SERVICE MANAGEMENT GROUP, LLC has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan SERVICE MANAGEMENT GROUP HEALTH & WELFARE BENEFITS
401k plan membership statisitcs for SERVICE MANAGEMENT GROUP HEALTH & WELFARE BENEFITS
Measure | Date | Value |
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2022: SERVICE MANAGEMENT GROUP HEALTH & WELFARE BENEFITS 2022 401k membership |
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Total participants, beginning-of-year | 2022-01-01 | 281 |
Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 300 |
Number of retired or separated participants receiving benefits | 2022-01-01 | 6 |
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 | 306 |
2021: SERVICE MANAGEMENT GROUP HEALTH & WELFARE BENEFITS 2021 401k membership |
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Total participants, beginning-of-year | 2021-01-01 | 289 |
Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 277 |
Number of retired or separated participants receiving benefits | 2021-01-01 | 4 |
Number of other retired or separated participants entitled to future benefits | 2021-01-01 | 0 |
Total of all active and inactive participants | 2021-01-01 | 281 |
2020: SERVICE MANAGEMENT GROUP HEALTH & WELFARE BENEFITS 2020 401k membership |
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Total participants, beginning-of-year | 2020-01-01 | 329 |
Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 282 |
Number of retired or separated participants receiving benefits | 2020-01-01 | 7 |
Number of other retired or separated participants entitled to future benefits | 2020-01-01 | 0 |
Total of all active and inactive participants | 2020-01-01 | 289 |
2019: SERVICE MANAGEMENT GROUP HEALTH & WELFARE BENEFITS 2019 401k membership |
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Total participants, beginning-of-year | 2019-01-01 | 313 |
Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 328 |
Number of retired or separated participants receiving benefits | 2019-01-01 | 1 |
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 | 329 |
2018: SERVICE MANAGEMENT GROUP HEALTH & WELFARE BENEFITS 2018 401k membership |
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Total participants, beginning-of-year | 2018-01-01 | 326 |
Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 310 |
Number of retired or separated participants receiving benefits | 2018-01-01 | 3 |
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 | 313 |
2017: SERVICE MANAGEMENT GROUP HEALTH & WELFARE BENEFITS 2017 401k membership |
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Total participants, beginning-of-year | 2017-01-01 | 281 |
Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 321 |
Number of retired or separated participants receiving benefits | 2017-01-01 | 5 |
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 | 326 |
2016: SERVICE MANAGEMENT GROUP HEALTH & WELFARE BENEFITS 2016 401k membership |
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Total participants, beginning-of-year | 2016-01-01 | 261 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 281 |
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 | 281 |
2015: SERVICE MANAGEMENT GROUP HEALTH & WELFARE BENEFITS 2015 401k membership |
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Total participants, beginning-of-year | 2015-01-01 | 236 |
Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 261 |
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 | 261 |
2014: SERVICE MANAGEMENT GROUP HEALTH & WELFARE BENEFITS 2014 401k membership |
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Total participants, beginning-of-year | 2014-01-01 | 197 |
Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 236 |
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 | 236 |
2013: SERVICE MANAGEMENT GROUP HEALTH & WELFARE BENEFITS 2013 401k membership |
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Total participants, beginning-of-year | 2013-01-01 | 179 |
Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 197 |
Total of all active and inactive participants | 2013-01-01 | 197 |
2012: SERVICE MANAGEMENT GROUP HEALTH & WELFARE BENEFITS 2012 401k membership |
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Total participants, beginning-of-year | 2012-01-01 | 146 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 179 |
Total of all active and inactive participants | 2012-01-01 | 179 |
2011: SERVICE MANAGEMENT GROUP HEALTH & WELFARE BENEFITS 2011 401k membership |
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Total participants, beginning-of-year | 2011-01-01 | 161 |
Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 146 |
Total of all active and inactive participants | 2011-01-01 | 146 |
2009: SERVICE MANAGEMENT GROUP HEALTH & WELFARE BENEFITS 2009 401k membership |
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Total participants, beginning-of-year | 2009-01-01 | 149 |
Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 151 |
Total of all active and inactive participants | 2009-01-01 | 151 |
FOUR EVER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80985 ) |
Policy contract number | 4EL-6080-21 |
Policy instance | 6 |
Insurance contract or identification number | 4EL-6080-21 | Insurance policy start date | 2021-07-01 | Insurance policy end date | 2022-06-30 | Total amount of commissions paid to insurance broker | USD $221 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,472 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $221 | Insurance broker organization code? | 3 |
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NEW DIRECTIONS BEHAVORIAL HEALTH (National Association of Insurance Commissioners NAIC id number: 00369 ) |
Policy contract number | EAP |
Policy instance | 5 |
Insurance contract or identification number | EAP | Number of Individuals Covered | 300 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Other welfare benefits provided | EAP | Welfare Benefit Premiums Paid to Carrier | USD $4,356 | 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: 71870 ) |
Policy contract number | MULTIPLE |
Policy instance | 4 |
Insurance contract or identification number | MULTIPLE | Number of Individuals Covered | 357 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $15,742 | 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 | 914160 |
