401k Plan data: CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON FLEXIBLE BENEFITS PROGRAM plan

CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON FLEXIBLE BENEFITS PROGRAM 401k Plan overview

Plan Name	CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON FLEXIBLE BENEFITS PROGRAM
Plan identification number	512

CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON FLEXIBLE BENEFITS PROGRAM Benefits

401k Plan Type	Welfare 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

CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON has sponsored the creation of one or more 401k plans.

Company Name: CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON

Employer identification number (EIN): 340714357

NAIC Classification: 622000
NAIC Description: Hospitals

Additional information about CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON

Jurisdiction of Incorporation: Ohio Secretary of State Business Services Division

Incorporation Date:

Company Identification Number: 28759

Legal Registered Office Address: ONE PERKINS SQUARE
-
AKRON
United States of America (USA)
443081062

More information about CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON FLEXIBLE BENEFITS PROGRAM

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
512 2022-01-01
512 2021-01-01
512 2020-01-01
512 2019-01-01
512 2018-01-01
512 2017-01-01 MICHAEL TRAINER
512 2017-01-01
512 2016-01-01 MICHAEL TRAINER
512 2016-01-01
512 2015-01-01 WALTER E. SCHWOEBLE
512 2015-01-01
512 2014-01-01 WALTER E. SCHWOEBLE
512 2013-01-01 WALTER E. SCHWOEBLE
512 2012-01-01 WALTER E. SCHWOEBLE
512 2011-01-01 WALTER E. SCHWOEBLE
512 2009-01-01 WALTER E. SCHWOEBLE

Plan Statistics for CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON FLEXIBLE BENEFITS PROGRAM

401k plan membership statisitcs for CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON FLEXIBLE BENEFITS PROGRAM

Measure Date Value
2022: CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON FLEXIBLE BENEFITS PROGRAM 2022 401k membership
Total participants, beginning-of-year 2022-01-01 7,475
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 6,204
Number of retired or separated participants receiving benefits 2022-01-01 1,404
Total of all active and inactive participants 2022-01-01 7,608
Total participants 2022-01-01 7,608
2021: CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON FLEXIBLE BENEFITS PROGRAM 2021 401k membership
Total participants, beginning-of-year 2021-01-01 7,316
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 6,113
Number of retired or separated participants receiving benefits 2021-01-01 1,362
Total of all active and inactive participants 2021-01-01 7,475
Total participants 2021-01-01 7,475
2020: CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON FLEXIBLE BENEFITS PROGRAM 2020 401k membership
Total participants, beginning-of-year 2020-01-01 7,298
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 6,012
Number of retired or separated participants receiving benefits 2020-01-01 1,304
Total of all active and inactive participants 2020-01-01 7,316
Total participants 2020-01-01 7,316
2019: CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON FLEXIBLE BENEFITS PROGRAM 2019 401k membership
Total participants, beginning-of-year 2019-01-01 7,461
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 6,028
Number of retired or separated participants receiving benefits 2019-01-01 1,270
Total of all active and inactive participants 2019-01-01 7,298
Total participants 2019-01-01 7,298
2018: CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON FLEXIBLE BENEFITS PROGRAM 2018 401k membership
Total participants, beginning-of-year 2018-01-01 7,198
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 6,273
Number of retired or separated participants receiving benefits 2018-01-01 1,188
Total of all active and inactive participants 2018-01-01 7,461
Total participants 2018-01-01 7,461
2017: CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON FLEXIBLE BENEFITS PROGRAM 2017 401k membership
Total participants, beginning-of-year 2017-01-01 6,497
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 6,078
Number of retired or separated participants receiving benefits 2017-01-01 727
Total of all active and inactive participants 2017-01-01 6,805
Total participants 2017-01-01 6,805
2016: CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON FLEXIBLE BENEFITS PROGRAM 2016 401k membership
Total participants, beginning-of-year 2016-01-01 6,132
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 5,794
Number of retired or separated participants receiving benefits 2016-01-01 703
Total of all active and inactive participants 2016-01-01 6,497
Total participants 2016-01-01 6,497
2015: CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON FLEXIBLE BENEFITS PROGRAM 2015 401k membership
Total participants, beginning-of-year 2015-01-01 5,620
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 5,455
Number of retired or separated participants receiving benefits 2015-01-01 677
Total of all active and inactive participants 2015-01-01 6,132
Total participants 2015-01-01 6,132
2014: CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON FLEXIBLE BENEFITS PROGRAM 2014 401k membership
Total participants, beginning-of-year 2014-01-01 5,307
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 4,998
Number of retired or separated participants receiving benefits 2014-01-01 622
Number of other retired or separated participants entitled to future benefits 2014-01-01 0
Total of all active and inactive participants 2014-01-01 5,620
Total participants 2014-01-01 5,620
2013: CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON FLEXIBLE BENEFITS PROGRAM 2013 401k membership
Total participants, beginning-of-year 2013-01-01 4,619
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 4,751
Number of retired or separated participants receiving benefits 2013-01-01 556
Total of all active and inactive participants 2013-01-01 5,307
Total participants 2013-01-01 5,307
2012: CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON FLEXIBLE BENEFITS PROGRAM 2012 401k membership
Total participants, beginning-of-year 2012-01-01 4,442
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 4,619
Number of retired or separated participants receiving benefits 2012-01-01 505
Total of all active and inactive participants 2012-01-01 5,124
2011: CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON FLEXIBLE BENEFITS PROGRAM 2011 401k membership
Total participants, beginning-of-year 2011-01-01 4,249
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 4,442
Number of retired or separated participants receiving benefits 2011-01-01 452
Total of all active and inactive participants 2011-01-01 4,894
2009: CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON FLEXIBLE BENEFITS PROGRAM 2009 401k membership
Total participants, beginning-of-year 2009-01-01 4,285
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 4,083
Number of retired or separated participants receiving benefits 2009-01-01 381
Total of all active and inactive participants 2009-01-01 4,464

