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LOGICORE CORPORATION HEALTH & WELFARE PLAN 401k Plan overview

Plan NameLOGICORE CORPORATION HEALTH & WELFARE PLAN
Plan identification number 501

LOGICORE CORPORATION HEALTH & WELFARE PLAN Benefits

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

401k Sponsoring company profile

LOGICORE CORPORATION has sponsored the creation of one or more 401k plans.

Company Name:LOGICORE CORPORATION
Employer identification number (EIN):320036146
NAIC Classification:541519
NAIC Description:Other Computer Related Services

Additional information about LOGICORE CORPORATION

Jurisdiction of Incorporation: Alabama Secretary of State
Incorporation Date: 2002-10-25
Company Identification Number: 225-761
Legal Registered Office Address: 360C QUALITY CIRCLE SUITE 350 HUNTSVILLE,


United States of America (USA)
35806

More information about LOGICORE CORPORATION

Form 5500 Filing Information

Submission information for form 5500 for 401k plan LOGICORE CORPORATION HEALTH & WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01
5012021-01-01
5012020-01-01
5012019-01-01
5012018-01-01
5012017-01-01MIRANDA BOULDIN
5012016-01-01MIRANDA BOULDIN
5012015-01-01MIRANDA BOULDIN
5012014-01-01MIRANDA BOULDIN
5012013-01-01MIRANDA BOULDIN

Plan Statistics for LOGICORE CORPORATION HEALTH & WELFARE PLAN

401k plan membership statisitcs for LOGICORE CORPORATION HEALTH & WELFARE PLAN

Measure Date Value
2022: LOGICORE CORPORATION HEALTH & WELFARE PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-0132
Total number of active participants reported on line 7a of the Form 55002022-01-0117
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-0117
2021: LOGICORE CORPORATION HEALTH & WELFARE PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-0139
Total number of active participants reported on line 7a of the Form 55002021-01-0132
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-0132
2020: LOGICORE CORPORATION HEALTH & WELFARE PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-0156
Total number of active participants reported on line 7a of the Form 55002020-01-0139
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-0139
2019: LOGICORE CORPORATION HEALTH & WELFARE PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01253
Total number of active participants reported on line 7a of the Form 55002019-01-0156
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-0156
2018: LOGICORE CORPORATION HEALTH & WELFARE PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01233
Total number of active participants reported on line 7a of the Form 55002018-01-01253
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-01253
2017: LOGICORE CORPORATION HEALTH & WELFARE PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01269
Total number of active participants reported on line 7a of the Form 55002017-01-01233
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 participants2017-01-01233
2016: LOGICORE CORPORATION HEALTH & WELFARE PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01350
Total number of active participants reported on line 7a of the Form 55002016-01-01269
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-01269
2015: LOGICORE CORPORATION HEALTH & WELFARE PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01225
Total number of active participants reported on line 7a of the Form 55002015-01-01350
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-01350
2014: LOGICORE CORPORATION HEALTH & WELFARE PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01233
Total number of active participants reported on line 7a of the Form 55002014-01-01225
Number of retired or separated participants receiving benefits2014-01-015
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-01230
2013: LOGICORE CORPORATION HEALTH & WELFARE PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01233
Total number of active participants reported on line 7a of the Form 55002013-01-01233
Total of all active and inactive participants2013-01-01233

