ROCKET FARM RESTAURANTS LLC has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan ROCKET FARM RESTAURANTS LLC WELFARE PLAN
Measure | Date | Value |
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2021: ROCKET FARM RESTAURANTS LLC WELFARE PLAN 2021 401k membership |
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Total participants, beginning-of-year | 2021-12-01 | 217 |
Total number of active participants reported on line 7a of the Form 5500 | 2021-12-01 | 352 |
Number of retired or separated participants receiving benefits | 2021-12-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2021-12-01 | 0 |
Total of all active and inactive participants | 2021-12-01 | 352 |
Number of employers contributing to the scheme | 2021-12-01 | 0 |
2020: ROCKET FARM RESTAURANTS LLC WELFARE PLAN 2020 401k membership |
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Total participants, beginning-of-year | 2020-12-01 | 258 |
Total number of active participants reported on line 7a of the Form 5500 | 2020-12-01 | 213 |
Number of retired or separated participants receiving benefits | 2020-12-01 | 4 |
Total of all active and inactive participants | 2020-12-01 | 217 |
2019: ROCKET FARM RESTAURANTS LLC WELFARE PLAN 2019 401k membership |
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Total participants, beginning-of-year | 2019-12-01 | 332 |
Total number of active participants reported on line 7a of the Form 5500 | 2019-12-01 | 255 |
Number of retired or separated participants receiving benefits | 2019-12-01 | 3 |
Total of all active and inactive participants | 2019-12-01 | 258 |
2018: ROCKET FARM RESTAURANTS LLC WELFARE PLAN 2018 401k membership |
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Total participants, beginning-of-year | 2018-12-01 | 265 |
Total number of active participants reported on line 7a of the Form 5500 | 2018-12-01 | 328 |
Number of retired or separated participants receiving benefits | 2018-12-01 | 4 |
Total of all active and inactive participants | 2018-12-01 | 332 |
2017: ROCKET FARM RESTAURANTS LLC WELFARE PLAN 2017 401k membership |
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Total participants, beginning-of-year | 2017-12-01 | 265 |
Total number of active participants reported on line 7a of the Form 5500 | 2017-12-01 | 265 |
Total of all active and inactive participants | 2017-12-01 | 265 |
2016: ROCKET FARM RESTAURANTS LLC WELFARE PLAN 2016 401k membership |
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Total participants, beginning-of-year | 2016-12-01 | 248 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-12-01 | 265 |
Total of all active and inactive participants | 2016-12-01 | 265 |
2015: ROCKET FARM RESTAURANTS LLC WELFARE PLAN 2015 401k membership |
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Total participants, beginning-of-year | 2015-12-01 | 198 |
Total number of active participants reported on line 7a of the Form 5500 | 2015-12-01 | 248 |
Total of all active and inactive participants | 2015-12-01 | 248 |
2014: ROCKET FARM RESTAURANTS LLC WELFARE PLAN 2014 401k membership |
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Total participants, beginning-of-year | 2014-12-01 | 140 |
Total number of active participants reported on line 7a of the Form 5500 | 2014-12-01 | 197 |
Number of retired or separated participants receiving benefits | 2014-12-01 | 1 |
Total of all active and inactive participants | 2014-12-01 | 198 |
2021: ROCKET FARM RESTAURANTS LLC WELFARE PLAN 2021 form 5500 responses |
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2021-12-01 | Type of plan entity | Single employer plan |
2021-12-01 | Submission has been amended | Yes |
2021-12-01 | Plan funding arrangement – Insurance | Yes |
2021-12-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2021-12-01 | Plan benefit arrangement – Insurance | Yes |
2021-12-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2020: ROCKET FARM RESTAURANTS LLC WELFARE PLAN 2020 form 5500 responses |
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2020-12-01 | Type of plan entity | Single employer plan |
2020-12-01 | Submission has been amended | No |
2020-12-01 | This submission is the final filing | No |
2020-12-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2020-12-01 | Plan is a collectively bargained plan | No |
2020-12-01 | Plan funding arrangement – Insurance | Yes |
2020-12-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2020-12-01 | Plan benefit arrangement – Insurance | Yes |
2020-12-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2019: ROCKET FARM RESTAURANTS LLC WELFARE PLAN 2019 form 5500 responses |
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2019-12-01 | Type of plan entity | Single employer plan |
2019-12-01 | Submission has been amended | No |
2019-12-01 | This submission is the final filing | No |
2019-12-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2019-12-01 | Plan is a collectively bargained plan | No |
2019-12-01 | Plan funding arrangement – Insurance | Yes |
2019-12-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2019-12-01 | Plan benefit arrangement – Insurance | Yes |
2019-12-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2018: ROCKET FARM RESTAURANTS LLC WELFARE PLAN 2018 form 5500 responses |