Policy instance | 3 |
Insurance contract or identification number | 914160 | Number of Individuals Covered | 67 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of fees paid to insurance company | USD $1,844 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $20,867 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 1043 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 |
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BLUE CROSS AND BLUE SHIELD OF KANSAS CITY (National Association of Insurance Commissioners NAIC id number: 47171 ) |
Policy contract number | 40977000 |
Policy instance | 2 |
Insurance contract or identification number | 40977000 | Number of Individuals Covered | 352 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $28,267 | Total amount of fees paid to insurance company | USD $42,015 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,093,843 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $28,267 | Amount paid for insurance broker fees | 42015 | Additional information about fees paid to insurance broker | ADMINISTRATIVE SERVICES OTHER 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 | 914159 |
Policy instance | 1 |
Insurance contract or identification number | 914159 | Number of Individuals Covered | 225 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of fees paid to insurance company | USD $4,492 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $51,393 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 2570 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GLUG0AF5F |
Policy instance | 1 |
Insurance contract or identification number | GLUG0AF5F | Number of Individuals Covered | 295 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of fees paid to insurance company | USD $2,454 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $54,097 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 2454 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 |
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BLUE CROSS AND BLUE SHIELD OF KANSAS CITY (National Association of Insurance Commissioners NAIC id number: 47171 ) |
Policy contract number | 40977000 |
Policy instance | 2 |
Insurance contract or identification number | 40977000 | Number of Individuals Covered | 522 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $31,792 | Total amount of fees paid to insurance company | USD $45,459 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,272,928 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $31,792 | Amount paid for insurance broker fees | 45459 | Additional information about fees paid to insurance broker | ADMINISTRATIVE SERVICES | Insurance broker organization code? | 3 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GLTD0AF5F |
Policy instance | 3 |
Insurance contract or identification number | GLTD0AF5F | Number of Individuals Covered | 295 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of fees paid to insurance company | USD $1,845 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $40,328 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 1845 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GVTL0AF5F |
Policy instance | 4 |
Insurance contract or identification number | GVTL0AF5F | Number of Individuals Covered | 94 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of fees paid to insurance company | USD $1,000 | Other welfare benefits provided | VOLUNTARY LIFE AND AD&D | Welfare Benefit Premiums Paid to Carrier | USD $22,541 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 1000 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 |
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NEW DIRECTIONS BEHAVORIAL HEALTH (National Association of Insurance Commissioners NAIC id number: 00369 ) |
Policy contract number | EAP |
Policy instance | 6 |
Insurance contract or identification number | EAP | Number of Individuals Covered | 287 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Other welfare benefits provided | EAP | Welfare Benefit Premiums Paid to Carrier | USD $2,405 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 ) |
Policy contract number | GTP 0009155640 |
Policy instance | 7 |
Insurance contract or identification number | GTP 0009155640 | Number of Individuals Covered | 332 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $257 | Other welfare benefits provided | BUSINESS TRAVEL ACCIDENT | Welfare Benefit Premiums Paid to Carrier | USD $1,284 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $257 | Insurance broker organization code? | 3 |
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EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | MULTIPLE |
Policy instance | 5 |
Insurance contract or identification number | MULTIPLE | Number of Individuals Covered | 535 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $17,662 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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BLUE CROSS AND BLUE SHIELD OF KANSAS CITY (National Association of Insurance Commissioners NAIC id number: 47171 ) |
Policy contract number | 40977000 |
Policy instance | 2 |
Insurance contract or identification number | 40977000 | Number of Individuals Covered | 484 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $27,287 | Total amount of fees paid to insurance company | USD $37,380 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,868,988 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $27,287 | Amount paid for insurance broker fees | 37380 | Additional information about fees paid to insurance broker | ADMINISTRATIVE SERVICES | Insurance broker organization code? | 3 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GLUG0AF5F |
Policy instance | 1 |
Insurance contract or identification number | GLUG0AF5F | Number of Individuals Covered | 282 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of fees paid to insurance company | USD $2,722 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $55,116 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 2722 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 |
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NEW DIRECTIONS BEHAVORIAL HEALTH (National Association of Insurance Commissioners NAIC id number: 00369 ) |
