
Additional information about fees paid to insurance brokerCOMMISSIONS
Insurance broker nameFORTUNE INSURANCE SOLUTIONS, LLC 13
GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 )
Policy contract numberIAT-G0562
Policy instance 3
Insurance contract or identification numberIAT-G0562
Number of Individuals Covered694
Insurance policy start date2011-09-01
Insurance policy end date2012-08-31
Welfare Benefit Premiums Paid to CarrierUSD $249,041
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 )
Policy contract number64885
Policy instance 1
Insurance contract or identification number64885
Number of Individuals Covered441
Insurance policy start date2011-09-01
Insurance policy end date2012-08-31
Total amount of commissions paid to insurance brokerUSD $72,700
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 $52,851
Additional information about fees paid to insurance brokerCOMMISSIONS
Insurance broker nameFORTUNE INSURANCE SOLUTIONS, LLC
BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 )
Policy contract number64885
Policy instance 1
Insurance contract or identification number64885
Number of Individuals Covered348
Insurance policy start date2010-09-01
Insurance policy end date2011-08-31
Total amount of commissions paid to insurance brokerUSD $62,381
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 95089 )
Policy contract number64885
Policy instance 2
Insurance contract or identification number64885
Number of Individuals Covered195
Insurance policy start date2010-09-01
Insurance policy end date2011-08-31
Total amount of commissions paid to insurance brokerUSD $20,299
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 )
Policy contract number64885
Policy instance 1
Insurance contract or identification number64885
Number of Individuals Covered887
Insurance policy start date2010-01-01
Insurance policy end date2010-08-31
Total amount of commissions paid to insurance brokerUSD $124,155
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 )
Policy contract number64885
Policy instance 1
Insurance contract or identification number64885
Number of Individuals Covered526
Insurance policy start date2008-01-01
Insurance policy end date2008-12-31
Total amount of fees paid to insurance companyUSD $46,260
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 $46,260
Insurance broker organization code?3
Insurance broker nameFIRST COAST PREMIER GROUP, INC.
BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 )
Policy contract number64885
Policy instance 1
Insurance contract or identification number64885
Number of Individuals Covered5
Insurance policy start date2007-12-01
Insurance policy end date2007-12-31
Total amount of commissions paid to insurance brokerUSD $3,682
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,144
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,682
Insurance broker organization code?3
Insurance broker nameFIRST COAST PREMIER

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