ILITCH HOLDINGS, INC. has sponsored the creation of one or more 401k plans.
Additional information about ILITCH HOLDINGS, INC.
Submission information for form 5500 for 401k plan ILITCH HOLDINGS, INC. WELFARE BENEFIT PLAN
401k plan membership statisitcs for ILITCH HOLDINGS, INC. WELFARE BENEFIT PLAN
Measure | Date | Value |
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2022: ILITCH HOLDINGS, INC. WELFARE BENEFIT PLAN 2022 401k membership |
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Total participants, beginning-of-year | 2022-01-01 | 3,147 |
Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 3,176 |
Number of retired or separated participants receiving benefits | 2022-01-01 | 64 |
Number of other retired or separated participants entitled to future benefits | 2022-01-01 | 0 |
Total of all active and inactive participants | 2022-01-01 | 3,240 |
Number of employers contributing to the scheme | 2022-01-01 | 0 |
2021: ILITCH HOLDINGS, INC. WELFARE BENEFIT PLAN 2021 401k membership |
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Total participants, beginning-of-year | 2021-01-01 | 3,306 |
Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 3,176 |
Number of retired or separated participants receiving benefits | 2021-01-01 | 6 |
Number of other retired or separated participants entitled to future benefits | 2021-01-01 | 3 |
Total of all active and inactive participants | 2021-01-01 | 3,185 |
Number of employers contributing to the scheme | 2021-01-01 | 0 |
2020: ILITCH HOLDINGS, INC. WELFARE BENEFIT PLAN 2020 401k membership |
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Total participants, beginning-of-year | 2020-01-01 | 3,510 |
Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 3,383 |
Number of retired or separated participants receiving benefits | 2020-01-01 | 41 |
Number of other retired or separated participants entitled to future benefits | 2020-01-01 | 60 |
Total of all active and inactive participants | 2020-01-01 | 3,484 |
Number of employers contributing to the scheme | 2020-01-01 | 0 |
2019: ILITCH HOLDINGS, INC. WELFARE BENEFIT PLAN 2019 401k membership |
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Total participants, beginning-of-year | 2019-01-01 | 3,404 |
Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 3,455 |
Number of retired or separated participants receiving benefits | 2019-01-01 | 27 |
Number of other retired or separated participants entitled to future benefits | 2019-01-01 | 0 |
Total of all active and inactive participants | 2019-01-01 | 3,482 |
2018: ILITCH HOLDINGS, INC. WELFARE BENEFIT PLAN 2018 401k membership |
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Total participants, beginning-of-year | 2018-01-01 | 3,497 |
Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 3,404 |
Number of retired or separated participants receiving benefits | 2018-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2018-01-01 | 0 |
Total of all active and inactive participants | 2018-01-01 | 3,404 |
2017: ILITCH HOLDINGS, INC. WELFARE BENEFIT PLAN 2017 401k membership |
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Total participants, beginning-of-year | 2017-01-01 | 3,176 |
Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 3,497 |
Number of retired or separated participants receiving benefits | 2017-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2017-01-01 | 0 |
Total of all active and inactive participants | 2017-01-01 | 3,497 |
2016: ILITCH HOLDINGS, INC. WELFARE BENEFIT PLAN 2016 401k membership |
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Total participants, beginning-of-year | 2016-01-01 | 3,024 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 3,176 |
Number of retired or separated participants receiving benefits | 2016-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2016-01-01 | 0 |
Total of all active and inactive participants | 2016-01-01 | 3,176 |
2015: ILITCH HOLDINGS, INC. WELFARE BENEFIT PLAN 2015 401k membership |
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Total participants, beginning-of-year | 2015-01-01 | 2,912 |
Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 3,024 |
Number of retired or separated participants receiving benefits | 2015-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2015-01-01 | 0 |
Total of all active and inactive participants | 2015-01-01 | 3,024 |
2014: ILITCH HOLDINGS, INC. WELFARE BENEFIT PLAN 2014 401k membership |
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Total participants, beginning-of-year | 2014-01-01 | 2,801 |
Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 2,912 |
Number of retired or separated participants receiving benefits | 2014-01-01 | 0 |
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 | 2,912 |
2013: ILITCH HOLDINGS, INC. WELFARE BENEFIT PLAN 2013 401k membership |
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Total participants, beginning-of-year | 2013-01-01 | 2,579 |
Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 2,801 |
Number of retired or separated participants receiving benefits | 2013-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2013-01-01 | 0 |
Total of all active and inactive participants | 2013-01-01 | 2,801 |
2012: ILITCH HOLDINGS, INC. WELFARE BENEFIT PLAN 2012 401k membership |
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Total participants, beginning-of-year | 2012-01-01 | 2,441 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 2,579 |
Number of retired or separated participants receiving benefits | 2012-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2012-01-01 | 0 |
Total of all active and inactive participants | 2012-01-01 | 2,579 |
2011: ILITCH HOLDINGS, INC. WELFARE BENEFIT PLAN 2011 401k membership |