Measure	Date	Value
2022: CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON FLEXIBLE BENEFITS PROGRAM 2022 401k membership
Total participants, beginning-of-year	2022-01-01	7,475
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	6,204
Number of retired or separated participants receiving benefits	2022-01-01	1,404
Total of all active and inactive participants	2022-01-01	7,608
Total participants	2022-01-01	7,608
2021: CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON FLEXIBLE BENEFITS PROGRAM 2021 401k membership
Total participants, beginning-of-year	2021-01-01	7,316
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	6,113
Number of retired or separated participants receiving benefits	2021-01-01	1,362
Total of all active and inactive participants	2021-01-01	7,475
Total participants	2021-01-01	7,475
2020: CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON FLEXIBLE BENEFITS PROGRAM 2020 401k membership
Total participants, beginning-of-year	2020-01-01	7,298
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	6,012
Number of retired or separated participants receiving benefits	2020-01-01	1,304
Total of all active and inactive participants	2020-01-01	7,316
Total participants	2020-01-01	7,316
2019: CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON FLEXIBLE BENEFITS PROGRAM 2019 401k membership
Total participants, beginning-of-year	2019-01-01	7,461
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	6,028
Number of retired or separated participants receiving benefits	2019-01-01	1,270
Total of all active and inactive participants	2019-01-01	7,298
Total participants	2019-01-01	7,298
2018: CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON FLEXIBLE BENEFITS PROGRAM 2018 401k membership
Total participants, beginning-of-year	2018-01-01	7,198
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	6,273
Number of retired or separated participants receiving benefits	2018-01-01	1,188
Total of all active and inactive participants	2018-01-01	7,461
Total participants	2018-01-01	7,461
2017: CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON FLEXIBLE BENEFITS PROGRAM 2017 401k membership
Total participants, beginning-of-year	2017-01-01	6,497
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	6,078
Number of retired or separated participants receiving benefits	2017-01-01	727
Total of all active and inactive participants	2017-01-01	6,805
Total participants	2017-01-01	6,805
2016: CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON FLEXIBLE BENEFITS PROGRAM 2016 401k membership
Total participants, beginning-of-year	2016-01-01	6,132
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	5,794
Number of retired or separated participants receiving benefits	2016-01-01	703
Total of all active and inactive participants	2016-01-01	6,497
Total participants	2016-01-01	6,497
2015: CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON FLEXIBLE BENEFITS PROGRAM 2015 401k membership
Total participants, beginning-of-year	2015-01-01	5,620
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	5,455
Number of retired or separated participants receiving benefits	2015-01-01	677
Total of all active and inactive participants	2015-01-01	6,132
Total participants	2015-01-01	6,132
2014: CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON FLEXIBLE BENEFITS PROGRAM 2014 401k membership
Total participants, beginning-of-year	2014-01-01	5,307
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	4,998
Number of retired or separated participants receiving benefits	2014-01-01	622
Number of other retired or separated participants entitled to future benefits	2014-01-01	0
Total of all active and inactive participants	2014-01-01	5,620
Total participants	2014-01-01	5,620
2013: CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON FLEXIBLE BENEFITS PROGRAM 2013 401k membership
Total participants, beginning-of-year	2013-01-01	4,619
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	4,751
Number of retired or separated participants receiving benefits	2013-01-01	556
Total of all active and inactive participants	2013-01-01	5,307
Total participants	2013-01-01	5,307
2012: CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON FLEXIBLE BENEFITS PROGRAM 2012 401k membership
Total participants, beginning-of-year	2012-01-01	4,442
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	4,619
Number of retired or separated participants receiving benefits	2012-01-01	505
Total of all active and inactive participants	2012-01-01	5,124
2011: CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON FLEXIBLE BENEFITS PROGRAM 2011 401k membership
Total participants, beginning-of-year	2011-01-01	4,249
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	4,442
Number of retired or separated participants receiving benefits	2011-01-01	452
Total of all active and inactive participants	2011-01-01	4,894
2009: CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON FLEXIBLE BENEFITS PROGRAM 2009 401k membership
Total participants, beginning-of-year	2009-01-01	4,285
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	4,083
Number of retired or separated participants receiving benefits	2009-01-01	381
Total of all active and inactive participants	2009-01-01	4,464