Form 5500 Responses for LOGICORE CORPORATION HEALTH & WELFARE PLAN

2022: LOGICORE CORPORATION HEALTH & WELFARE PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – InsuranceYes
2021: LOGICORE CORPORATION HEALTH & WELFARE PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – InsuranceYes
2020: LOGICORE CORPORATION HEALTH & WELFARE PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – InsuranceYes
2019: LOGICORE CORPORATION HEALTH & WELFARE PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: LOGICORE CORPORATION HEALTH & WELFARE PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: LOGICORE CORPORATION HEALTH & WELFARE PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: LOGICORE CORPORATION HEALTH & WELFARE PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: LOGICORE CORPORATION HEALTH & WELFARE PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: LOGICORE CORPORATION HEALTH & WELFARE PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: LOGICORE CORPORATION HEALTH & WELFARE PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01First time form 5500 has been submittedYes
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
Policy contract number18220
Policy instance 7
Insurance contract or identification number18220
Number of Individuals Covered17
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $900
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $9,003
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $900
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGUC0AYDY
Policy instance 1
Insurance contract or identification numberGUC0AYDY
Number of Individuals Covered8
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $405
Total amount of fees paid to insurance companyUSD $251
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,048
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $405
Amount paid for insurance broker fees251
Additional information about fees paid to insurance brokerAGENT OR BROKER OF RECORD OTHER COMPENSATION
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0AYDY
Policy instance 2
Insurance contract or identification numberGLUG0AYDY
Number of Individuals Covered17
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $411
Total amount of fees paid to insurance companyUSD $287
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,107
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $411
Amount paid for insurance broker fees287
Additional information about fees paid to insurance brokerAGENT OR BROKER OF RECORD OTHER COMPENSATION
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGUPR0AYDY
Policy instance 3
Insurance contract or identification numberGUPR0AYDY
Number of Individuals Covered4
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $784
Total amount of fees paid to insurance companyUSD $469
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,842
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $784
Amount paid for insurance broker fees469
Additional information about fees paid to insurance brokerAGENT OR BROKER OF RECORD OTHER COMPENSATION
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGVTL0AYDY
Policy instance 4
Insurance contract or identification numberGVTL0AYDY
Number of Individuals Covered4
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $624
Total amount of fees paid to insurance companyUSD $623
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D VOLUNTARY
Welfare Benefit Premiums Paid to CarrierUSD $6,237
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $624
Amount paid for insurance broker fees623
Additional information about fees paid to insurance brokerAGENT OR BROKER OF RECORD OTHER COMPENSATION
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF ALABAMA (National Association of Insurance Commissioners NAIC id number: 55433 )
Policy contract number52811
Policy instance 5
Insurance contract or identification number52811
Number of Individuals Covered14
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Health Insurance Welfare BenefitYes
Other welfare benefits providedBABY YOURSELF, AIRMED, EXPANDED PSY
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number610331
Policy instance 6
Insurance contract or identification number610331
Number of Individuals Covered5
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $64
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $64
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGUC0AYDY
Policy instance 1
Insurance contract or identification numberGUC0AYDY
Number of Individuals Covered8
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $405
Total amount of fees paid to insurance companyUSD $251
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,048
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $405
Amount paid for insurance broker fees251
Additional information about fees paid to insurance brokerAGENT OR BROKER OF RECORD OTHER COMPENSATION
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0AYDY
Policy instance 2
Insurance contract or identification numberGLUG0AYDY
Number of Individuals Covered17
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $411
Total amount of fees paid to insurance companyUSD $287
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,107
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $411
Amount paid for insurance broker fees287
Additional information about fees paid to insurance brokerAGENT OR BROKER OF RECORD OTHER COMPENSATION
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGUPR0AYDY
Policy instance 3
Insurance contract or identification numberGUPR0AYDY
Number of Individuals Covered4
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $784
Total amount of fees paid to insurance companyUSD $469
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,842
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $784
Amount paid for insurance broker fees469
Additional information about fees paid to insurance brokerAGENT OR BROKER OF RECORD OTHER COMPENSATION
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGVTL0AYDY
Policy instance 4
Insurance contract or identification numberGVTL0AYDY
Number of Individuals Covered4
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $624
Total amount of fees paid to insurance companyUSD $623
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,237
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $624
Amount paid for insurance broker fees623
Additional information about fees paid to insurance brokerAGENT OR BROKER OF RECORD OTHER COMPENSATION
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF ALABAMA (National Association of Insurance Commissioners NAIC id number: 55433 )
Policy contract number52811
Policy instance 5
Insurance contract or identification number52811
Number of Individuals Covered26
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Health Insurance Welfare BenefitYes
Other welfare benefits providedBABY YOURSELF, AIRMED, EXPANDED PSY
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number610331
Policy instance 6
Insurance contract or identification number610331