Policy contract number | EAP |
Policy instance | 6 |
Insurance contract or identification number | EAP | Number of Individuals Covered | 320 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Other welfare benefits provided | EAP | Welfare Benefit Premiums Paid to Carrier | USD $2,672 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GLTD0AF5F |
Policy instance | 3 |
Insurance contract or identification number | GLTD0AF5F | Number of Individuals Covered | 281 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of fees paid to insurance company | USD $2,067 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $41,477 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 2067 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GVTL0AF5F |
Policy instance | 4 |
Insurance contract or identification number | GVTL0AF5F | Number of Individuals Covered | 92 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of fees paid to insurance company | USD $1,142 | Other welfare benefits provided | VOLUNTARY LIFE AND AD&D | Welfare Benefit Premiums Paid to Carrier | USD $22,429 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 1142 | Additional information about fees paid to insurance broker | OTHER 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 | MULTIPLE |
Policy instance | 5 |
Insurance contract or identification number | MULTIPLE | Number of Individuals Covered | 521 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $17,732 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 ) |
Policy contract number | GTP 0009155640 |
Policy instance | 7 |
Insurance contract or identification number | GTP 0009155640 | Number of Individuals Covered | 335 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $368 | Other welfare benefits provided | BUSINESS TRAVEL ACCIDENT | Welfare Benefit Premiums Paid to Carrier | USD $1,840 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $368 | Insurance broker organization code? | 3 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GLUG0AF5F |
Policy instance | 1 |
Insurance contract or identification number | GLUG0AF5F | Number of Individuals Covered | 328 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of fees paid to insurance company | USD $2,418 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $55,575 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 2418 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 |
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BLUE CROSS AND BLUE SHIELD OF KANSAS CITY (National Association of Insurance Commissioners NAIC id number: 47171 ) |
Policy contract number | 40977000 |
Policy instance | 2 |
Insurance contract or identification number | 40977000 | Number of Individuals Covered | 531 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $23,686 | Total amount of fees paid to insurance company | USD $31,763 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,579,070 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $23,686 | Amount paid for insurance broker fees | 31763 | Additional information about fees paid to insurance broker | ADMINISTRATIVE SERVICES NON-MONETARY COMPENSATION | Insurance broker organization code? | 3 |
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DELTA DENTAL OF MISSOURI (National Association of Insurance Commissioners NAIC id number: 55697 ) |
Policy contract number | 19510022 |
Policy instance | 3 |
Insurance contract or identification number | 19510022 | Number of Individuals Covered | 515 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $22,224 | Total amount of fees paid to insurance company | USD $1,604 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $205,536 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $22,224 | Amount paid for insurance broker fees | 1604 | Additional information about fees paid to insurance broker | BROKER BONUS | Insurance broker organization code? | 3 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GLTD0AF5F |
Policy instance | 4 |
Insurance contract or identification number | GLTD0AF5F | Number of Individuals Covered | 328 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of fees paid to insurance company | USD $1,833 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $42,206 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 1833 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GVTL0AF5F |
Policy instance | 5 |
Insurance contract or identification number | GVTL0AF5F | Number of Individuals Covered | 113 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of fees paid to insurance company | USD $1,042 | Other welfare benefits provided | VOLUNTARY LIFE AND AD&D | Welfare Benefit Premiums Paid to Carrier | USD $23,240 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 1042 | Additional information about fees paid to insurance broker | OTHER 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 | MULTIPLE |
Policy instance | 6 |
Insurance contract or identification number | MULTIPLE | Number of Individuals Covered | 573 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $16,784 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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NEW DIRECTIONS BEHAVORIAL HEALTH (National Association of Insurance Commissioners NAIC id number: 00369 ) |
Policy contract number | EAP |
Policy instance | 7 |
Insurance contract or identification number | EAP | Number of Individuals Covered | 302 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Other welfare benefits provided | EAP | Welfare Benefit Premiums Paid to Carrier | USD $2,630 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 ) |
Policy contract number | GTP 0009155640 |
Policy instance | 8 |
Insurance contract or identification number | GTP 0009155640 | Number of Individuals Covered | 381 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $368 | Other welfare benefits provided | BUSINESS TRAVEL ACCIDENT | Welfare Benefit Premiums Paid to Carrier | USD $1,840 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $368 | Insurance broker organization code? | 3 |
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COMPBENEFITS (National Association of Insurance Commissioners NAIC id number: 60984 ) |
Policy contract number | 707728 |
Policy instance | 6 |