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Total participants, beginning-of-year | 2011-01-01 | 2,391 |
Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 2,441 |
Number of retired or separated participants receiving benefits | 2011-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2011-01-01 | 0 |
Total of all active and inactive participants | 2011-01-01 | 2,441 |
2009: ILITCH HOLDINGS, INC. WELFARE BENEFIT PLAN 2009 401k membership |
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Total participants, beginning-of-year | 2009-12-01 | 2,356 |
Total number of active participants reported on line 7a of the Form 5500 | 2009-12-01 | 2,391 |
Number of retired or separated participants receiving benefits | 2009-12-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2009-12-01 | 0 |
Total of all active and inactive participants | 2009-12-01 | 2,391 |
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | 97718331001 |
Policy instance | 6 |
Insurance contract or identification number | 97718331001 | Number of Individuals Covered | 4130 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $36,680 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | Yes | 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 $287,550 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $36,680 | 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 | 564248 0001 |
Policy instance | 5 |
Insurance contract or identification number | 564248 0001 | Number of Individuals Covered | 3370 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $250,135 | Total amount of fees paid to insurance company | USD $26,241 | 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 | No | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT,ACCIDENT, CRITICAL ILLNESS | Welfare Benefit Premiums Paid to Carrier | USD $2,593,635 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $215,960 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION |
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PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) |
Policy contract number | 10355147 |
Policy instance | 4 |
Insurance contract or identification number | 10355147 | Number of Individuals Covered | 878 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $19,119 | Total amount of fees paid to insurance company | USD $1,009 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $278,277 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $14,817 | Amount paid for insurance broker fees | 747 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 |
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METROPOLITAN PROPERTY AND CASUALTY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 26298 ) |
Policy contract number | 6090487 |
Policy instance | 3 |
Insurance contract or identification number | 6090487 | Number of Individuals Covered | 486 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $10,683 | Total amount of fees paid to insurance company | USD $1,407 | Other welfare benefits provided | LEGAL | Welfare Benefit Premiums Paid to Carrier | USD $99,090 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $10,683 | Amount paid for insurance broker fees | 173 | Additional information about fees paid to insurance broker | NON-MONETARY COMPENSATION, SUPPLEMENTAL COMPENSATION | Insurance broker organization code? | 3 |
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DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 ) |
Policy contract number | 1170-0001 |
Policy instance | 2 |
Insurance contract or identification number | 1170-0001 | Number of Individuals Covered | 1170 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $39,395 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $39,395 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 |
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HEALTH ADVOCATE, INC. (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | EAP |
Policy instance | 1 |
Insurance contract or identification number | EAP | Number of Individuals Covered | 4046 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | EMPLOYEE ASSISTANCE PROGRAM | Welfare Benefit Premiums Paid to Carrier | USD $41,306 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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ULLIANCE, INC. (National Association of Insurance Commissioners NAIC id number: 62419 ) |
Policy contract number | EAP |
Policy instance | 1 |
Insurance contract or identification number | EAP | Number of Individuals Covered | 3383 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | EMPLOYEE ASSISTANCE PROGRAM | Welfare Benefit Premiums Paid to Carrier | USD $109,617 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 ) |
Policy contract number | 1170 |
Policy instance | 2 |
Insurance contract or identification number | 1170 | Number of Individuals Covered | 5091 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $42,067 | Total amount of fees paid to insurance company | USD $1,958 | Dental Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $42,067 | Amount paid for insurance broker fees | 1958 | Additional information about fees paid to insurance broker | RETENTION BONUS | Insurance broker organization code? | 3 |
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METROPOLITAN PROPERTY AND CASUALTY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 26298 ) |
Policy contract number | 6090487 |
Policy instance | 3 |
Insurance contract or identification number | 6090487 | Number of Individuals Covered | 476 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $11,426 | Total amount of fees paid to insurance company | USD $931 | Other welfare benefits provided | LEGAL | Welfare Benefit Premiums Paid to Carrier | USD $114,570 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,091 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION |
|
PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) |
Policy contract number | 10355147 |
Policy instance | 4 |
Insurance contract or identification number | 10355147 | Number of Individuals Covered | 1226 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $58,959 | Total amount of fees paid to insurance company | USD $5,472 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $342,124 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $50,063 | Amount paid for insurance broker fees | 4653 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 |
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EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | 97718331001 |
Policy instance | 5 |
Insurance contract or identification number | 97718331001 | Number of Individuals Covered | 4236 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $34,186 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | Yes | 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 $312,073 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $34,186 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 564248 0001 |
Policy instance | 6 |
Insurance contract or identification number | 564248 0001 | Number of Individuals Covered | 3219 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $149,466 | Total amount of fees paid to insurance company | USD $19,084 | 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 | No | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT,ACCIDENT, CRITICAL ILLNESS | Welfare Benefit Premiums Paid to Carrier | USD $1,527,876 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $149,466 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION |
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ULLIANCE, INC. (National Association of Insurance Commissioners NAIC id number: 62419 ) |
Policy contract number | EAP |
Policy instance | 1 |
Insurance contract or identification number | EAP | Number of Individuals Covered | 3606 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | EMPLOYEE ASSISTANCE PROGRAM | Welfare Benefit Premiums Paid to Carrier | USD $116,843 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 ) |
Policy contract number | 1170 |
Policy instance | 2 |
Insurance contract or identification number | 1170 | Number of Individuals Covered | 5499 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $43,992 | Total amount of fees paid to insurance company | USD $17,226 | Dental Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $40,469 | Amount paid for insurance broker fees | 8748 | Additional information about fees paid to insurance broker | NEW BUSINESS BONUS RETENTION BONUS | Insurance broker organization code? | 3 |
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METROPOLITAN PROPERTY AND CASUALTY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 26298 ) |
Policy contract number | 6090487 |
Policy instance | 3 |
Insurance contract or identification number | 6090487 | Number of Individuals Covered | 533 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $12,413 | Total amount of fees paid to insurance company | USD $1,781 | Other welfare benefits provided | LEGAL | Welfare Benefit Premiums Paid to Carrier | USD $125,208 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $11,362 | Amount paid for insurance broker fees | 41 | Additional information about fees paid to insurance broker | NON-MONETARY COMPENSATION | Insurance broker organization code? | 3 |
|
PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) |
Policy contract number | 10355147 |
Policy instance | 4 |
Insurance contract or identification number | 10355147 | Number of Individuals Covered | 1382 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $96,394 | Total amount of fees paid to insurance company | USD $10,150 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $354,552 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $81,872 | Amount paid for insurance broker fees | 8760 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 |
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FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
Policy contract number | R0561795 |
Policy instance | 5 |
Insurance contract or identification number | R0561795 | Number of Individuals Covered | 1 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $144 | 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: 62146 ) |
Policy contract number | 97718331001 |
Policy instance | 6 |
Insurance contract or identification number | 97718331001 | Number of Individuals Covered | 4597 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $31,841 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | Yes | 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 $318,705 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $29,181 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 564248 |
Policy instance | 7 |
Insurance contract or identification number | 564248 | Number of Individuals Covered | 3407 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $589,072 | Total amount of fees paid to insurance company | USD $68,849 | 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 | No | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT,ACCIDENT, CRITICAL ILLNESS | Welfare Benefit Premiums Paid to Carrier | USD $3,320,122 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $360,930 | Amount paid for insurance broker fees | 43912 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | R0561795 |
Policy instance | 6 |
