FOERTSCH GROUP, LLC has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan FOERTSCH GROUP, LLC WELFARE BENEFIT PLAN
Measure | Date | Value |
---|
2021: FOERTSCH GROUP, LLC WELFARE BENEFIT PLAN 2021 401k membership |
---|
Total participants, beginning-of-year | 2021-02-01 | 111 |
Total number of active participants reported on line 7a of the Form 5500 | 2021-02-01 | 0 |
Number of retired or separated participants receiving benefits | 2021-02-01 | 2 |
Number of other retired or separated participants entitled to future benefits | 2021-02-01 | 0 |
Total of all active and inactive participants | 2021-02-01 | 2 |
Number of employers contributing to the scheme | 2021-02-01 | 0 |
2020: FOERTSCH GROUP, LLC WELFARE BENEFIT PLAN 2020 401k membership |
---|
Total participants, beginning-of-year | 2020-02-01 | 120 |
Total number of active participants reported on line 7a of the Form 5500 | 2020-02-01 | 111 |
Number of retired or separated participants receiving benefits | 2020-02-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2020-02-01 | 0 |
Total of all active and inactive participants | 2020-02-01 | 111 |
Number of employers contributing to the scheme | 2020-02-01 | 0 |
2019: FOERTSCH GROUP, LLC WELFARE BENEFIT PLAN 2019 401k membership |
---|
Total participants, beginning-of-year | 2019-02-01 | 126 |
Total number of active participants reported on line 7a of the Form 5500 | 2019-02-01 | 119 |
Number of retired or separated participants receiving benefits | 2019-02-01 | 1 |
Number of other retired or separated participants entitled to future benefits | 2019-02-01 | 0 |
Total of all active and inactive participants | 2019-02-01 | 120 |
2018: FOERTSCH GROUP, LLC WELFARE BENEFIT PLAN 2018 401k membership |
---|
Total participants, beginning-of-year | 2018-02-01 | 134 |
Total number of active participants reported on line 7a of the Form 5500 | 2018-02-01 | 125 |
Number of retired or separated participants receiving benefits | 2018-02-01 | 1 |
Number of other retired or separated participants entitled to future benefits | 2018-02-01 | 0 |
Total of all active and inactive participants | 2018-02-01 | 126 |
2017: FOERTSCH GROUP, LLC WELFARE BENEFIT PLAN 2017 401k membership |
---|
Total participants, beginning-of-year | 2017-02-01 | 156 |
Total number of active participants reported on line 7a of the Form 5500 | 2017-02-01 | 134 |
Number of retired or separated participants receiving benefits | 2017-02-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2017-02-01 | 0 |
Total of all active and inactive participants | 2017-02-01 | 134 |
2021: FOERTSCH GROUP, LLC WELFARE BENEFIT PLAN 2021 form 5500 responses |
---|
2021-02-01 | Type of plan entity | Single employer plan |
2021-02-01 | Plan funding arrangement – Insurance | Yes |
2021-02-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2021-02-01 | Plan benefit arrangement – Insurance | Yes |
2021-02-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2020: FOERTSCH GROUP, LLC WELFARE BENEFIT PLAN 2020 form 5500 responses |
---|
2020-02-01 | Type of plan entity | Single employer plan |
2020-02-01 | Plan funding arrangement – Insurance | Yes |
2020-02-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2020-02-01 | Plan benefit arrangement – Insurance | Yes |
2020-02-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2019: FOERTSCH GROUP, LLC WELFARE BENEFIT PLAN 2019 form 5500 responses |
---|
2019-02-01 | Type of plan entity | Single employer plan |
2019-02-01 | Submission has been amended | No |
2019-02-01 | This submission is the final filing | No |
2019-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2019-02-01 | Plan is a collectively bargained plan | No |
2019-02-01 | Plan funding arrangement – Insurance | Yes |
2019-02-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2019-02-01 | Plan benefit arrangement – Insurance | Yes |
2019-02-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2018: FOERTSCH GROUP, LLC WELFARE BENEFIT PLAN 2018 form 5500 responses |
---|
2018-02-01 | Type of plan entity | Single employer plan |
2018-02-01 | Submission has been amended | No |
2018-02-01 | This submission is the final filing | No |
2018-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2018-02-01 | Plan is a collectively bargained plan | No |
2018-02-01 | Plan funding arrangement – Insurance | Yes |
2018-02-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2018-02-01 | Plan benefit arrangement – Insurance | Yes |
2018-02-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2017: FOERTSCH GROUP, LLC WELFARE BENEFIT PLAN 2017 form 5500 responses |
---|
2017-02-01 | Type of plan entity | Single employer plan |
2017-02-01 | First time form 5500 has been submitted | Yes |
2017-02-01 | Submission has been amended | No |
2017-02-01 | This submission is the final filing | No |
2017-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2017-02-01 | Plan is a collectively bargained plan | No |
2017-02-01 | Plan funding arrangement – Insurance | Yes |
2017-02-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2017-02-01 | Plan benefit arrangement – Insurance | Yes |
2017-02-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 571357 |
Policy instance | 4 |
Insurance contract or identification number | 571357 | Number of Individuals Covered | 101 | Insurance policy start date | 2021-02-01 | Insurance policy end date | 2022-01-31 | Total amount of commissions paid to insurance broker | USD $5,455 | Total amount of fees paid to insurance company | USD $470 | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $37,560 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,455 | Amount paid for insurance broker fees | 470 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 |
|
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) |
Policy contract number | FG664 |
Policy instance | 3 |
