FLEET FARM WHOLESALE SUPPLY COMPANY, LLC has sponsored the creation of one or more 401k plans.
| Measure | Date | Value |
|---|
| 2022: FLEET FARM CAFETERIA PLAN 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-07-01 | 2,358 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-07-01 | 2,369 |
| Total of all active and inactive participants | 2022-07-01 | 2,369 |
| 2021: FLEET FARM CAFETERIA PLAN 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-07-01 | 2,376 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-07-01 | 2,358 |
| Total of all active and inactive participants | 2021-07-01 | 2,358 |
| 2020: FLEET FARM CAFETERIA PLAN 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-07-01 | 2,979 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-07-01 | 2,376 |
| Total of all active and inactive participants | 2020-07-01 | 2,376 |
| 2019: FLEET FARM CAFETERIA PLAN 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-07-01 | 2,815 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-07-01 | 2,979 |
| Total of all active and inactive participants | 2019-07-01 | 2,979 |
| 2018: FLEET FARM CAFETERIA PLAN 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-07-01 | 2,620 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-07-01 | 2,815 |
| Total of all active and inactive participants | 2018-07-01 | 2,815 |
| 2017: FLEET FARM CAFETERIA PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-07-01 | 2,640 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-07-01 | 2,620 |
| Total of all active and inactive participants | 2017-07-01 | 2,620 |
| 2016: FLEET FARM CAFETERIA PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-07-01 | 3,087 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-07-01 | 2,640 |
| Total of all active and inactive participants | 2016-07-01 | 2,640 |
| 2015: FLEET FARM CAFETERIA PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-07-01 | 3,212 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-07-01 | 3,087 |
| Total of all active and inactive participants | 2015-07-01 | 3,087 |
| 2014: FLEET FARM CAFETERIA PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-07-01 | 3,169 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-07-01 | 3,212 |
| Total of all active and inactive participants | 2014-07-01 | 3,212 |
| 2013: FLEET FARM CAFETERIA PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-07-01 | 3,118 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-07-01 | 3,169 |
| Total of all active and inactive participants | 2013-07-01 | 3,169 |
| 2012: FLEET FARM CAFETERIA PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-07-01 | 3,000 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-07-01 | 3,118 |
| Total of all active and inactive participants | 2012-07-01 | 3,118 |
| 2011: FLEET FARM CAFETERIA PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-07-01 | 2,965 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-07-01 | 3,000 |
| Total of all active and inactive participants | 2011-07-01 | 3,000 |
| 2009: FLEET FARM CAFETERIA PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-07-01 | 2,999 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-07-01 | 2,973 |
| Total of all active and inactive participants | 2009-07-01 | 2,973 |
| 2022: FLEET FARM CAFETERIA PLAN 2022 form 5500 responses |
|---|
| 2022-07-01 | Type of plan entity | Single employer plan |
| 2022-07-01 | Plan funding arrangement – Insurance | Yes |
| 2022-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2021: FLEET FARM CAFETERIA PLAN 2021 form 5500 responses |
|---|
| 2021-07-01 | Type of plan entity | Single employer plan |
| 2021-07-01 | Plan funding arrangement – Insurance | Yes |
| 2021-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2020: FLEET FARM CAFETERIA PLAN 2020 form 5500 responses |
|---|
| 2020-07-01 | Type of plan entity | Single employer plan |
| 2020-07-01 | Plan funding arrangement – Insurance | Yes |
| 2020-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2019: FLEET FARM CAFETERIA PLAN 2019 form 5500 responses |
|---|
| 2019-07-01 | Type of plan entity | Single employer plan |
| 2019-07-01 | Plan funding arrangement – Insurance | Yes |
| 2019-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: FLEET FARM CAFETERIA PLAN 2018 form 5500 responses |
|---|
| 2018-07-01 | Type of plan entity | Single employer plan |
| 2018-07-01 | Plan funding arrangement – Insurance | Yes |
| 2018-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: FLEET FARM CAFETERIA PLAN 2017 form 5500 responses |
|---|
| 2017-07-01 | Type of plan entity | Single employer plan |
| 2017-07-01 | Plan funding arrangement – Insurance | Yes |
| 2017-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: FLEET FARM CAFETERIA PLAN 2016 form 5500 responses |
|---|
| 2016-07-01 | Type of plan entity | Single employer plan |
| 2016-07-01 | Plan funding arrangement – Insurance | Yes |
| 2016-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: FLEET FARM CAFETERIA PLAN 2015 form 5500 responses |
|---|
| 2015-07-01 | Type of plan entity | Single employer plan |
| 2015-07-01 | Plan funding arrangement – Insurance | Yes |
| 2015-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: FLEET FARM CAFETERIA PLAN 2014 form 5500 responses |
|---|
| 2014-07-01 | Type of plan entity | Single employer plan |
| 2014-07-01 | Plan funding arrangement – Insurance | Yes |
| 2014-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: FLEET FARM CAFETERIA PLAN 2013 form 5500 responses |
|---|
| 2013-07-01 | Type of plan entity | Single employer plan |
| 2013-07-01 | Plan funding arrangement – Insurance | Yes |