Insurance contract or identification number | R0561795 | Number of Individuals Covered | 3093 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2020-01-01 | Total amount of commissions paid to insurance broker | USD $218,566 | Total amount of fees paid to insurance company | USD $26,187 | Other welfare benefits provided | ACCIDENTAL AND CRITICAL ILLNESS | Welfare Benefit Premiums Paid to Carrier | USD $883,208 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $181,314 | Amount paid for insurance broker fees | 23913 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION PAID | Insurance broker organization code? | 3 |
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METROPOLITAN PROPERTY AND CASUALTY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 26298 ) |
Policy contract number | 6090487 |
Policy instance | 5 |
Insurance contract or identification number | 6090487 | Number of Individuals Covered | 525 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $11,528 | Total amount of fees paid to insurance company | USD $1,604 | Other welfare benefits provided | LEGAL CONSULTING | Welfare Benefit Premiums Paid to Carrier | USD $115,686 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $11,528 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 1550 | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION |
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DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 ) |
Policy contract number | 1170 |
Policy instance | 4 |
Insurance contract or identification number | 1170 | Number of Individuals Covered | 5457 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $44,216 | Total amount of fees paid to insurance company | USD $2,643 | Dental Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $44,216 | Amount paid for insurance broker fees | 2643 | Additional information about fees paid to insurance broker | NEW BUSINESS BONUS, RETENTION BONUS | Insurance broker organization code? | 3 |
|
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 62146 ) |
Policy contract number | 97718331001 |
Policy instance | 3 |
Insurance contract or identification number | 97718331001 | Number of Individuals Covered | 4513 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $36,311 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $312,377 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $36,311 | Insurance broker organization code? | 3 |
|
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 564248 |
Policy instance | 2 |
Insurance contract or identification number | 564248 | Number of Individuals Covered | 3462 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2020-01-01 | Total amount of commissions paid to insurance broker | USD $136,461 | Total amount of fees paid to insurance company | USD $17,533 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $1,406,720 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $136,461 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 17533 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION PAID |
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ULLIANCE, INC. (National Association of Insurance Commissioners NAIC id number: 62419 ) |
Policy contract number | NONE |
Policy instance | 1 |
Insurance contract or identification number | NONE | Number of Individuals Covered | 3436 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | EMPLOYEE ASSISTANCE PROGRAM | Welfare Benefit Premiums Paid to Carrier | USD $111,529 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) |
Policy contract number | 0010355147 |
Policy instance | 7 |
Insurance contract or identification number | 0010355147 | Number of Individuals Covered | 1370 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2020-01-01 | Total amount of commissions paid to insurance broker | USD $105,681 | Total amount of fees paid to insurance company | USD $11,251 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | WHOLE LIFE | Welfare Benefit Premiums Paid to Carrier | USD $355,797 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $89,761 | Amount paid for insurance broker fees | 9696 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION PAID | Insurance broker organization code? | 3 |
|
ULLIANCE, INC. (National Association of Insurance Commissioners NAIC id number: 62419 ) |
Policy contract number | NONE |
Policy instance | 1 |
Insurance contract or identification number | NONE | Number of Individuals Covered | 3355 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | EMPLOYEE ASSISTANCE PROGRAM | Welfare Benefit Premiums Paid to Carrier | USD $108,694 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 564248 |
Policy instance | 2 |
Insurance contract or identification number | 564248 | Number of Individuals Covered | 3388 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2019-01-01 | Total amount of commissions paid to insurance broker | USD $116,730 | Total amount of fees paid to insurance company | USD $14,937 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $1,194,962 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $116,730 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 14937 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION PAID |
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EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 62146 ) |
Policy contract number | 97718331001 |
Policy instance | 3 |
Insurance contract or identification number | 97718331001 | Number of Individuals Covered | 4331 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $27,959 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $330,338 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $27,959 | Insurance broker organization code? | 3 |
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DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 ) |
Policy contract number | 1170 |
Policy instance | 4 |