Insurance contract or identification number | 707728 | Number of Individuals Covered | 234 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $21,355 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GVTL0AF5F |
Policy instance | 5 |
Insurance contract or identification number | GVTL0AF5F | Number of Individuals Covered | 104 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of fees paid to insurance company | USD $615 | Other welfare benefits provided | VOLUNTARY LIFE AND AD&D | Welfare Benefit Premiums Paid to Carrier | USD $21,746 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 615 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | LOCKTON COMPANIES, LLC |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GLTD0AF5F |
Policy instance | 4 |
Insurance contract or identification number | GLTD0AF5F | Number of Individuals Covered | 320 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of fees paid to insurance company | USD $1,041 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $36,663 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 1041 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | LOCKTON COMPANIES, LLC |
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DELTA DENTAL OF MISSOURI (National Association of Insurance Commissioners NAIC id number: 55697 ) |
Policy contract number | 19510022 |
Policy instance | 3 |
Insurance contract or identification number | 19510022 | Number of Individuals Covered | 455 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $18,254 | Total amount of fees paid to insurance company | USD $987 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $184,063 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $18,254 | Amount paid for insurance broker fees | 987 | Additional information about fees paid to insurance broker | BROKER BONUS | Insurance broker organization code? | 3 | Insurance broker name | LOCKTON COMPANIES, LLC |
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HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 ) |
Policy contract number | 707728 |
Policy instance | 2 |
Insurance contract or identification number | 707728 | Number of Individuals Covered | 219 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $46,347 | Total amount of fees paid to insurance company | USD $1,559 | Health Insurance Welfare Benefit | Yes | Other welfare benefits provided | EAP | Welfare Benefit Premiums Paid to Carrier | USD $1,231,775 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $46,347 | Amount paid for insurance broker fees | 1559 | Additional information about fees paid to insurance broker | BONUS | Insurance broker organization code? | 3 | Insurance broker name | LOCKTON COMPANIES, LLC |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GLUG0AF5F |
Policy instance | 1 |
Insurance contract or identification number | GLUG0AF5F | Number of Individuals Covered | 321 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of fees paid to insurance company | USD $1,375 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $48,445 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 1375 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | LOCKTON COMPANIES, LLC |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GLUG0AF5F |
Policy instance | 1 |
Insurance contract or identification number | GLUG0AF5F | Number of Individuals Covered | 261 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $37,418 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 ) |
Policy contract number | 707728 |
Policy instance | 2 |
Insurance contract or identification number | 707728 | Number of Individuals Covered | 186 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $49,972 | Total amount of fees paid to insurance company | USD $1,411 | Health Insurance Welfare Benefit | Yes | Other welfare benefits provided | EAP | Welfare Benefit Premiums Paid to Carrier | USD $1,426,949 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $49,972 | Amount paid for insurance broker fees | 1411 | Additional information about fees paid to insurance broker | ADMINISTRATIVE FEES NON-MONETARY COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | LOCKTON COMPANIES, LLC |
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DELTA DENTAL OF MISSOURI (National Association of Insurance Commissioners NAIC id number: 55697 ) |
Policy contract number | 1951-1022&2022 |
Policy instance | 3 |
Insurance contract or identification number | 1951-1022&2022 | Number of Individuals Covered | 422 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $12,735 | Total amount of fees paid to insurance company | USD $742 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $139,044 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $12,735 | Amount paid for insurance broker fees | 742 | Additional information about fees paid to insurance broker | BROKER BONUS | Insurance broker organization code? | 3 | Insurance broker name | LOCKTON COMPANIES, LLC |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GLTD0AF5F |
Policy instance | 4 |
Insurance contract or identification number | GLTD0AF5F | Number of Individuals Covered | 261 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $28,142 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GVTL0AF5F |
Policy instance | 5 |
Insurance contract or identification number | GVTL0AF5F | Number of Individuals Covered | 91 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Other welfare benefits provided | VOLUNTARY LIFE AND AD&D | Welfare Benefit Premiums Paid to Carrier | USD $13,960 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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COMPBENEFITS (National Association of Insurance Commissioners NAIC id number: 60984 ) |
Policy contract number | 707728 |
Policy instance | 6 |
Insurance contract or identification number | 707728 | Number of Individuals Covered | 192 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of fees paid to insurance company | USD $110 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $18,912 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 110 | Additional information about fees paid to insurance broker | BROKER BONUS NON-MONETARY COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | LOCKTON COMPANIES, LLC |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GVTL0AF5F |