Insurance contract or identification number | FG664 | Number of Individuals Covered | 41 | Insurance policy start date | 2021-02-01 | Insurance policy end date | 2022-01-31 | Total amount of commissions paid to insurance broker | USD $6,005 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | CANCER, DISABILITY | Welfare Benefit Premiums Paid to Carrier | USD $39,159 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,914 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 |
|
HEALTH RESOURCES INC (National Association of Insurance Commissioners NAIC id number: 96687 ) |
Policy contract number | 154130421030 |
Policy instance | 2 |
Insurance contract or identification number | 154130421030 | Number of Individuals Covered | 246 | Insurance policy start date | 2021-02-01 | Insurance policy end date | 2022-01-31 | Total amount of commissions paid to insurance broker | USD $1,839 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Welfare Benefit Premiums Paid to Carrier | USD $61,834 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,839 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 |
|
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
Policy contract number | 136-008955 |
Policy instance | 1 |
Insurance contract or identification number | 136-008955 | Number of Individuals Covered | 165 | Insurance policy start date | 2021-02-01 | Insurance policy end date | 2022-01-31 | Total amount of commissions paid to insurance broker | USD $3,380 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $33,797 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,380 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 |
|
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
Policy contract number | 136-008955 |
Policy instance | 1 |
Insurance contract or identification number | 136-008955 | Number of Individuals Covered | 187 | Insurance policy start date | 2020-02-01 | Insurance policy end date | 2021-01-31 | Total amount of commissions paid to insurance broker | USD $1,742 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $17,423 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,742 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 |
|
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 571357 |
Policy instance | 2 |
Insurance contract or identification number | 571357 | Number of Individuals Covered | 111 | Insurance policy start date | 2020-02-01 | Insurance policy end date | 2021-01-31 | Total amount of commissions paid to insurance broker | USD $5,813 | Total amount of fees paid to insurance company | USD $320 | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $39,996 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,813 | Amount paid for insurance broker fees | 320 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 |
|
HEALTH RESOURCES INC (National Association of Insurance Commissioners NAIC id number: 96687 ) |
Policy contract number | 1541030421030 |
Policy instance | 3 |
Insurance contract or identification number | 1541030421030 | Number of Individuals Covered | 163 | Insurance policy start date | 2020-02-01 | Insurance policy end date | 2021-01-31 | Total amount of commissions paid to insurance broker | USD $1,927 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Welfare Benefit Premiums Paid to Carrier | USD $64,230 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,927 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 |
|
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) |
Policy contract number | FG664 |
Policy instance | 4 |
Insurance contract or identification number | FG664 | Number of Individuals Covered | 22 | Insurance policy start date | 2020-02-01 | Insurance policy end date | 2021-01-31 | Total amount of commissions paid to insurance broker | USD $5,867 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | CANCER | Welfare Benefit Premiums Paid to Carrier | USD $45,228 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,118 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 |
|
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) |
Policy contract number | FG662 |
Policy instance | 11 |
Insurance contract or identification number | FG662 | Number of Individuals Covered | 7 | Insurance policy start date | 2019-02-01 | Insurance policy end date | 2020-01-31 | Total amount of commissions paid to insurance broker | USD $495 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | VOLUNTARY WORKSITE BENEFITS | Welfare Benefit Premiums Paid to Carrier | USD $5,145 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $202 | Insurance broker organization code? | 3 |
|
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) |
Policy contract number | FG664 |
Policy instance | 10 |
Insurance contract or identification number | FG664 | Number of Individuals Covered | 27 | Insurance policy start date | 2019-02-01 | Insurance policy end date | 2020-01-31 | Total amount of commissions paid to insurance broker | USD $5,273 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | VOLUNTARY WORKSITE BENEFITS | Welfare Benefit Premiums Paid to Carrier | USD $28,688 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,623 | Insurance broker organization code? | 3 |
|
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) |
Policy contract number | MG544 |
Policy instance | 9 |
Insurance contract or identification number | MG544 | Number of Individuals Covered | 6 | Insurance policy start date | 2019-02-01 | Insurance policy end date | 2020-01-31 | Total amount of commissions paid to insurance broker | USD $610 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | VOLUNTARY WORKSITE BENEFITS | Welfare Benefit Premiums Paid to Carrier | USD $5,068 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $349 | Insurance broker organization code? | 3 |
|