Number of Individuals Covered12
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $143
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $143
Insurance broker organization code?3
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
Policy contract number18220
Policy instance 7
Insurance contract or identification number18220
Number of Individuals Covered32
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $1,658
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $16,580
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,658
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGUC0AYDY
Policy instance 1
Insurance contract or identification numberGUC0AYDY
Number of Individuals Covered9
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $418
Total amount of fees paid to insurance companyUSD $907
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,176
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $418
Amount paid for insurance broker fees907
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0AYDY
Policy instance 2
Insurance contract or identification numberGLUG0AYDY
Number of Individuals Covered28
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $478
Total amount of fees paid to insurance companyUSD $843
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,775
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $478
Amount paid for insurance broker fees843
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGUPR0AYDY
Policy instance 3
Insurance contract or identification numberGUPR0AYDY
Number of Individuals Covered8
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $782
Total amount of fees paid to insurance companyUSD $1,351
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,823
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $782
Amount paid for insurance broker fees1351
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGVTL0AYDY
Policy instance 4
Insurance contract or identification numberGVTL0AYDY
Number of Individuals Covered9
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $1,038
Total amount of fees paid to insurance companyUSD $1,379
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $10,381
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,038
Amount paid for insurance broker fees1379
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF ALABAMA (National Association of Insurance Commissioners NAIC id number: 55433 )
Policy contract number52811
Policy instance 5
Insurance contract or identification number52811
Number of Individuals Covered28
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Health Insurance Welfare BenefitYes
Other welfare benefits providedBABY YOURSELF, AIRMED, EXPANDED PSY
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number610331
Policy instance 6
Insurance contract or identification number610331
Number of Individuals Covered18
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $166
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $166
Insurance broker organization code?3
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
Policy contract number18220
Policy instance 7
Insurance contract or identification number18220
Number of Individuals Covered39
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $1,780
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $16,485
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,780
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGUC0AYDY
Policy instance 1
Insurance contract or identification numberGUC0AYDY
Number of Individuals Covered11
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $1,511
Total amount of fees paid to insurance companyUSD $1,210
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $15,109
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,511
Amount paid for insurance broker fees1210
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0AYDY
Policy instance 2
Insurance contract or identification numberGLUG0AYDY
Number of Individuals Covered35
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $1,404
Total amount of fees paid to insurance companyUSD $1,159
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $14,044
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,404
Amount paid for insurance broker fees1159
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGUPR0AYDY
Policy instance 3
Insurance contract or identification numberGUPR0AYDY
Number of Individuals Covered10
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $2,252
Total amount of fees paid to insurance companyUSD $1,615
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $22,516
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,252
Amount paid for insurance broker fees1615
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGVTL0AYDY
Policy instance 4
Insurance contract or identification numberGVTL0AYDY
Number of Individuals Covered12
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $2,299
Total amount of fees paid to insurance companyUSD $1,658
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $22,990
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,299
Amount paid for insurance broker fees1658
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF ALABAMA (National Association of Insurance Commissioners NAIC id number: 55433 )
Policy contract number52811
Policy instance 5
Insurance contract or identification number52811
Number of Individuals Covered37
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Health Insurance Welfare BenefitYes
Other welfare benefits providedC-PLUS, BABY YOURSELF, AIRMED
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number610331
Policy instance 6
Insurance contract or identification number610331
Number of Individuals Covered23
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $455
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $455
Insurance broker organization code?3
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
Policy contract number18220
Policy instance 7
Insurance contract or identification number18220
Number of Individuals Covered56
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $5,193
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $51,931
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,193
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGUPR0AYDY
Policy instance 3
Insurance contract or identification numberGUPR0AYDY
Number of Individuals Covered37
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $3,196
Total amount of fees paid to insurance companyUSD $1,168
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $31,953
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,676
Insurance broker organization code?3
Amount paid for insurance broker fees1168
Insurance broker nameJ SMITH LANIER
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGVTL0AYDY
Policy instance 4
Insurance contract or identification numberGVTL0AYDY
Number of Individuals Covered58
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $3,456
Total amount of fees paid to insurance companyUSD $1,518