Policy instance | 5 |
Insurance contract or identification number | GVTL0AF5F | Number of Individuals Covered | 77 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of fees paid to insurance company | USD $340 | Other welfare benefits provided | VOLUNTARY LIFE AND AD&D | Welfare Benefit Premiums Paid to Carrier | USD $10,720 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 340 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | LOCKTON COMPANIES, LLC |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GLUG0AF5F |
Policy instance | 1 |
Insurance contract or identification number | GLUG0AF5F | Number of Individuals Covered | 236 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of fees paid to insurance company | USD $1,158 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $32,609 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 1158 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | LOCKTON COMPANIES, LLC |
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HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 ) |
Policy contract number | 707728 |
Policy instance | 2 |
Insurance contract or identification number | 707728 | Number of Individuals Covered | 173 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $57,793 | Total amount of fees paid to insurance company | USD $6,662 | Health Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Other welfare benefits provided | EAP, HSA | Welfare Benefit Premiums Paid to Carrier | USD $1,445,624 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $57,793 | Amount paid for insurance broker fees | 6662 | Additional information about fees paid to insurance broker | ADMINISTRATIVE FEES | Insurance broker organization code? | 3 | Insurance broker name | LOCKTON COMPANIES, LLC |
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DELTA DENTAL OF MISSOURI (National Association of Insurance Commissioners NAIC id number: 55697 ) |
Policy contract number | 1951-1022&2022 |
Policy instance | 3 |
Insurance contract or identification number | 1951-1022&2022 | Number of Individuals Covered | 379 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $13,311 | Total amount of fees paid to insurance company | USD $574 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $133,552 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $13,311 | Amount paid for insurance broker fees | 574 | Additional information about fees paid to insurance broker | BROKER BONUS | Insurance broker organization code? | 3 | Insurance broker name | LOCKTON COMPANIES, LLC |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GLTD0AF5F |
Policy instance | 4 |
Insurance contract or identification number | GLTD0AF5F | Number of Individuals Covered | 236 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of fees paid to insurance company | USD $873 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $24,577 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 873 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | LOCKTON COMPANIES, LLC |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GLTD0AF5F |
Policy instance | 4 |
Insurance contract or identification number | GLTD0AF5F | Number of Individuals Covered | 197 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of fees paid to insurance company | USD $1,038 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $21,296 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 1038 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | LOCKTON COMPANIES, LLC |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GVTL0AF5F |
Policy instance | 5 |
Insurance contract or identification number | GVTL0AF5F | Number of Individuals Covered | 52 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of fees paid to insurance company | USD $439 | Other welfare benefits provided | VOLUNTARY LIFE AND AD&D | Welfare Benefit Premiums Paid to Carrier | USD $8,232 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 439 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | LOCKTON COMPANIES, LLC |
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HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 ) |
Policy contract number | 707728 |
Policy instance | 2 |
Insurance contract or identification number | 707728 | Number of Individuals Covered | 145 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $60,193 | Total amount of fees paid to insurance company | USD $5,614 | Health Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Other welfare benefits provided | EAP | Welfare Benefit Premiums Paid to Carrier | USD $1,292,600 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $60,193 | Amount paid for insurance broker fees | 5614 | Insurance broker organization code? | 3 | Insurance broker name | LOCKTON COMPANIES, LLC |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GLUG0AF5F |
Policy instance | 1 |
Insurance contract or identification number | GLUG0AF5F | Number of Individuals Covered | 197 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of fees paid to insurance company | USD $1,379 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $28,339 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 1379 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | LOCKTON COMPANIES, LLC |
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DELTA DENTAL OF MISSOURI (National Association of Insurance Commissioners NAIC id number: 55697 ) |
Policy contract number | 1951-1022&2022 |
Policy instance | 3 |
Insurance contract or identification number | 1951-1022&2022 | Number of Individuals Covered | 315 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $10,720 | Total amount of fees paid to insurance company | USD $498 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $99,087 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $10,720 | Amount paid for insurance broker fees | 498 | Additional information about fees paid to insurance broker | DELTA REWARDS | Insurance broker organization code? | 3 | Insurance broker name | LOCKTON COMPANIES, LLC |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GLTD0AF5F |
Policy instance | 4 |