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2018-12-01 | Type of plan entity | Single employer plan |
2018-12-01 | Submission has been amended | No |
2018-12-01 | This submission is the final filing | No |
2018-12-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2018-12-01 | Plan is a collectively bargained plan | No |
2018-12-01 | Plan funding arrangement – Insurance | Yes |
2018-12-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2018-12-01 | Plan benefit arrangement – Insurance | Yes |
2018-12-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2017: ROCKET FARM RESTAURANTS LLC WELFARE PLAN 2017 form 5500 responses |
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2017-12-01 | Type of plan entity | Single employer plan |
2017-12-01 | Submission has been amended | No |
2017-12-01 | This submission is the final filing | No |
2017-12-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2017-12-01 | Plan is a collectively bargained plan | No |
2017-12-01 | Plan funding arrangement – Insurance | Yes |
2017-12-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2017-12-01 | Plan benefit arrangement – Insurance | Yes |
2017-12-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2016: ROCKET FARM RESTAURANTS LLC WELFARE PLAN 2016 form 5500 responses |
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2016-12-01 | Type of plan entity | Single employer plan |
2016-12-01 | Submission has been amended | No |
2016-12-01 | This submission is the final filing | No |
2016-12-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2016-12-01 | Plan is a collectively bargained plan | No |
2016-12-01 | Plan funding arrangement – Insurance | Yes |
2016-12-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2016-12-01 | Plan benefit arrangement – Insurance | Yes |
2016-12-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2015: ROCKET FARM RESTAURANTS LLC WELFARE PLAN 2015 form 5500 responses |
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2015-12-01 | Type of plan entity | Single employer plan |
2015-12-01 | Submission has been amended | No |
2015-12-01 | This submission is the final filing | No |
2015-12-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2015-12-01 | Plan is a collectively bargained plan | No |
2015-12-01 | Plan funding arrangement – Insurance | Yes |
2015-12-01 | Plan benefit arrangement – Insurance | Yes |
2014: ROCKET FARM RESTAURANTS LLC WELFARE PLAN 2014 form 5500 responses |
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2014-12-01 | Type of plan entity | Single employer plan |
2014-12-01 | First time form 5500 has been submitted | Yes |
2014-12-01 | Submission has been amended | No |
2014-12-01 | This submission is the final filing | No |
2014-12-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2014-12-01 | Plan is a collectively bargained plan | No |
2014-12-01 | Plan funding arrangement – Insurance | Yes |
2014-12-01 | Plan benefit arrangement – Insurance | Yes |
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 5913417 |
Policy instance | 3 |
Insurance contract or identification number | 5913417 | Number of Individuals Covered | 226 | Insurance policy start date | 2021-12-01 | Insurance policy end date | 2022-11-30 | Total amount of commissions paid to insurance broker | USD $43,907 | Total amount of fees paid to insurance company | USD $4,296 | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT,CRITICAL ILLNESS,HOSPITAL,ACCIDENT | Welfare Benefit Premiums Paid to Carrier | USD $177,548 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $19,713 | Amount paid for insurance broker fees | 27 | Additional information about fees paid to insurance broker | PRODUCER SERVICE FEES, NON-MONETARY COMPENSATION | Insurance broker organization code? | 3 |
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UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 218717 |
Policy instance | 2 |
Insurance contract or identification number | 218717 | Number of Individuals Covered | 352 | Insurance policy start date | 2021-12-01 | Insurance policy end date | 2022-11-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $0 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 5913417 |
Policy instance | 2 |
Insurance contract or identification number | 5913417 | Number of Individuals Covered | 226 | Insurance policy start date | 2021-12-01 | Insurance policy end date | 2022-11-30 | Total amount of commissions paid to insurance broker | USD $44,202 | Total amount of fees paid to insurance company | USD $4,333 | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT,CRITICAL ILLNESS,HOSPITAL,ACCIDENT | Welfare Benefit Premiums Paid to Carrier | USD $184,307 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $19,747 | Amount paid for insurance broker fees | -25 | Additional information about fees paid to insurance broker | PRODUCER SERVICE FEES, NON-MONETARY COMPENSATION, NON-MONETARY COMPENSATION, PRODUCER SERVICE FEES | Insurance broker organization code? | 3 |
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FLEXCARE, LLC (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | GRSRFR |
Policy instance | 1 |