Form 5500 Responses for CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON FLEXIBLE BENEFITS PROGRAM

2022: CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON FLEXIBLE BENEFITS PROGRAM 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2021: CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON FLEXIBLE BENEFITS PROGRAM 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2020: CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON FLEXIBLE BENEFITS PROGRAM 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2019: CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON FLEXIBLE BENEFITS PROGRAM 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2018: CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON FLEXIBLE BENEFITS PROGRAM 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2017: CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON FLEXIBLE BENEFITS PROGRAM 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	Yes
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2016: CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON FLEXIBLE BENEFITS PROGRAM 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	Yes
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2015: CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON FLEXIBLE BENEFITS PROGRAM 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	Yes
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2014: CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON FLEXIBLE BENEFITS PROGRAM 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2013: CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON FLEXIBLE BENEFITS PROGRAM 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2012: CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON FLEXIBLE BENEFITS PROGRAM 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2011: CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON FLEXIBLE BENEFITS PROGRAM 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2009: CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON FLEXIBLE BENEFITS PROGRAM 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )

Policy contract number

98295401001

Policy instance

Insurance contract or identification number	98295401001
Number of Individuals Covered	8636
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $477,449
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

MCKINLEY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 77216 )

Policy contract number

950066

Policy instance

Insurance contract or identification number	950066
Number of Individuals Covered	130
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Welfare Benefit Premiums Paid to Carrier	USD $1,944,760
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

00037917

Policy instance

Insurance contract or identification number	00037917
Number of Individuals Covered	5541
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $29,067
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $283,078
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $29,067
Insurance broker organization code?	5

TRUSTMARK INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61425 )

Policy contract number

0341900000

Policy instance

Insurance contract or identification number	0341900000
Number of Individuals Covered	262
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $12,118
Health Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENT
Welfare Benefit Premiums Paid to Carrier	USD $155,723
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $9,607
Insurance broker organization code?	3

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

565306

Policy instance

Insurance contract or identification number	565306
Number of Individuals Covered	1285
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $150,184
Health Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENT
Welfare Benefit Premiums Paid to Carrier	USD $563,659
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $133,287
Insurance broker organization code?	3

FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 )

Policy contract number

99067581

Policy instance

Insurance contract or identification number	99067581
Insurance policy start date	2021-06-01
Insurance policy end date	2022-06-01
Total amount of commissions paid to insurance broker	USD $155
Other welfare benefits provided	ACCIDENT POLICY
Welfare Benefit Premiums Paid to Carrier	USD $1,000
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $155
Insurance broker organization code?	5

EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )

Policy contract number

99242181001

Policy instance

Insurance contract or identification number	99242181001
Number of Individuals Covered	2007
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $335,762
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

MEDICAL MUTUAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 29076 )

Policy contract number

464003

Policy instance

Insurance contract or identification number	464003
Number of Individuals Covered	4858
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Welfare Benefit Premiums Paid to Carrier	USD $4,153,292
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

SA388005450901

Policy instance

Insurance contract or identification number	SA388005450901
Number of Individuals Covered	6272
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $1,529,271
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

GF388005450901

Policy instance

Insurance contract or identification number	GF388005450901
Number of Individuals Covered	5167
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $2,007,833
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

GF388005450901

Policy instance

Insurance contract or identification number	GF388005450901
Number of Individuals Covered	5083
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,632,393
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

565306

Policy instance

Insurance contract or identification number	565306
Number of Individuals Covered	1178
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $140,824
Health Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENT
Welfare Benefit Premiums Paid to Carrier	USD $422,100
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $126,837
Insurance broker organization code?	3

MCKINLEY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 77216 )

Policy contract number

950066

Policy instance

Insurance contract or identification number	950066
Number of Individuals Covered	276
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Welfare Benefit Premiums Paid to Carrier	USD $1,944,760
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 )

Policy contract number

000099062407

Policy instance

Insurance contract or identification number	000099062407
Insurance policy start date	2020-06-01
Insurance policy end date	2021-06-01
Total amount of commissions paid to insurance broker	USD $2,372
Other welfare benefits provided	ACCIDENT POLICY
Welfare Benefit Premiums Paid to Carrier	USD $15,756
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,372
Insurance broker organization code?	5

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

00037917

Policy instance

Insurance contract or identification number	00037917
Number of Individuals Covered	5616
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $27,030
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $267,627
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $27,030
Insurance broker organization code?	5

TRUSTMARK INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61425 )

Policy contract number

0341900000

Policy instance

Insurance contract or identification number	0341900000
Number of Individuals Covered	259
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $14,613
Health Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENT
Welfare Benefit Premiums Paid to Carrier	USD $165,027
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $11,700
Insurance broker organization code?	3

EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )

Policy contract number

98295401001

Policy instance

Insurance contract or identification number	98295401001
Number of Individuals Covered	9048
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $529,440
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 )