Insurance contract or identification number | GLTD0AF5F | Number of Individuals Covered | 179 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of fees paid to insurance company | USD $687 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $17,294 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 687 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | LOCKTON COMPANIES, LLC |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GLUG0AF5F |
Policy instance | 1 |
Insurance contract or identification number | GLUG0AF5F | Number of Individuals Covered | 179 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of fees paid to insurance company | USD $903 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $22,985 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 903 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | LOCKTON COMPANIES, LLC |
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DELTA DENTAL OF MISSOURI (National Association of Insurance Commissioners NAIC id number: 55697 ) |
Policy contract number | 1951-1022&2022 |
Policy instance | 3 |
Insurance contract or identification number | 1951-1022&2022 | Number of Individuals Covered | 283 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $9,030 | Total amount of fees paid to insurance company | USD $421 | 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 $9,030 | Amount paid for insurance broker fees | 421 | Additional information about fees paid to insurance broker | DELTA REWARDS | Insurance broker organization code? | 3 | Insurance broker name | LOCKTON COMPANIES, LLC |
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HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 ) |
Policy contract number | 707728 |
Policy instance | 2 |
Insurance contract or identification number | 707728 | Number of Individuals Covered | 130 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $42,327 | Total amount of fees paid to insurance company | USD $5,141 | Health Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Other welfare benefits provided | EAP | Welfare Benefit Premiums Paid to Carrier | USD $951,783 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $42,327 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 5141 | Additional information about fees paid to insurance broker | ADMINISTRATIVE FEES | Insurance broker name | HUMANA INSURANCE COMPANY |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GVTL0AF5F |
Policy instance | 5 |
Insurance contract or identification number | GVTL0AF5F | Number of Individuals Covered | 45 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of fees paid to insurance company | USD $350 | Other welfare benefits provided | VOLUNTARY LIFE/AD&D | Welfare Benefit Premiums Paid to Carrier | USD $7,319 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 350 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | LOCKTON COMPANIES, LLC |
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HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 ) |
Policy contract number | 707728 |
Policy instance | 2 |
Insurance contract or identification number | 707728 | Number of Individuals Covered | 111 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $49,655 | Total amount of fees paid to insurance company | USD $5,486 | Health Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Other welfare benefits provided | EAP | Welfare Benefit Premiums Paid to Carrier | USD $862,347 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GLUG0AF5F |
Policy instance | 1 |
Insurance contract or identification number | GLUG0AF5F | Number of Individuals Covered | 146 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of fees paid to insurance company | USD $670 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $22,205 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GLTD0AF5F |
Policy instance | 4 |
Insurance contract or identification number | GLTD0AF5F | Number of Individuals Covered | 146 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of fees paid to insurance company | USD $515 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $16,856 | 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 MISSOURI (National Association of Insurance Commissioners NAIC id number: 55697 ) |
Policy contract number | 1951-1022 |
Policy instance | 3 |
Insurance contract or identification number | 1951-1022 | Number of Individuals Covered | 111 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $8,456 | Total amount of fees paid to insurance company | USD $581 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $84,564 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GLUG0AF5F |
Policy instance | 1 |
Insurance contract or identification number | GLUG0AF5F | Number of Individuals Covered | 161 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $20,194 | 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 MISSOURI (National Association of Insurance Commissioners NAIC id number: 55697 ) |
Policy contract number | 1951-1022 |
Policy instance | 3 |
Insurance contract or identification number | 1951-1022 | Number of Individuals Covered | 128 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $8,674 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $82,625 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $8,674 | Insurance broker organization code? | 3 | Insurance broker name | LOCKTON COMPANIES, LLC |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | GLTD0AF5F |
Policy instance | 4 |
Insurance contract or identification number | GLTD0AF5F | Number of Individuals Covered | 161 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $15,466 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 ) |
Policy contract number | 707728 |
Policy instance | 2 |
Insurance contract or identification number | 707728 | Number of Individuals Covered | 128 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $39,151 | Total amount of fees paid to insurance company | USD $5,445 | Health Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Other welfare benefits provided | EAP | Welfare Benefit Premiums Paid to Carrier | USD $700,164 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $39,151 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 5445 | Additional information about fees paid to insurance broker | ADMINISTRATIVE FEES | Insurance broker name | HUMANA HEALTH PLAN, INC. |
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