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $34,566
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,866
Insurance broker organization code?3
Amount paid for insurance broker fees1518
Insurance broker nameJ SMITH LANIER
BLUE CROSS BLUE SHIELD OF ALABAMA (National Association of Insurance Commissioners NAIC id number: 55433 )
Policy contract number52811
Policy instance 5
Insurance contract or identification number52811
Number of Individuals Covered123
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Health Insurance Welfare BenefitYes
Other welfare benefits providedEPS, BABY YOURSELF, AIRMED
Welfare Benefit Premiums Paid to CarrierUSD $5,175
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number610331
Policy instance 6
Insurance contract or identification number610331
Number of Individuals Covered106
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $1,055
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $587
Insurance broker organization code?3
Insurance broker nameMARSH & MCLENNAN- J SMISH HUNTSVILL
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
Policy contract number18220
Policy instance 7
Insurance contract or identification number18220
Number of Individuals Covered233
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $10,917
Dental 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 $9,950
Insurance broker organization code?3
Insurance broker nameJ SMITH LANIER
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGUC0AYDY
Policy instance 1
Insurance contract or identification numberGUC0AYDY
Number of Individuals Covered56
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $2,409
Total amount of fees paid to insurance companyUSD $1,073
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $24,084
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,013
Insurance broker organization code?3
Amount paid for insurance broker fees1073
Insurance broker nameJ SMITH LANIER
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0AYDY
Policy instance 2
Insurance contract or identification numberGLUG0AYDY
Number of Individuals Covered159
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $2,528
Total amount of fees paid to insurance companyUSD $990
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $25,275
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,099
Insurance broker organization code?3
Amount paid for insurance broker fees990
Insurance broker nameJ SMITH LANIER
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number06608
Policy instance 3
Insurance contract or identification number06608
Number of Individuals Covered91
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Other welfare benefits providedVOLUNTARY AD&D
Welfare Benefit Premiums Paid to CarrierUSD $1,329
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITED CONCORDIA DENTAL CORPORATION OF ALABAMA (National Association of Insurance Commissioners NAIC id number: 47038 )
Policy contract number907744-000
Policy instance 13
Insurance contract or identification number907744-000
Number of Individuals Covered350
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $11,250
Dental 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 $11,250
Insurance broker organization code?3
Insurance broker nameJ SMITH LANIER
HUMANA (National Association of Insurance Commissioners NAIC id number: 70580 )
Policy contract number610331
Policy instance 12
Insurance contract or identification number610331
Number of Individuals Covered150
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $959
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $959
Insurance broker organization code?3
Insurance broker nameJ SMITH LANIER & CO OF HUNTSVILLE
BLUE CROSS BLUE SHIELD OF ALABAMA (National Association of Insurance Commissioners NAIC id number: 55433 )
Policy contract number52811
Policy instance 11
Insurance contract or identification number52811
Number of Individuals Covered179
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Health Insurance Welfare BenefitYes
Other welfare benefits providedEPS, BABY YOURSELF, AIRMED
Welfare Benefit Premiums Paid to CarrierUSD $7,062
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number06608
Policy instance 1
Insurance contract or identification number06608
Number of Individuals Covered87
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $69,942
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number06608
Policy instance 2
Insurance contract or identification number06608
Number of Individuals Covered74
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $26,261
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number06608
Policy instance 4
Insurance contract or identification number06608
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,490
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number06608
Policy instance 5
Insurance contract or identification number06608
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $447
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number06608
Policy instance 6
Insurance contract or identification number06608
Number of Individuals Covered44
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $28,255
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number06608
Policy instance 7
Insurance contract or identification number06608
Number of Individuals Covered87
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $10,159
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number06608
Policy instance 8
Insurance contract or identification number06608
Number of Individuals Covered208
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $27,410
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number06608
Policy instance 9
Insurance contract or identification number06608
Number of Individuals Covered208
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $23,417
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number06608
Policy instance 10
Insurance contract or identification number06608
Number of Individuals Covered208
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $12,724
Total amount of fees paid to insurance companyUSD $79
Other welfare benefits providedBASIC AD&D
Welfare Benefit Premiums Paid to CarrierUSD $3,993
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,724
Insurance broker organization code?3
Amount paid for insurance broker fees79
Insurance broker nameAXA ASSISTANCE, USA
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number06608
Policy instance 5
Insurance contract or identification number06608
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $470
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number06608
Policy instance 4
Insurance contract or identification number06608
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,025
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number06608
Policy instance 3
Insurance contract or identification number06608
Number of Individuals Covered93
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Other welfare benefits providedVOLUNTARY AD&D