Insurance contract or identification number | 1170 | Number of Individuals Covered | 5337 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $45,146 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $45,146 | Insurance broker organization code? | 3 |
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METROPOLITAN PROPERTY AND CASUALTY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 26298 ) |
Policy contract number | 6090487 |
Policy instance | 5 |
Insurance contract or identification number | 6090487 | Number of Individuals Covered | 473 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Total amount of commissions paid to insurance broker | USD $10,429 | Total amount of fees paid to insurance company | USD $1,928 | Other welfare benefits provided | LEGAL CONSULTING | Welfare Benefit Premiums Paid to Carrier | USD $112,428 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $10,429 | Amount paid for insurance broker fees | 139 | Additional information about fees paid to insurance broker | NON-MONETARY COMPENSATION | Insurance broker organization code? | 3 |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | R0561795 |
Policy instance | 6 |
Insurance contract or identification number | R0561795 | Number of Individuals Covered | 3018 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2019-01-01 | Total amount of commissions paid to insurance broker | USD $187,687 | Total amount of fees paid to insurance company | USD $22,080 | Other welfare benefits provided | ACCIDENTAL AND CRITICAL ILLNESS | Welfare Benefit Premiums Paid to Carrier | USD $854,692 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $153,314 | Amount paid for insurance broker fees | 20193 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION PAID | Insurance broker organization code? | 3 |
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PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) |
Policy contract number | 0010355147 |
Policy instance | 7 |
Insurance contract or identification number | 0010355147 | Number of Individuals Covered | 1335 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2019-01-01 | Total amount of commissions paid to insurance broker | USD $100,336 | Total amount of fees paid to insurance company | USD $10,420 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | WHOLE LIFE | Welfare Benefit Premiums Paid to Carrier | USD $334,837 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $85,194 | Amount paid for insurance broker fees | 9494 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION PAID | Insurance broker organization code? | 3 |
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PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) |
Policy contract number | 0010355147 |
Policy instance | 7 |
Insurance contract or identification number | 0010355147 | Number of Individuals Covered | 1216 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2018-01-01 | Total amount of commissions paid to insurance broker | USD $138,995 | Total amount of fees paid to insurance company | USD $7,400 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | WHOLE LIFE | Welfare Benefit Premiums Paid to Carrier | USD $306,691 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $117,376 | Amount paid for insurance broker fees | 6752 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION PAID | Insurance broker organization code? | 3 | Insurance broker name | MORRIS, CHRISTOPHER, ROBERT |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | R0561795 |
Policy instance | 6 |
Insurance contract or identification number | R0561795 | Number of Individuals Covered | 2898 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2018-01-01 | Total amount of commissions paid to insurance broker | USD $167,328 | Total amount of fees paid to insurance company | USD $19,861 | Other welfare benefits provided | ACCIDENTAL AND CRITICAL ILLNESS | Welfare Benefit Premiums Paid to Carrier | USD $802,205 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $134,810 | Amount paid for insurance broker fees | 18077 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION PAID | Insurance broker organization code? | 3 | Insurance broker name | MORRIS, CHRISTOPHER, ROBERT |
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HYATT LEGAL PLANS (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 6090487 |
Policy instance | 5 |
Insurance contract or identification number | 6090487 | Number of Individuals Covered | 463 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $9,853 | Total amount of fees paid to insurance company | USD $64 | Other welfare benefits provided | LEGAL CONSULTING | Welfare Benefit Premiums Paid to Carrier | USD $97,434 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $9,853 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 64 | Additional information about fees paid to insurance broker | NON-MONETARY COMPENSAION | Insurance broker name | GALLAGHER BENEFIT SERVICES OF MI, I |
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DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 ) |
Policy contract number | 1170 |
Policy instance | 4 |
Insurance contract or identification number | 1170 | Number of Individuals Covered | 5216 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $38,012 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $38,012 | Insurance broker organization code? | 3 | Insurance broker name | GALLAGHER BENEFIT SERVICES INC. |
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EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 62146 ) |
Policy contract number | 97718331001 |
Policy instance | 3 |