| 2013-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: FLEET FARM CAFETERIA PLAN 2012 form 5500 responses |
|---|
| 2012-07-01 | Type of plan entity | Single employer plan |
| 2012-07-01 | Plan funding arrangement – Insurance | Yes |
| 2012-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: FLEET FARM CAFETERIA PLAN 2011 form 5500 responses |
|---|
| 2011-07-01 | Type of plan entity | Single employer plan |
| 2011-07-01 | Plan funding arrangement – Insurance | Yes |
| 2011-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: FLEET FARM CAFETERIA PLAN 2009 form 5500 responses |
|---|
| 2009-07-01 | Type of plan entity | Single employer plan |
| 2009-07-01 | This submission is the final filing | No |
| 2009-07-01 | Plan funding arrangement – Insurance | Yes |
| 2009-07-01 | Plan benefit arrangement – Insurance | Yes |
| RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 ) |
| Policy contract number | 70101-7 |
| Policy instance | 1 |
| Insurance contract or identification number | 70101-7 | | Number of Individuals Covered | 2657 | | Insurance policy start date | 2022-07-01 | | Insurance policy end date | 2023-06-30 | | Total amount of commissions paid to insurance broker | USD $93,691 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $567,835 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $93,691 |
|
| RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 ) |
| Policy contract number | 70101-7 |
| Policy instance | 1 |
| Insurance contract or identification number | 70101-7 | | Number of Individuals Covered | 2189 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2022-06-30 | | Total amount of commissions paid to insurance broker | USD $65,051 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $275,669 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $65,051 |
|
| CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 ) |
| Policy contract number | 0000018124 |
| Policy instance | 1 |
| Insurance contract or identification number | 0000018124 | | Number of Individuals Covered | 2863 | | Insurance policy start date | 2020-07-01 | | Insurance policy end date | 2021-06-30 | | Total amount of commissions paid to insurance broker | USD $56,000 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $276,730 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $41,528 |
|
| CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 ) |
| Policy contract number | 0000018124 |
| Policy instance | 1 |
| Insurance contract or identification number | 0000018124 | | Number of Individuals Covered | 2863 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2020-06-30 | | Total amount of commissions paid to insurance broker | USD $80,402 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $294,126 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $59,804 |
|
| CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 ) |
| Policy contract number | 0000018124 |
| Policy instance | 1 |
| Insurance contract or identification number | 0000018124 | | Number of Individuals Covered | 2843 | | Insurance policy start date | 2018-07-01 | | Insurance policy end date | 2019-06-30 | | Total amount of commissions paid to insurance broker | USD $105,379 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $378,068 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $77,823 |
|
| CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 ) |
| Policy contract number | 0000018124 |
| Policy instance | 1 |
| Insurance contract or identification number | 0000018124 | | Number of Individuals Covered | 2818 | | Insurance policy start date | 2017-07-01 | | Insurance policy end date | 2018-06-30 | | Total amount of commissions paid to insurance broker | USD $138,577 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $495,175 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 ) |
| Policy contract number | R5898 |
| Policy instance | 1 |
| Insurance contract or identification number | R5898 | | Number of Individuals Covered | 1171 | | Insurance policy start date | 2015-07-01 | | Insurance policy end date | 2016-06-30 | | Total amount of commissions paid to insurance broker | USD $104,185 | | Total amount of fees paid to insurance company | USD $3,195 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $638,902 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $32,370 | | Amount paid for insurance broker fees | 824 | | Insurance broker organization code? | 3 | | Insurance broker name | SONYE KUECHENMEISTER |
|
| AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 ) |
| Policy contract number | PW328 |
| Policy instance | 2 |
| Insurance contract or identification number | PW328 | | Number of Individuals Covered | 157 | | Insurance policy start date | 2015-07-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $9,845 | | Total amount of fees paid to insurance company | USD $1,382 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $53,173 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,050 | | Amount paid for insurance broker fees | 793 | | Insurance broker organization code? | 3 | | Insurance broker name | RICHARD R KIMBROUGH |
|
| AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 ) |
| Policy contract number | R5898 |
| Policy instance | 1 |
| Insurance contract or identification number | R5898 | | Number of Individuals Covered | 1195 | | Insurance policy start date | 2014-07-01 | | Insurance policy end date | 2015-06-30 | | Total amount of commissions paid to insurance broker | USD $92,755 | | Total amount of fees paid to insurance company | USD $5,853 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $561,235 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $28,431 | | Amount paid for insurance broker fees | 2587 | | Insurance broker organization code? | 3 | | Insurance broker name | MARC A HANSON |