Policy contract number

99067581

Policy instance

Insurance contract or identification number	99067581
Insurance policy start date	2020-06-01
Insurance policy end date	2021-06-01
Total amount of commissions paid to insurance broker	USD $151
Other welfare benefits provided	ACCIDENT POLICY
Welfare Benefit Premiums Paid to Carrier	USD $1,000
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $151
Insurance broker organization code?	5

EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )

Policy contract number

99242181001

Policy instance

Insurance contract or identification number	99242181001
Number of Individuals Covered	1897
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $349,493
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

MEDICAL MUTUAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 29076 )

Policy contract number

464003

Policy instance

Insurance contract or identification number	464003
Number of Individuals Covered	4910
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Welfare Benefit Premiums Paid to Carrier	USD $3,752,615
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

SA388005450901

Policy instance

Insurance contract or identification number	SA388005450901
Number of Individuals Covered	6158
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $1,201,159
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

TRUSTMARK INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61425 )

Policy contract number

0341900000

Policy instance

Insurance contract or identification number	0341900000
Number of Individuals Covered	282
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $18,133
Health Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENT
Welfare Benefit Premiums Paid to Carrier	USD $210,514
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $14,429
Insurance broker organization code?	3

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

00037917

Policy instance

Insurance contract or identification number	00037917
Number of Individuals Covered	5532
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $22,556
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $223,322
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $22,556
Insurance broker organization code?	5

FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 )

Policy contract number

000099062407

Policy instance

Insurance contract or identification number	000099062407
Insurance policy start date	2019-06-01
Insurance policy end date	2020-06-01
Total amount of commissions paid to insurance broker	USD $2,526
Other welfare benefits provided	ACCIDENT POLICY
Welfare Benefit Premiums Paid to Carrier	USD $15,756
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,526
Insurance broker organization code?	5

MCKINLEY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 77216 )

Policy contract number

950066

Policy instance

Insurance contract or identification number	950066
Number of Individuals Covered	262
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Welfare Benefit Premiums Paid to Carrier	USD $1,792,627
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )

Policy contract number

98295401001

Policy instance

Insurance contract or identification number	98295401001
Number of Individuals Covered	8963
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $447,602
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 )

Policy contract number

99067581

Policy instance

Insurance contract or identification number	99067581
Insurance policy start date	2019-06-01
Insurance policy end date	2020-06-01
Total amount of commissions paid to insurance broker	USD $150
Other welfare benefits provided	ACCIDENT POLICY
Welfare Benefit Premiums Paid to Carrier	USD $1,000
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $150
Insurance broker organization code?	5

EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )

Policy contract number

99242181001

Policy instance

Insurance contract or identification number	99242181001
Number of Individuals Covered	1819
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $289,062
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 )

Policy contract number

SA388005450901

Policy instance

Insurance contract or identification number	SA388005450901
Number of Individuals Covered	6036
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $1,610,422
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 )

Policy contract number

GF388005450901

Policy instance

Insurance contract or identification number	GF388005450901
Number of Individuals Covered	5214
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $2,212,614
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

565306

Policy instance

Insurance contract or identification number	565306
Number of Individuals Covered	977
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $241,850
Health Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENT
Welfare Benefit Premiums Paid to Carrier	USD $428,090
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $230,330
Insurance broker organization code?	3

MEDICAL MUTUAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 29076 )

Policy contract number

464003

Policy instance

Insurance contract or identification number	464003
Number of Individuals Covered	4985
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Welfare Benefit Premiums Paid to Carrier	USD $4,158,895
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

TRUSTMARK INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61425 )

Policy contract number

0341900000

Policy instance

Insurance contract or identification number	0341900000
Number of Individuals Covered	1041
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $50,233
Health Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENT
Welfare Benefit Premiums Paid to Carrier	USD $456,481
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $40,538
Insurance broker organization code?	3

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

00037917

Policy instance

Insurance contract or identification number	00037917
Number of Individuals Covered	5504
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $25,745
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $254,899
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $25,745
Insurance broker organization code?	5

FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 )

Policy contract number

000099062407

Policy instance

Insurance contract or identification number	000099062407
Insurance policy start date	2018-06-01
Insurance policy end date	2019-06-01
Total amount of commissions paid to insurance broker	USD $2,363
Other welfare benefits provided	ACCIDENT POLICY
Welfare Benefit Premiums Paid to Carrier	USD $15,756
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,363
Insurance broker organization code?	5

MCKINLEY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 77216 )

Policy contract number

950066

Policy instance

Insurance contract or identification number	950066
Number of Individuals Covered	338
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Welfare Benefit Premiums Paid to Carrier	USD $2,097,849
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )

Policy contract number

98295401001

Policy instance

Insurance contract or identification number	98295401001
Number of Individuals Covered	8980
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $509,974
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 )

Policy contract number

99067581

Policy instance

Insurance contract or identification number	99067581
Insurance policy start date	2018-06-01
Insurance policy end date	2019-06-01
Total amount of commissions paid to insurance broker	USD $150
Other welfare benefits provided	ACCIDENT POLICY
Welfare Benefit Premiums Paid to Carrier	USD $1,000
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $150
Insurance broker organization code?	5

EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )

Policy contract number

99242181001

Policy instance

Insurance contract or identification number	99242181001
Number of Individuals Covered	1784
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $310,995
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

MEDICAL MUTUAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 29076 )

Policy contract number

464003

Policy instance

Insurance contract or identification number	464003
Number of Individuals Covered	4770
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Welfare Benefit Premiums Paid to Carrier	USD $4,920,780
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 )

Policy contract number

SA388005450901

Policy instance

Insurance contract or identification number	SA388005450901
Number of Individuals Covered	6072
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $1,347,486
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 )

Policy contract number

GF388005450901

Policy instance

Insurance contract or identification number	GF388005450901
Number of Individuals Covered	4995
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,803,254
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

TRUSTMARK INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61425 )

Policy contract number

0341900000

Policy instance

Insurance contract or identification number	0341900000
Number of Individuals Covered	1106
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $56,529
Health Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENT
Welfare Benefit Premiums Paid to Carrier	USD $476,616
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $36,805
Insurance broker organization code?	3
Insurance broker name	RESCHINI AGENCY INC

EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )

Policy contract number

98295401001

Policy instance

Insurance contract or identification number	98295401001
Number of Individuals Covered	8318
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $445,065
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 )

Policy contract number

000099067581

Policy instance

Insurance contract or identification number	000099067581
Insurance policy start date	2016-06-01
Insurance policy end date	2017-06-01
Total amount of commissions paid to insurance broker	USD $150
Total amount of fees paid to insurance company	USD $7
Other welfare benefits provided	ACCIDENT POLICY
Welfare Benefit Premiums Paid to Carrier	USD $1,000
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $150
Amount paid for insurance broker fees	7
Additional information about fees paid to insurance broker	GUARANTEED SUPPLEMENTAL COMPENSATION
Insurance broker organization code?	5
Insurance broker name	SEIBERT-KECK INSURANCE AGENCY INC

EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )

Policy contract number

99242181001

Policy instance

Insurance contract or identification number	99242181001
Number of Individuals Covered	1471
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $248,177
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 )

Policy contract number

SA388005450901

Policy instance

Insurance contract or identification number	SA388005450901
Number of Individuals Covered	5560
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $26,191
Total amount of fees paid to insurance company	USD $18,348
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $1,240,176
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $26,191
Amount paid for insurance broker fees	18348
Additional information about fees paid to insurance broker	SUPPLEMENTAL COMPENSATION
Insurance broker organization code?	3
Insurance broker name	RESCHINI AGENCY INC

LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 )

Policy contract number

GF388005450901

Policy instance

Insurance contract or identification number	GF388005450901
Number of Individuals Covered	4708
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $35,149
Total amount of fees paid to insurance company	USD $24,588
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,679,388
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $35,149
Amount paid for insurance broker fees	24588
Additional information about fees paid to insurance broker	SUPPLEMENTAL COMPENSATION
Insurance broker organization code?	3
Insurance broker name	RESCHINI AGENCY INC

MEDICAL MUTUAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 29076 )

Policy contract number

464003

Policy instance

Insurance contract or identification number	464003
Number of Individuals Covered	4241
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Welfare Benefit Premiums Paid to Carrier	USD $3,709,664
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

37917

Policy instance

Insurance contract or identification number	37917
Number of Individuals Covered	4928
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $22,746
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $225,211
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $22,746
Insurance broker organization code?	5
Insurance broker name	PHILIP C LOPEZ

FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 )

Policy contract number

000099062407

Policy instance

Insurance contract or identification number	000099062407
Insurance policy start date	2017-06-01
Insurance policy end date	2018-06-01
Total amount of commissions paid to insurance broker	USD $2,023
Other welfare benefits provided	ACCIDENT POLICY
Welfare Benefit Premiums Paid to Carrier	USD $13,489
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,023
Insurance broker organization code?	5
Insurance broker name	SEIBERT-KECK INSURANCE AGENCY INC

MCKINLEY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 77216 )

Policy contract number

950066

Policy instance

Insurance contract or identification number	950066
Number of Individuals Covered	262
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Welfare Benefit Premiums Paid to Carrier	USD $1,494,184
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )

Policy contract number

9924218

Policy instance

Insurance contract or identification number	9924218
Number of Individuals Covered	962
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $149,537
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 )

Policy contract number

000099067581

Policy instance

Insurance contract or identification number	000099067581
Insurance policy start date	2014-06-01
Insurance policy end date	2015-06-01
Total amount of commissions paid to insurance broker	USD $153
Other welfare benefits provided	ACCIDENT POLICY
Welfare Benefit Premiums Paid to Carrier	USD $1,000
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $153
Insurance broker organization code?	5
Insurance broker name	SEIBERT-KECK INSURANCE AGENCY

EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )

Policy contract number

9829540

Policy instance

Insurance contract or identification number	9829540
Number of Individuals Covered	7568
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $375,716
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 )

Policy contract number

402833 0010 SSL

Policy instance

Insurance contract or identification number	402833 0010 SSL
Number of Individuals Covered	3853
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $180,643
Welfare Benefit Premiums Paid to Carrier	USD $1,806,427
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $180,643
Insurance broker organization code?	3
Insurance broker name	RESCHINI AGENCY INC.