Insurance contract or identification number | GRSRFR | Number of Individuals Covered | 352 | Insurance policy start date | 2021-12-01 | Insurance policy end date | 2022-11-30 | Total amount of commissions paid to insurance broker | USD $2,044 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | EMPLOYEE ASSISTANCE PROGRAM, TELEHEALTH | Welfare Benefit Premiums Paid to Carrier | USD $26,662 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | Commission paid to Insurance Broker | USD $2,044 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 218717 |
Policy instance | 1 |
Insurance contract or identification number | 218717 | Number of Individuals Covered | 46 | Insurance policy start date | 2020-12-01 | Insurance policy end date | 2021-11-30 | Total amount of commissions paid to insurance broker | USD $1,444 | Total amount of fees paid to insurance company | USD $848 | Other welfare benefits provided | WSTD | Welfare Benefit Premiums Paid to Carrier | USD $22,626 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,011 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 5913417 |
Policy instance | 2 |
Insurance contract or identification number | 5913417 | Number of Individuals Covered | 213 | Insurance policy start date | 2020-12-01 | Insurance policy end date | 2021-11-30 | Total amount of commissions paid to insurance broker | USD $14,898 | Total amount of fees paid to insurance company | USD $4,985 | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $133,912 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $9,012 | Amount paid for insurance broker fees | 4985 | Additional information about fees paid to insurance broker | SERVICE, MARKETING, NON-MONETARY AND SUPPLEMENTAL COMPENSATION | Insurance broker organization code? | 3 |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 0218713 |
Policy instance | 3 |
Insurance contract or identification number | 0218713 | Number of Individuals Covered | 50 | Insurance policy start date | 2020-12-01 | Insurance policy end date | 2021-11-30 | Total amount of commissions paid to insurance broker | USD $2,754 | Total amount of fees paid to insurance company | USD $438 | Other welfare benefits provided | CRITICAL ILLNESS | Welfare Benefit Premiums Paid to Carrier | USD $11,899 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,928 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Additional information about fees paid to insurance broker | SERVICE, MARKETING, NON-MONETARY AND SUPPLEMENTAL COMPENSATION |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 218715 |
Policy instance | 4 |
Insurance contract or identification number | 218715 | Number of Individuals Covered | 61 | Insurance policy start date | 2020-12-01 | Insurance policy end date | 2021-11-30 | Total amount of commissions paid to insurance broker | USD $7,927 | Total amount of fees paid to insurance company | USD $809 | Other welfare benefits provided | HOSPITAL | Welfare Benefit Premiums Paid to Carrier | USD $27,642 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,549 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Additional information about fees paid to insurance broker | SERVICE, MARKETING NON-MONETARY AND SUPPLEMENT COMPENSATION |
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MERITAIN HEALTH (National Association of Insurance Commissioners NAIC id number: 77828 ) |
Policy contract number | 16993 |
Policy instance | 5 |
Insurance contract or identification number | 16993 | Number of Individuals Covered | 151 | Insurance policy start date | 2020-12-01 | Insurance policy end date | 2021-11-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Welfare Benefit Premiums Paid to Carrier | USD $158,304 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 218714 |
Policy instance | 6 |
Insurance contract or identification number | 218714 | Number of Individuals Covered | 130 | Insurance policy start date | 2020-12-01 | Insurance policy end date | 2021-11-30 | Total amount of commissions paid to insurance broker | USD $5,824 | Total amount of fees paid to insurance company | USD $775 | Other welfare benefits provided | ACCIDENT | Welfare Benefit Premiums Paid to Carrier | USD $25,279 | Commission paid to Insurance Broker | USD $4,078 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Additional information about fees paid to insurance broker | SERVICE, MARKETING, NON-MONETARY AND SUPPLEMENTAL COMPENSATION |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 218717 |
Policy instance | 6 |
Insurance contract or identification number | 218717 | Number of Individuals Covered | 66 | Insurance policy start date | 2019-12-01 | Insurance policy end date | 2020-11-30 | Total amount of commissions paid to insurance broker | USD $28,518 | Total amount of fees paid to insurance company | USD $228 | Other welfare benefits provided | WSTD | Welfare Benefit Premiums Paid to Carrier | USD $61,084 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $19,963 | Amount paid for insurance broker fees | 184 | Additional information about fees paid to insurance broker | SUPPLEMENTAL & NON-MONETARY COMPENSATION | Insurance broker organization code? | 3 |
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MERITAIN HEALTH (National Association of Insurance Commissioners NAIC id number: 77828 ) |
Policy contract number | 16993 |
Policy instance | 5 |