Welfare Benefit Premiums Paid to CarrierUSD $1,527
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number06608
Policy instance 2
Insurance contract or identification number06608
Number of Individuals Covered84
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $27,678
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number06608
Policy instance 1
Insurance contract or identification number06608
Number of Individuals Covered84
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $38,639
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number06608
Policy instance 7
Insurance contract or identification number06608
Number of Individuals Covered1
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $12
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number06608
Policy instance 8
Insurance contract or identification number06608
Number of Individuals Covered225
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $27,511
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number06608
Policy instance 6
Insurance contract or identification number06608
Number of Individuals Covered53
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,927
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
Policy contract number16232
Policy instance 13
Insurance contract or identification number16232
Number of Individuals Covered173
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $12,163
Dental 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 $12,163
Insurance broker organization code?3
Insurance broker nameJ SMITH LANIER
HUMANA (National Association of Insurance Commissioners NAIC id number: 70580 )
Policy contract number610331
Policy instance 12
Insurance contract or identification number610331
Number of Individuals Covered156
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $968
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $968
Insurance broker organization code?3
Insurance broker nameJ SMITH LANIER & CO OF HUNTSVILLE
BLUE CROSS BLUE SHIELD OF ALABAMA (National Association of Insurance Commissioners NAIC id number: 55433 )
Policy contract number52811
Policy instance 11
Insurance contract or identification number52811
Number of Individuals Covered104
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Health Insurance Welfare BenefitYes
Other welfare benefits providedEPS, BABY YOURSELF, AIRMED
Welfare Benefit Premiums Paid to CarrierUSD $9,249
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number06608
Policy instance 10
Insurance contract or identification number06608
Number of Individuals Covered223
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $8,300
Total amount of fees paid to insurance companyUSD $83
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $23,497
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,300
Insurance broker organization code?3
Amount paid for insurance broker fees83
Insurance broker nameAXA ASSISTANCE, USA
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number06608
Policy instance 9
Insurance contract or identification number06608
Number of Individuals Covered225
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $4,014
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number06608
Policy instance 2
Insurance contract or identification number06608
Number of Individuals Covered85
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $24,541
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number06608
Policy instance 3
Insurance contract or identification number06608
Number of Individuals Covered105
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Other welfare benefits providedVOLUNTARY AD&D
Welfare Benefit Premiums Paid to CarrierUSD $1,464
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number06608
Policy instance 4
Insurance contract or identification number06608
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,738
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number06608
Policy instance 5
Insurance contract or identification number06608
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $418
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number06608
Policy instance 6
Insurance contract or identification number06608
Number of Individuals Covered233
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $22,870
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number06608
Policy instance 7
Insurance contract or identification number06608
Number of Individuals Covered233
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $50,238
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number06608
Policy instance 8
Insurance contract or identification number06608
Number of Individuals Covered233
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $15,765
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number06608
Policy instance 9
Insurance contract or identification number06608
Number of Individuals Covered232
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $2,902
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number06608
Policy instance 1
Insurance contract or identification number06608
Number of Individuals Covered233
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $53,032
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number06608
Policy instance 10
Insurance contract or identification number06608
Number of Individuals Covered233
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $12,549
Total amount of fees paid to insurance companyUSD $72
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $31,571
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,835
Insurance broker organization code?3
Amount paid for insurance broker fees72
Insurance broker nameAXA ASSISTANCE, USA
HUMANA (National Association of Insurance Commissioners NAIC id number: 70580 )
Policy contract number610331
Policy instance 12
Insurance contract or identification number610331
Number of Individuals Covered167
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $1,658
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,658
Insurance broker organization code?3
Insurance broker nameJ SMITH LANIER & CO OF HUNTSVILLE
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
Policy contract number16232
Policy instance 13
Insurance contract or identification number16232
Number of Individuals Covered170
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $9,736
Dental 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 $9,736
Insurance broker organization code?3
Insurance broker nameJ SMITH LANIER
BLUE CROSS BLUE SHIELD OF ALABAMA (National Association of Insurance Commissioners NAIC id number: 55433 )
Policy contract number52811
Policy instance 11
Insurance contract or identification number52811
Number of Individuals Covered126
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Health Insurance Welfare BenefitYes
Other welfare benefits providedEPS, BABY YOURSELF, AIRMED
Welfare Benefit Premiums Paid to CarrierUSD $9,296
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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