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )

Policy contract number

402362G

Policy instance

Insurance contract or identification number	402362G
Number of Individuals Covered	4961
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $177,012
Total amount of fees paid to insurance company	USD $59,543
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $2,131,986
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $74,882
Amount paid for insurance broker fees	26289
Additional information about fees paid to insurance broker	BONUS PAID
Insurance broker organization code?	3
Insurance broker name	RESCHINI AGENCY INC.

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )

Policy contract number

ADD-S07611

Policy instance

Insurance contract or identification number	ADD-S07611
Number of Individuals Covered	2452
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $4,285
Total amount of fees paid to insurance company	USD $4,811
Other welfare benefits provided	AD % D
Welfare Benefit Premiums Paid to Carrier	USD $110,862
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,285
Amount paid for insurance broker fees	4811
Additional information about fees paid to insurance broker	BONUS PAID
Insurance broker organization code?	3
Insurance broker name	CHILD HEALTH CORP OF AMERICA

TRUSTMARK INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61425 )

Policy contract number

0341900000

Policy instance

Insurance contract or identification number	0341900000
Number of Individuals Covered	1265
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $77,359
Health Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENT
Welfare Benefit Premiums Paid to Carrier	USD $463,344
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $49,857
Insurance broker organization code?	3
Insurance broker name	RESCHINI AGENCY INC.

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

37917

Policy instance

Insurance contract or identification number	37917
Number of Individuals Covered	4352
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $19,635
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $178,498
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $19,635
Insurance broker organization code?	5
Insurance broker name	PHILIP C. LOPEZ

FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 )

Policy contract number

000099062407

Policy instance

Insurance contract or identification number	000099062407
Insurance policy start date	2014-06-01
Insurance policy end date	2015-06-01
Total amount of commissions paid to insurance broker	USD $1,541
Other welfare benefits provided	ACCIDENT POLICY
Welfare Benefit Premiums Paid to Carrier	USD $10,070
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,541
Insurance broker organization code?	5
Insurance broker name	SEIBERT-KECK INSURANCE AGENCY INC

MCKINLEY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 77216 )

Policy contract number

950066

Policy instance

Insurance contract or identification number	950066
Number of Individuals Covered	195
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Welfare Benefit Premiums Paid to Carrier	USD $1,318,134
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 )

Policy contract number

402833 0010 SSL

Policy instance

Insurance contract or identification number	402833 0010 SSL
Number of Individuals Covered	3580
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $112,729
Welfare Benefit Premiums Paid to Carrier	USD $1,127,292
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $112,729
Insurance broker organization code?	3
Insurance broker name	RESCHINI AGENCY INC.

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )

Policy contract number

402362G

Policy instance

Insurance contract or identification number	402362G
Number of Individuals Covered	4559
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $171,245
Total amount of fees paid to insurance company	USD $31,795
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,908,001
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $77,014
Insurance broker organization code?	3
Amount paid for insurance broker fees	31795
Additional information about fees paid to insurance broker	ADMINISTRATIVE FEES
Insurance broker name	RESCHINI AGENCY INC.

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )

Policy contract number

ADD-S07611

Policy instance

Insurance contract or identification number	ADD-S07611
Number of Individuals Covered	4514
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $4,249
Total amount of fees paid to insurance company	USD $2,095
Other welfare benefits provided	AD % D
Welfare Benefit Premiums Paid to Carrier	USD $95,472
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,249
Insurance broker organization code?	3
Amount paid for insurance broker fees	2095
Additional information about fees paid to insurance broker	ADMINISTRATIVE
Insurance broker name	MARSH & MCLENNAN AGENCY LLC

TRUSTMARK INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61425 )

Policy contract number

0341900000

Policy instance

Insurance contract or identification number	0341900000
Number of Individuals Covered	1293
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $238,648
Health Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENT
Welfare Benefit Premiums Paid to Carrier	USD $516,438
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $123,286
Insurance broker organization code?	3
Insurance broker name	RESCHINI AGENCY INC.

FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 )

Policy contract number

000099067581

Policy instance

Insurance contract or identification number	000099067581
Insurance policy start date	2013-06-01
Insurance policy end date	2014-06-01
Total amount of commissions paid to insurance broker	USD $161
Other welfare benefits provided	ACCIDENT POLICY
Welfare Benefit Premiums Paid to Carrier	USD $1,000
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $161
Insurance broker organization code?	5
Insurance broker name	SEIBERT-KECK INSURANCE AGENCY

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

37917

Policy instance

Insurance contract or identification number	37917
Number of Individuals Covered	4071
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $19,970
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $167,859
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $19,970
Insurance broker organization code?	5
Insurance broker name	PHILIP C. LOPEZ

EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )

Policy contract number

9829540

Policy instance

Insurance contract or identification number	9829540
Number of Individuals Covered	7827
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $407,335
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

MCKINLEY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 77216 )