Insurance contract or identification number | 16993 | Insurance policy start date | 2019-12-01 | Insurance policy end date | 2020-11-30 | Welfare Benefit Premiums Paid to Carrier | USD $137,128 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 218714 |
Policy instance | 4 |
Insurance contract or identification number | 218714 | Number of Individuals Covered | 245 | Insurance policy start date | 2019-12-01 | Insurance policy end date | 2020-11-30 | Total amount of commissions paid to insurance broker | USD $21,762 | Total amount of fees paid to insurance company | USD $2,077 | Other welfare benefits provided | ACCIDENT | Welfare Benefit Premiums Paid to Carrier | USD $38,818 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $15,235 | Amount paid for insurance broker fees | 1264 | Additional information about fees paid to insurance broker | ADDITIONAL, SUPPLEMENT & NON-MONETARY | Insurance broker organization code? | 3 |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 0218713 |
Policy instance | 3 |
Insurance contract or identification number | 0218713 | Number of Individuals Covered | 69 | Insurance policy start date | 2019-12-01 | Insurance policy end date | 2020-11-30 | Total amount of commissions paid to insurance broker | USD $14,416 | Total amount of fees paid to insurance company | USD $155 | Other welfare benefits provided | CRITICAL ILLNESS | Welfare Benefit Premiums Paid to Carrier | USD $16,577 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $10,124 | Amount paid for insurance broker fees | 111 | Additional information about fees paid to insurance broker | SUPPLEMENTAL & NON-MONETARY COMPENSATION | Insurance broker organization code? | 3 |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 218715 |
Policy instance | 2 |
Insurance contract or identification number | 218715 | Number of Individuals Covered | 94 | Insurance policy start date | 2019-12-01 | Insurance policy end date | 2020-11-30 | Total amount of commissions paid to insurance broker | USD $16,112 | Total amount of fees paid to insurance company | USD $162 | Other welfare benefits provided | HOSPITAL | Welfare Benefit Premiums Paid to Carrier | USD $34,743 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $11,278 | Amount paid for insurance broker fees | 118 | Additional information about fees paid to insurance broker | SUPPLEMENTAL & NON-MONETARY COMPENSATION | Insurance broker organization code? | 3 |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 5913417 |
Policy instance | 1 |
Insurance contract or identification number | 5913417 | Number of Individuals Covered | 255 | Insurance policy start date | 2019-12-01 | Insurance policy end date | 2020-11-30 | Total amount of commissions paid to insurance broker | USD $11,592 | Total amount of fees paid to insurance company | USD $12,243 | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $180,041 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $11,592 | Amount paid for insurance broker fees | 12243 | Additional information about fees paid to insurance broker | SERVICE FEES, SUPPLEMENTAL & NON- MONETARY COMPENSATION | Insurance broker organization code? | 3 |
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COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
Policy contract number | E4714689 |
Policy instance | 1 |
Insurance contract or identification number | E4714689 | Number of Individuals Covered | 219 | Insurance policy start date | 2018-12-01 | Insurance policy end date | 2019-11-30 | Total amount of commissions paid to insurance broker | USD $3,229 | Total amount of fees paid to insurance company | USD $375 | Other welfare benefits provided | ACCIDENT,CRITICAL ILLNESS, HOSPITAL | Welfare Benefit Premiums Paid to Carrier | USD $10,321 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $110 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Additional information about fees paid to insurance broker | BONUS |
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AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95094 ) |
Policy contract number | 0737855HNO |
Policy instance | 2 |
Insurance contract or identification number | 0737855HNO | Number of Individuals Covered | 250 | Insurance policy start date | 2018-12-01 | Insurance policy end date | 2019-11-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,162,064 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 218715 |
Policy instance | 3 |
Insurance contract or identification number | 218715 | Number of Individuals Covered | 76 | Insurance policy start date | 2018-12-01 | Insurance policy end date | 2019-11-30 | Total amount of commissions paid to insurance broker | USD $16,112 | Total amount of fees paid to insurance company | USD $162 | Other welfare benefits provided | HOSPITAL | Welfare Benefit Premiums Paid to Carrier | USD $26,906 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $11,278 | Amount paid for insurance broker fees | 118 | Additional information about fees paid to insurance broker | SUPPLEMENTAL AND NON-MONETRARY COMPENSATION | Insurance broker organization code? | 3 |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 5913417 |
Policy instance | 4 |