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 571357 |
Policy instance | 8 |
Insurance contract or identification number | 571357 | Number of Individuals Covered | 119 | Insurance policy start date | 2019-02-01 | Insurance policy end date | 2020-01-31 | Total amount of commissions paid to insurance broker | USD $2,930 | Total amount of fees paid to insurance company | USD $158 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $20,989 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,930 | Amount paid for insurance broker fees | 158 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION PAID | Insurance broker organization code? | 3 |
|
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) |
Policy contract number | FG663 |
Policy instance | 7 |
Insurance contract or identification number | FG663 | Number of Individuals Covered | 14 | Insurance policy start date | 2019-02-01 | Insurance policy end date | 2020-01-31 | Total amount of commissions paid to insurance broker | USD $2,488 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | VOLUNTARY WORKSITE BENEFITS | Welfare Benefit Premiums Paid to Carrier | USD $16,818 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,458 | Insurance broker organization code? | 3 |
|
HEALTH RESOURCES INC (National Association of Insurance Commissioners NAIC id number: 96687 ) |
Policy contract number | 738930410330 |
Policy instance | 6 |
Insurance contract or identification number | 738930410330 | Number of Individuals Covered | 19 | Insurance policy start date | 2019-02-01 | Insurance policy end date | 2020-01-31 | Total amount of commissions paid to insurance broker | USD $170 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $5,662 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $170 | Insurance broker organization code? | 3 |
|
HEALTH RESOURCES INC (National Association of Insurance Commissioners NAIC id number: 96687 ) |
Policy contract number | 15413042FCL |
Policy instance | 5 |
Insurance contract or identification number | 15413042FCL | Number of Individuals Covered | 26 | Insurance policy start date | 2019-02-01 | Insurance policy end date | 2020-01-31 | Total amount of commissions paid to insurance broker | USD $140 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $4,663 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $140 | Insurance broker organization code? | 3 |
|
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 579324 |
Policy instance | 4 |
Insurance contract or identification number | 579324 | Number of Individuals Covered | 42 | Insurance policy start date | 2019-02-01 | Insurance policy end date | 2020-01-31 | Total amount of commissions paid to insurance broker | USD $3,030 | Total amount of fees paid to insurance company | USD $151 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $20,197 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,030 | Amount paid for insurance broker fees | 151 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION PAID | Insurance broker organization code? | 3 |
|
HEALTH RESOURCES INC (National Association of Insurance Commissioners NAIC id number: 96687 ) |
Policy contract number | 373130341020 |
Policy instance | 3 |
Insurance contract or identification number | 373130341020 | Number of Individuals Covered | 175 | Insurance policy start date | 2019-02-01 | Insurance policy end date | 2020-01-31 | Total amount of commissions paid to insurance broker | USD $1,181 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $39,375 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,181 | Insurance broker organization code? | 3 |
|
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
Policy contract number | 136-008955 |
Policy instance | 2 |
Insurance contract or identification number | 136-008955 | Number of Individuals Covered | 200 | Insurance policy start date | 2019-02-01 | Insurance policy end date | 2020-01-31 | Total amount of commissions paid to insurance broker | USD $1,920 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $19,202 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,920 | Insurance broker organization code? | 3 |
|
HEALTH RESOURCES INC (National Association of Insurance Commissioners NAIC id number: 96687 ) |
Policy contract number | 154130421030 |
Policy instance | 1 |
Insurance contract or identification number | 154130421030 | Number of Individuals Covered | 54 | Insurance policy start date | 2019-02-01 | Insurance policy end date | 2020-01-31 | Total amount of commissions paid to insurance broker | USD $370 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $12,333 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $370 | Insurance broker organization code? | 3 |
|
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
Policy contract number | 136-008955 |
Policy instance | 2 |
Insurance contract or identification number | 136-008955 | Number of Individuals Covered | 93 | Insurance policy start date | 2017-02-01 | Insurance policy end date | 2018-01-31 | Total amount of commissions paid to insurance broker | USD $1,949 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $19,491 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,949 | Insurance broker organization code? | 3 | Insurance broker name | APEX BENEFITS GROUP INC. |
|
HEALTH RESOURCES INC (National Association of Insurance Commissioners NAIC id number: 96687 ) |
Policy contract number | 373130341020 |
Policy instance | 3 |
Insurance contract or identification number | 373130341020 | Number of Individuals Covered | 189 | Insurance policy start date | 2017-02-01 | Insurance policy end date | 2018-01-31 | Total amount of commissions paid to insurance broker | USD $1,290 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $42,989 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,290 | Insurance broker organization code? | 3 | Insurance broker name | MJ INSURANCE INC. |