Policy contract number

950066

Policy instance

Insurance contract or identification number	950066
Number of Individuals Covered	158
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Welfare Benefit Premiums Paid to Carrier	USD $1,146,528
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 )

Policy contract number

000099062407

Policy instance

Insurance contract or identification number	000099062407
Insurance policy start date	2013-06-01
Insurance policy end date	2014-06-01
Total amount of commissions paid to insurance broker	USD $1,621
Other welfare benefits provided	ACCIDENT POLICY
Welfare Benefit Premiums Paid to Carrier	USD $10,070
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,621
Insurance broker organization code?	5
Insurance broker name	SEIBERT-KECK INSURANCE AGENCY INC

MCKINLEY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 77216 )

Policy contract number

950066

Policy instance

Insurance contract or identification number	950066
Number of Individuals Covered	172
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Welfare Benefit Premiums Paid to Carrier	USD $880,239
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

37917

Policy instance

Insurance contract or identification number	37917
Number of Individuals Covered	3868
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $17,767
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $146,045
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $17,767
Insurance broker organization code?	5
Insurance broker name	PHILIP C. LOPEZ

FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 )

Policy contract number

000099062407

Policy instance

Insurance contract or identification number	000099062407
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $1,989
Other welfare benefits provided	ACCIDENT POLICY
Welfare Benefit Premiums Paid to Carrier	USD $12,530
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,989
Insurance broker organization code?	5
Insurance broker name	SEIBERT-KECK INSURANCE AGENCY INC

AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )

Policy contract number

FG938

Policy instance

Insurance contract or identification number	FG938
Number of Individuals Covered	327
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $12,262
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $97,465
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,820
Insurance broker organization code?	3
Insurance broker name	WILLIAM J. MARKS

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )

Policy contract number

402362G

Policy instance

Insurance contract or identification number	402362G
Number of Individuals Covered	4323
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $170,372
Total amount of fees paid to insurance company	USD $44,463
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,901,611
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $75,131
Insurance broker organization code?	3
Amount paid for insurance broker fees	44463
Additional information about fees paid to insurance broker	ADMINISTRATIVE FEES
Insurance broker name	RESCHINI AGENCY INC.

HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 )

Policy contract number

402833 0010 SSL

Policy instance

Insurance contract or identification number	402833 0010 SSL
Number of Individuals Covered	3467
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $100,058
Welfare Benefit Premiums Paid to Carrier	USD $1,000,578
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $100,058
Insurance broker name	RESCHINI AGENCY INC.

EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )

Policy contract number

9829540

Policy instance

Insurance contract or identification number	9829540
Number of Individuals Covered	7554
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $389,581
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )

Policy contract number

ADD-S07611

Policy instance

Insurance contract or identification number	ADD-S07611
Number of Individuals Covered	4323
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $2,769
Total amount of fees paid to insurance company	USD $2,335
Other welfare benefits provided	AD % D
Welfare Benefit Premiums Paid to Carrier	USD $100,114
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,769
Insurance broker organization code?	3
Amount paid for insurance broker fees	2335
Additional information about fees paid to insurance broker	ADMINISTRATIVE
Insurance broker name	ALEXANDER BENEFITS CONSULTING LLC

HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 )

Policy contract number

402833 0010 SSL

Policy instance

Insurance contract or identification number	402833 0010 SSL
Number of Individuals Covered	3325
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $97,909
Welfare Benefit Premiums Paid to Carrier	USD $979,095
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $97,909
Insurance broker organization code?	3
Insurance broker name	RESCHINI AGENCY INC

FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 )

Policy contract number

000099062407

Policy instance

Insurance contract or identification number	000099062407
Number of Individuals Covered	4619
Insurance policy start date	2012-02-01
Insurance policy end date	2013-02-01
Total amount of commissions paid to insurance broker	USD $1,252
Other welfare benefits provided	ACCIDENT POLICY
Welfare Benefit Premiums Paid to Carrier	USD $8,000
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,252
Insurance broker organization code?	3
Insurance broker name	SEIBERT-KECK INSURANCE AGENCY

AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )

Policy contract number

FG938

Policy instance

Insurance contract or identification number	FG938
Number of Individuals Covered	359
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $38,355
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $98,332
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $19,274
Insurance broker organization code?	3
Insurance broker name	MELISSA MCCLAIN

EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )

Policy contract number

9829540

Policy instance

Insurance contract or identification number	9829540
Number of Individuals Covered	7320
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $375,870
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

37917

Policy instance

Insurance contract or identification number	37917
Number of Individuals Covered	3738
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $15,700
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $140,615
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $15,700
Insurance broker organization code?	3
Insurance broker name	PHILIP C LOPEZ

LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 )

Policy contract number

GF3-88003496901

Policy instance

Insurance contract or identification number	GF3-88003496901
Number of Individuals Covered	1922
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $31,143
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $749,511
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $31,143
Insurance broker organization code?	3
Insurance broker name	RESCHINI AGENCY INC

LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 )

Policy contract number

SA3-88003496901

Policy instance

Insurance contract or identification number	SA3-88003496901
Number of Individuals Covered	4183
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $29,813
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $771,978
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $29,813
Insurance broker organization code?	3
Insurance broker name	RESCHINI AGENCY INC.