Insurance contract or identification number | 5913417 | Number of Individuals Covered | 307 | Insurance policy start date | 2018-12-01 | Insurance policy end date | 2019-11-30 | Total amount of commissions paid to insurance broker | USD $12,104 | Total amount of fees paid to insurance company | USD $246 | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $168,934 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $12,104 | Amount paid for insurance broker fees | 246 | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | Insurance broker organization code? | 3 |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 218713 |
Policy instance | 5 |
Insurance contract or identification number | 218713 | Number of Individuals Covered | 108 | Insurance policy start date | 2018-12-01 | Insurance policy end date | 2019-11-30 | Total amount of commissions paid to insurance broker | USD $14,416 | Total amount of fees paid to insurance company | USD $155 | Other welfare benefits provided | CRITICAL ILLNESS | Welfare Benefit Premiums Paid to Carrier | USD $23,986 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $10,124 | Amount paid for insurance broker fees | 111 | Additional information about fees paid to insurance broker | SUPPLEMNETAL AND NON-MONETARY COMPENSATION | Insurance broker organization code? | 3 |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 218714 |
Policy instance | 6 |
Insurance contract or identification number | 218714 | Number of Individuals Covered | 234 | Insurance policy start date | 2018-12-01 | Insurance policy end date | 2019-11-30 | Total amount of commissions paid to insurance broker | USD $21,762 | Total amount of fees paid to insurance company | USD $2,077 | Other welfare benefits provided | ACCIDENT | Welfare Benefit Premiums Paid to Carrier | USD $36,211 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $15,235 | Amount paid for insurance broker fees | 1264 | Additional information about fees paid to insurance broker | SUPPLEMENTAL AND NON-MONETARY COMPENSATION | Insurance broker organization code? | 3 |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 0218713 |
Policy instance | 7 |
Insurance contract or identification number | 0218713 | Number of Individuals Covered | 103 | Insurance policy start date | 2018-12-01 | Insurance policy end date | 2019-11-30 | Total amount of commissions paid to insurance broker | USD $14,416 | Total amount of fees paid to insurance company | USD $155 | Other welfare benefits provided | CRITICAL ILLNESS | Commission paid to Insurance Broker | USD $10,127 | Amount paid for insurance broker fees | 111 | Additional information about fees paid to insurance broker | SUPPLEMENTAL AND NON-MONETARY COMPENSATION | Insurance broker organization code? | 3 |
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AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 0737855 |
Policy instance | 8 |
Insurance contract or identification number | 0737855 | Number of Individuals Covered | 19 | Insurance policy start date | 2018-12-01 | Insurance policy end date | 2019-11-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $49,631 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 218717 |
Policy instance | 9 |
Insurance contract or identification number | 218717 | Number of Individuals Covered | 110 | Insurance policy start date | 2018-12-01 | Insurance policy end date | 2019-11-30 | Total amount of commissions paid to insurance broker | USD $28,518 | Total amount of fees paid to insurance company | USD $228 | Other welfare benefits provided | WSTD | Welfare Benefit Premiums Paid to Carrier | USD $47,539 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $19,963 | Amount paid for insurance broker fees | 184 | Additional information about fees paid to insurance broker | SUPPLEMENTAL AND NON-MONETARY COMPENSATION | Insurance broker organization code? | 3 |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 5913417 |
Policy instance | 4 |
Insurance contract or identification number | 5913417 | Number of Individuals Covered | 263 | Insurance policy start date | 2017-12-01 | Insurance policy end date | 2018-11-30 | Total amount of commissions paid to insurance broker | USD $8,349 | Total amount of fees paid to insurance company | USD $16 | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $152,164 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 0737855 |
Policy instance | 3 |
Insurance contract or identification number | 0737855 | Number of Individuals Covered | 3 | Insurance policy start date | 2017-12-01 | Insurance policy end date | 2018-11-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $5,239 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95094 ) |
Policy contract number | 0737855HNO |
Policy instance | 2 |
Insurance contract or identification number | 0737855HNO | Number of Individuals Covered | 262 | Insurance policy start date | 2017-12-01 | Insurance policy end date | 2018-11-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $7,100 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,060,457 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
Policy contract number | E4714689 |
Policy instance | 1 |
Insurance contract or identification number | E4714689 | Number of Individuals Covered | 224 | Insurance policy start date | 2017-12-01 | Insurance policy end date | 2018-11-30 | Total amount of commissions paid to insurance broker | USD $52,748 | Total amount of fees paid to insurance company | USD $15,113 |
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