Insurance contract or identification number | 97718331001 | Number of Individuals Covered | 4251 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $28,550 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $290,069 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $28,550 | Insurance broker organization code? | 3 | Insurance broker name | GALLAGHER BENEFIT SERVICES INC. |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 564248 |
Policy instance | 2 |
Insurance contract or identification number | 564248 | Number of Individuals Covered | 3286 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2018-01-01 | Total amount of commissions paid to insurance broker | USD $106,798 | Total amount of fees paid to insurance company | USD $13,679 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $1,094,342 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $106,798 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 13679 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION PAID | Insurance broker name | GALLAGHER BENEFIT SERVICES INC. |
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ULLIANCE, INC. (National Association of Insurance Commissioners NAIC id number: 62419 ) |
Policy contract number | NONE |
Policy instance | 1 |
Insurance contract or identification number | NONE | Number of Individuals Covered | 3170 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | EMPLOYEE ASSISTANCE PROGRAM | Welfare Benefit Premiums Paid to Carrier | USD $102,708 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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HYATT LEGAL PLANS (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 6090487 |
Policy instance | 5 |
Insurance contract or identification number | 6090487 | Number of Individuals Covered | 368 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $8,089 | Total amount of fees paid to insurance company | USD $40 | Other welfare benefits provided | LEGAL CONSULTING | Welfare Benefit Premiums Paid to Carrier | USD $78,390 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $8,089 | Amount paid for insurance broker fees | 40 | Additional information about fees paid to insurance broker | NON-MONETARY COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | GALLAGHER BENEFIT SERVICES INC. |
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DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 ) |
Policy contract number | 1170 |
Policy instance | 4 |
Insurance contract or identification number | 1170 | Number of Individuals Covered | 4760 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $37,580 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $37,580 | Insurance broker organization code? | 3 | Insurance broker name | GALLAGHER BENEFIT SERVICES INC. |
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EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 62146 ) |
Policy contract number | 9771833 |
Policy instance | 3 |
Insurance contract or identification number | 9771833 | Number of Individuals Covered | 3642 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $24,635 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $247,124 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $24,635 | Insurance broker organization code? | 3 | Insurance broker name | GALLAGHER BENEFIT SERVICES INC. |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 564248 |
Policy instance | 2 |
Insurance contract or identification number | 564248 | Number of Individuals Covered | 2995 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2016-12-31 | Total amount of commissions paid to insurance broker | USD $95,346 | Total amount of fees paid to insurance company | USD $12,158 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $978,002 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $95,346 | Amount paid for insurance broker fees | 4590 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION PAID | Insurance broker organization code? | 3 | Insurance broker name | GALLAGHER BENEFIT SERVICES INC. |
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ULLIANCE, INC. (National Association of Insurance Commissioners NAIC id number: 62419 ) |
Policy contract number | ILITCH HOLDINGS |
Policy instance | 1 |
Insurance contract or identification number | ILITCH HOLDINGS | Number of Individuals Covered | 2926 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $94,802 | Other welfare benefits provided | EMPLOYEE ASSISTANCE PROGRAM | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 94802 | Insurance broker organization code? | 3 | Insurance broker name | |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | R0561795 |
Policy instance | 6 |
Insurance contract or identification number | R0561795 | Number of Individuals Covered | 2320 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2016-01-01 | Total amount of commissions paid to insurance broker | USD $382,066 | Total amount of fees paid to insurance company | USD $59,552 | Temporary Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL AND CRITICAL ILLNESS | Welfare Benefit Premiums Paid to Carrier | USD $623,060 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $244,512 | Amount paid for insurance broker fees | 44739 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION PAID | Insurance broker organization code? | 3 | Insurance broker name | MORRIS, CHRISTOPHER, ROBERT |
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EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 62146 ) |
Policy contract number | 9771833 |
Policy instance | 3 |
Insurance contract or identification number | 9771833 | Number of Individuals Covered | 3521 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $17,788 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $195,786 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $17,788 | Insurance broker organization code? | 3 | Insurance broker name | GALLAGHER BENEFIT SERVICES INC. |