MCKINLEY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 77216 )

Policy contract number

950066

Policy instance

Insurance contract or identification number	950066
Number of Individuals Covered	147
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Welfare Benefit Premiums Paid to Carrier	USD $754,964
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

MCKINLEY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 77216 )

Policy contract number

950066

Policy instance

Insurance contract or identification number	950066
Number of Individuals Covered	170
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Welfare Benefit Premiums Paid to Carrier	USD $679,980
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 )

Policy contract number

000099062407

Policy instance

Insurance contract or identification number	000099062407
Number of Individuals Covered	4442
Insurance policy start date	2011-02-01
Insurance policy end date	2012-02-01
Total amount of commissions paid to insurance broker	USD $1,224
Other welfare benefits provided	ACCIDENT POLICY
Welfare Benefit Premiums Paid to Carrier	USD $8,000
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )

Policy contract number

9737016

Policy instance

Insurance contract or identification number	9737016
Number of Individuals Covered	6683
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $324,322
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 )

Policy contract number

GF3-88003496901

Policy instance

Insurance contract or identification number	GF3-88003496901
Number of Individuals Covered	1917
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $37,235
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $642,664
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 )

Policy contract number

SA3-88003496901

Policy instance

Insurance contract or identification number	SA3-88003496901
Number of Individuals Covered	3954
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $39,683
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	ADD
Welfare Benefit Premiums Paid to Carrier	USD $733,940
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

37917

Policy instance

Insurance contract or identification number	37917
Number of Individuals Covered	3489
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $14,823
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $121,501
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )

Policy contract number

FG938

Policy instance

Insurance contract or identification number	FG938
Number of Individuals Covered	357
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $18,246
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $49,320
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 )

Policy contract number

402833 0010 SSL

Policy instance

Insurance contract or identification number	402833 0010 SSL
Number of Individuals Covered	3122
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $115,121
Welfare Benefit Premiums Paid to Carrier	USD $1,151,206
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 )

Policy contract number

GF388003496901

Policy instance

Insurance contract or identification number	GF388003496901
Number of Individuals Covered	1629
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $25,416
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $610,375
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $25,416
Insurance broker organization code?	3
Insurance broker name	RESCHINI INSURANCE AGENCY

LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 )

Policy contract number

SA388003496901

Policy instance

Insurance contract or identification number	SA388003496901
Number of Individuals Covered	3719
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $25,560
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	ADD
Welfare Benefit Premiums Paid to Carrier	USD $632,976
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $25,560
Insurance broker organization code?	3
Insurance broker name	RESCHINI INSURANCE AGENCY

FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 )

Policy contract number

000099062407

Policy instance

Insurance contract or identification number	000099062407
Number of Individuals Covered	4083
Insurance policy start date	2010-02-01
Insurance policy end date	2011-02-01
Total amount of commissions paid to insurance broker	USD $1,200
Other welfare benefits provided	ACCIDENT POLICY
Welfare Benefit Premiums Paid to Carrier	USD $8,000
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,200
Insurance broker organization code?	3
Insurance broker name	SIEBERT KECK INSURANCE AGENCY

HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 )

Policy contract number

402833 0010 SSL

Policy instance

Insurance contract or identification number	402833 0010 SSL
Number of Individuals Covered	2946
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $101,090
Welfare Benefit Premiums Paid to Carrier	USD $1,010,901
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $101,090
Insurance broker organization code?	3
Insurance broker name	RESCHINI AGENCY INC.

MCKINLEY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 77216 )

Policy contract number

950066

Policy instance

Insurance contract or identification number	950066
Number of Individuals Covered	130
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Welfare Benefit Premiums Paid to Carrier	USD $589,100
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )

Policy contract number

9737016

Policy instance

Insurance contract or identification number	9737016
Number of Individuals Covered	6048
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $295,440
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

Potentially related plans

Was this data useful?

If you found the data here useful, PLEASE HELP US. We are a start-up and believe in making information freely available. By linking to us, posting on twitter, facebook and linkedin about us and generally spreading the word, you'll help us to grow. Our vision is to provide high quality data about the activities of all the companies in the world and where possible make it free to use and view. Finding and integrating data from thousands of data sources is time consuming and needs lots of effort. By simply spreading the word about us, you will help us. Please use the share buttons. It will only take a few seconds of your time. Thanks for helping

Information Disclaimer

The information provided on this website is not advice, endorsement or recommendation
The information published is supplied by third parties so we make no warranty on the accuracy, completeness etc. This information is provided "as-is". The information is subject to change as we obtain updates and corrections from the primary information sources.
You are free to use the information for your own personal research on the understanding to do so is at your own risk.

See full terms and conditions

Company Name:	CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON
Employer identification number (EIN):	340714357
NAIC Classification:	622000
NAIC Description:	Hospitals

Jurisdiction of Incorporation:	Ohio Secretary of State Business Services Division
Incorporation Date:
Company Identification Number:	28759
Legal Registered Office Address:	ONE PERKINS SQUARE - AKRON United States of America (USA) 443081062