|
| AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 ) |
| Policy contract number | PW328 |
| Policy instance | 2 |
| Insurance contract or identification number | PW328 | | Number of Individuals Covered | 166 | | Insurance policy start date | 2014-07-01 | | Insurance policy end date | 2015-06-30 | | Total amount of commissions paid to insurance broker | USD $12,829 | | Total amount of fees paid to insurance company | USD $644 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $70,233 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,803 | | Amount paid for insurance broker fees | 433 | | Insurance broker organization code? | 3 | | Insurance broker name | RODRIGO Q SANTA CRUZ |
|
| AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 ) |
| Policy contract number | R5898 |
| Policy instance | 1 |
| Insurance contract or identification number | R5898 | | Number of Individuals Covered | 1175 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-06-30 | | Total amount of commissions paid to insurance broker | USD $128,445 | | Total amount of fees paid to insurance company | USD $3,947 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $719,688 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $30,040 | | Amount paid for insurance broker fees | 2262 | | Insurance broker organization code? | 3 | | Insurance broker name | RANDA R ELLWANGER |
|
| AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 ) |
| Policy contract number | PW328 |
| Policy instance | 2 |
| Insurance contract or identification number | PW328 | | Number of Individuals Covered | 164 | | Insurance policy start date | 2013-07-01 | | Insurance policy end date | 2014-06-30 | | Total amount of commissions paid to insurance broker | USD $14,651 | | Total amount of fees paid to insurance company | USD $603 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $94,527 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,321 | | Amount paid for insurance broker fees | 415 | | Insurance broker organization code? | 3 | | Insurance broker name | LORI OLSON |
|
| AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 ) |
| Policy contract number | PW328 |
| Policy instance | 2 |
| Insurance contract or identification number | PW328 | | Number of Individuals Covered | 165 | | Insurance policy start date | 2012-07-01 | | Insurance policy end date | 2013-06-30 | | Total amount of commissions paid to insurance broker | USD $17,365 | | Total amount of fees paid to insurance company | USD $190 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $113,376 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,959 | | Amount paid for insurance broker fees | 23 | | Insurance broker organization code? | 3 | | Insurance broker name | ROBERTA JAY |
|
| AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 ) |
| Policy contract number | R5898 |
| Policy instance | 1 |
| Insurance contract or identification number | R5898 | | Number of Individuals Covered | 1217 | | Insurance policy start date | 2012-07-01 | | Insurance policy end date | 2013-06-30 | | Total amount of commissions paid to insurance broker | USD $132,307 | | Total amount of fees paid to insurance company | USD $508 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $780,996 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $39,181 | | Amount paid for insurance broker fees | 121 | | Insurance broker organization code? | 3 | | Insurance broker name | SCOTT R FRITCHER |
|
| AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 ) |
| Policy contract number | R5898 |
| Policy instance | 1 |
| Insurance contract or identification number | R5898 | | Number of Individuals Covered | 1275 | | Insurance policy start date | 2011-07-01 | | Insurance policy end date | 2012-06-30 | | Total amount of commissions paid to insurance broker | USD $126,545 | | Total amount of fees paid to insurance company | USD $4,366 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $763,987 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 ) |
| Policy contract number | PW328 |
| Policy instance | 2 |
| Insurance contract or identification number | PW328 | | Number of Individuals Covered | 182 | | Insurance policy start date | 2011-07-01 | | Insurance policy end date | 2012-06-30 | | Total amount of commissions paid to insurance broker | USD $17,309 | | Total amount of fees paid to insurance company | USD $651 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $105,386 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 ) |
| Policy contract number | R5898 |
| Policy instance | 1 |
| Insurance contract or identification number | R5898 | | Number of Individuals Covered | 1266 | | Insurance policy start date | 2010-07-01 | | Insurance policy end date | 2011-06-30 | | Total amount of commissions paid to insurance broker | USD $138,651 | | Total amount of fees paid to insurance company | USD $5,309 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $827,379 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 ) |
| Policy contract number | PW328 |
| Policy instance | 2 |
| Insurance contract or identification number | PW328 | | Number of Individuals Covered | 170 | | Insurance policy start date | 2010-07-01 | | Insurance policy end date | 2011-06-30 | | Total amount of commissions paid to insurance broker | USD $17,790 | | Total amount of fees paid to insurance company | USD $579 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $110,383 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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