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ULLIANCE, INC. (National Association of Insurance Commissioners NAIC id number: 62419 ) |
Policy contract number | ILITCH HOLDINGS |
Policy instance | 1 |
Insurance contract or identification number | ILITCH HOLDINGS | Number of Individuals Covered | 2833 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $91,781 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Other welfare benefits provided | EMPLOYEE ASSISTANCE PROGRAM | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 91781 | Insurance broker name | |
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DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 ) |
Policy contract number | 1170 |
Policy instance | 4 |
Insurance contract or identification number | 1170 | Number of Individuals Covered | 4813 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $30,568 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $30,568 | Insurance broker organization code? | 3 | Insurance broker name | GALLAGHER BENEFIT SERVICES INC. |
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HYATT LEGAL PLANS (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 6090487 |
Policy instance | 5 |
Insurance contract or identification number | 6090487 | Number of Individuals Covered | 208 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $4,223 | Total amount of fees paid to insurance company | USD $12 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Other welfare benefits provided | LEGAL CONSULTING | Welfare Benefit Premiums Paid to Carrier | USD $40,572 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,223 | Amount paid for insurance broker fees | 12 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION PAID | Insurance broker organization code? | 3 | Insurance broker name | GALLAGHER BENEFIT SERVICES INC. |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 564248 |
Policy instance | 2 |
Insurance contract or identification number | 564248 | Number of Individuals Covered | 2889 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $66,866 | Total amount of fees paid to insurance company | USD $8,498 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $748,984 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $66,866 | Amount paid for insurance broker fees | 8498 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION PAID | Insurance broker organization code? | 3 | Insurance broker name | GALLAGHER BENEFIT SERVICES INC. |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 564248 |
Policy instance | 2 |
Insurance contract or identification number | 564248 | Number of Individuals Covered | 2793 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $76,368 | Total amount of fees paid to insurance company | USD $1,473 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $775,856 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $76,368 | Amount paid for insurance broker fees | 1473 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION PAID | Insurance broker organization code? | 3 | Insurance broker name | GALLAGHER BENEFIT SERVICES INC. |
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ULLIANCE, INC. (National Association of Insurance Commissioners NAIC id number: 62419 ) |
Policy contract number | ILITCH HOLDINGS |
Policy instance | 1 |
Insurance contract or identification number | ILITCH HOLDINGS | Number of Individuals Covered | 2644 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $83,429 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Other welfare benefits provided | EMPLOYEE ASSISTANCE PROGRAM | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 83429 | Insurance broker name | |
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DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 ) |
Policy contract number | 1170 |
Policy instance | 4 |
Insurance contract or identification number | 1170 | Number of Individuals Covered | 4554 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $29,986 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $29,986 | Insurance broker organization code? | 3 | Insurance broker name | GALLAGHER BENEFIT SERVICES INC. |
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HYATT LEGAL PLANS (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 6090487 |
Policy instance | 5 |
Insurance contract or identification number | 6090487 | Number of Individuals Covered | 123 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $2,511 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Other welfare benefits provided | LEGAL CONSULTING | Welfare Benefit Premiums Paid to Carrier | USD $22,824 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,511 | Insurance broker organization code? | 3 | Insurance broker name | GALLAGHER BENEFIT SERVICES INC. |
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EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 62146 ) |
Policy contract number | 9771833 |
Policy instance | 3 |
Insurance contract or identification number | 9771833 | Number of Individuals Covered | 2991 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $17,941 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $167,213 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $17,941 | Insurance broker organization code? | 3 | Insurance broker name | GALLAGHER BENEFIT SERVICES INC. |
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DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 ) |
Policy contract number | 1170 |
Policy instance | 4 |
Insurance contract or identification number | 1170 | Number of Individuals Covered | 4362 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $33,371 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $33,371 | Insurance broker organization code? | 3 | Insurance broker name | GALLAGHER BENEFIT SERVICES INC. |