|
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 579324 |
Policy instance | 4 |
Insurance contract or identification number | 579324 | Number of Individuals Covered | 42 | Insurance policy start date | 2017-02-01 | Insurance policy end date | 2018-01-31 | Total amount of commissions paid to insurance broker | USD $3,092 | Total amount of fees paid to insurance company | USD $155 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $21,803 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,092 | Amount paid for insurance broker fees | 155 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION PAID | Insurance broker organization code? | 3 | Insurance broker name | MJ INSURANCE, INC. |
|
HEALTH RESOURCES INC (National Association of Insurance Commissioners NAIC id number: 96687 ) |
Policy contract number | 15413042FCL |
Policy instance | 5 |
Insurance contract or identification number | 15413042FCL | Number of Individuals Covered | 20 | Insurance policy start date | 2017-02-01 | Insurance policy end date | 2018-01-31 | Total amount of commissions paid to insurance broker | USD $118 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $3,924 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $118 | Insurance broker organization code? | 3 | Insurance broker name | MJ INSURANCE INC. |
|
HEALTH RESOURCES INC (National Association of Insurance Commissioners NAIC id number: 96687 ) |
Policy contract number | 738930410330 |
Policy instance | 6 |
Insurance contract or identification number | 738930410330 | Number of Individuals Covered | 27 | Insurance policy start date | 2017-02-01 | Insurance policy end date | 2018-01-31 | Total amount of commissions paid to insurance broker | USD $177 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $5,914 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $177 | Insurance broker organization code? | 3 | Insurance broker name | MJ INSURANCE INC. |
|
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) |
Policy contract number | FG663 |
Policy instance | 7 |
Insurance contract or identification number | FG663 | Number of Individuals Covered | 13 | Insurance policy start date | 2017-02-01 | Insurance policy end date | 2018-01-31 | Total amount of commissions paid to insurance broker | USD $2,907 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | VOLUNTARY WORKSITE BENEFITS | Welfare Benefit Premiums Paid to Carrier | USD $18,975 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,706 | Insurance broker organization code? | 3 | Insurance broker name | MARTIN S CULLEN |
|
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 571357 |
Policy instance | 8 |
Insurance contract or identification number | 571357 | Number of Individuals Covered | 28 | Insurance policy start date | 2017-02-01 | Insurance policy end date | 2018-01-31 | Total amount of commissions paid to insurance broker | USD $3,352 | Total amount of fees paid to insurance company | USD $180 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $8,303 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,352 | Amount paid for insurance broker fees | 180 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION PAID | Insurance broker organization code? | 3 | Insurance broker name | MJ INSURANCE, INC. |
|
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) |
Policy contract number | MG544 |
Policy instance | 9 |
Insurance contract or identification number | MG544 | Number of Individuals Covered | 5 | Insurance policy start date | 2017-02-01 | Insurance policy end date | 2018-01-31 | Total amount of commissions paid to insurance broker | USD $1,001 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | VOLUNTARY WORKSITE BENEFITS | Welfare Benefit Premiums Paid to Carrier | USD $4,865 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $719 | Insurance broker organization code? | 3 | Insurance broker name | MARTIN S CULLEN |
|
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) |
Policy contract number | FG664 |
Policy instance | 10 |
Insurance contract or identification number | FG664 | Number of Individuals Covered | 61 | Insurance policy start date | 2017-02-01 | Insurance policy end date | 2018-01-31 | Total amount of commissions paid to insurance broker | USD $4,223 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | VOLUNTARY WORKSITE BENEFITS | Welfare Benefit Premiums Paid to Carrier | USD $34,133 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,076 | Insurance broker organization code? | 3 | Insurance broker name | MARTIN S CULLEN |
|
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) |
Policy contract number | FG662 |
Policy instance | 11 |
Insurance contract or identification number | FG662 | Number of Individuals Covered | 13 | Insurance policy start date | 2017-02-01 | Insurance policy end date | 2018-01-31 | Total amount of commissions paid to insurance broker | USD $705 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | VOLUNTARY WORKSITE BENEFITS | Welfare Benefit Premiums Paid to Carrier | USD $7,288 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $352 | Insurance broker organization code? | 3 | Insurance broker name | MARTIN S CULLEN |
|
HEALTH RESOURCES INC (National Association of Insurance Commissioners NAIC id number: 96687 ) |
Policy contract number | 154130421030 |
Policy instance | 1 |
Insurance contract or identification number | 154130421030 | Number of Individuals Covered | 42 | Insurance policy start date | 2017-02-01 | Insurance policy end date | 2018-01-31 | Total amount of commissions paid to insurance broker | USD $338 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $11,266 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $338 | Insurance broker organization code? | 3 | Insurance broker name | MJ INSURANCE INC. |
|