Insurance contract or identification number | G00620721 |
Number of Individuals Covered | 126 |
Insurance policy start date | 2020-12-01 |
Insurance policy end date | 2021-11-30 |
Total amount of commissions paid to insurance broker | USD $7,298 |
Total amount of fees paid to insurance company | USD $2,487 |
Life Insurance Welfare Benefit | Yes |
Temporary Disability Insurance Welfare Benefit | Yes |
Long Term Disability Insurance Welfare Benefit | Yes |
Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT |
Welfare Benefit Premiums Paid to Carrier | USD $57,616 |
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
Commission paid to Insurance Broker | USD $7,298 |
Amount paid for insurance broker fees | 2487 |
Additional information about fees paid to insurance broker | OTHER COMPENSATION |
Insurance broker organization code? | 3 |