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EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 62146 ) |
Policy contract number | 9771833 |
Policy instance | 3 |
Insurance contract or identification number | 9771833 | Number of Individuals Covered | 2606 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $15,476 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $144,304 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $15,476 | Insurance broker organization code? | 3 | Insurance broker name | GALLAGHER BENEFIT SERVICES INC. |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 564248 |
Policy instance | 2 |
Insurance contract or identification number | 564248 | Number of Individuals Covered | 2629 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $54,230 | Total amount of fees paid to insurance company | USD $-77 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $640,676 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $54,007 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION PAID | Insurance broker organization code? | 3 | Insurance broker name | THE RAINS GROUP INC |
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ULLIANCE, INC. (National Association of Insurance Commissioners NAIC id number: 62419 ) |
Policy contract number | ILITCH HOLDINGS |
Policy instance | 1 |
Insurance contract or identification number | ILITCH HOLDINGS | Number of Individuals Covered | 2535 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Other welfare benefits provided | EMPLOYEE ASSISTANCE PROGRAM | Welfare Benefit Premiums Paid to Carrier | USD $87,745 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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ULLIANCE, INC. (National Association of Insurance Commissioners NAIC id number: 62419 ) |
Policy contract number | ILITCH HOLDINGS |
Policy instance | 1 |
Insurance contract or identification number | ILITCH HOLDINGS | Number of Individuals Covered | 2452 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Other welfare benefits provided | EMPLOYEE ASSISTANCE PROGRAM | Welfare Benefit Premiums Paid to Carrier | USD $85,037 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 564248 |
Policy instance | 2 |
Insurance contract or identification number | 564248 | Number of Individuals Covered | 2453 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $42,366 | Total amount of fees paid to insurance company | USD $3,630 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $583,268 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Commission paid to Insurance Broker | USD $21,539 | Additional information about fees paid to insurance broker | BASE COMMISSIONS | Insurance broker organization code? | 3 |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 119662 |
Policy instance | 3 |
Insurance contract or identification number | 119662 | Number of Individuals Covered | 0 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $1,411 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 62146 ) |
Policy contract number | 9771833 |
Policy instance | 4 |
Insurance contract or identification number | 9771833 | Number of Individuals Covered | 2291 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $11,847 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $119,369 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 ) |
Policy contract number | 1170 |
Policy instance | 5 |
Insurance contract or identification number | 1170 | Number of Individuals Covered | 4285 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $21,679 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 62146 ) |
Policy contract number | 9771833 |
Policy instance | 4 |
Insurance contract or identification number | 9771833 | Number of Individuals Covered | 1974 | Insurance policy start date | 2010-12-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $0 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Insurance broker name | GALLAGHER BENEFIT SERVICES INC. |
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ULLIANCE, INC. (National Association of Insurance Commissioners NAIC id number: 62419 ) |
Policy contract number | ILITCH HOLDINGS |
Policy instance | 1 |
Insurance contract or identification number | ILITCH HOLDINGS | Number of Individuals Covered | 2438 | Insurance policy start date | 2010-12-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Other welfare benefits provided | EMPLOYEE ASSISTANCE PROGRAM | Welfare Benefit Premiums Paid to Carrier | USD $6,412 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 564248 |
Policy instance | 2 |
Insurance contract or identification number | 564248 | Number of Individuals Covered | 2382 | Insurance policy start date | 2010-12-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $3,108 | Total amount of fees paid to insurance company | USD $267 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,895 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 267 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION PAID | Insurance broker name | THE RAINS GROUP INC |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 119662 |
Policy instance | 3 |
Insurance contract or identification number | 119662 | Number of Individuals Covered | 3830 | Insurance policy start date | 2010-12-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $1,403 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $69,714 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $0 | Amount paid for insurance broker fees | 1403 | Insurance broker organization code? | 3 | Insurance broker name | |
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