CARLISLE ETCETERA LLC has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan CARLISLE ETCETERA LLC WELFARE AND BENEFIT PLAN
401k plan membership statisitcs for CARLISLE ETCETERA LLC WELFARE AND BENEFIT PLAN
Measure | Date | Value |
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2022: CARLISLE ETCETERA LLC WELFARE AND BENEFIT PLAN 2022 401k membership |
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Total participants, beginning-of-year | 2022-01-01 | 164 |
Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 72 |
Total of all active and inactive participants | 2022-01-01 | 72 |
2021: CARLISLE ETCETERA LLC WELFARE AND BENEFIT PLAN 2021 401k membership |
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Total participants, beginning-of-year | 2021-01-01 | 206 |
Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 164 |
Total of all active and inactive participants | 2021-01-01 | 164 |
2020: CARLISLE ETCETERA LLC WELFARE AND BENEFIT PLAN 2020 401k membership |
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Total participants, beginning-of-year | 2020-01-01 | 189 |
Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 206 |
Total of all active and inactive participants | 2020-01-01 | 206 |
2019: CARLISLE ETCETERA LLC WELFARE AND BENEFIT PLAN 2019 401k membership |
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Total participants, beginning-of-year | 2019-01-01 | 202 |
Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 189 |
Total of all active and inactive participants | 2019-01-01 | 189 |
2018: CARLISLE ETCETERA LLC WELFARE AND BENEFIT PLAN 2018 401k membership |
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Total participants, beginning-of-year | 2018-01-01 | 241 |
Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 202 |
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 | 202 |
Number of employers contributing to the scheme | 2018-01-01 | 0 |
2017: CARLISLE ETCETERA LLC WELFARE AND BENEFIT PLAN 2017 401k membership |
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Total participants, beginning-of-year | 2017-01-01 | 247 |
Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 241 |
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 | 241 |
Number of employers contributing to the scheme | 2017-01-01 | 0 |
2016: CARLISLE ETCETERA LLC WELFARE AND BENEFIT PLAN 2016 401k membership |
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Total participants, beginning-of-year | 2016-01-01 | 267 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 247 |
Total of all active and inactive participants | 2016-01-01 | 247 |
2015: CARLISLE ETCETERA LLC WELFARE AND BENEFIT PLAN 2015 401k membership |
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Total participants, beginning-of-year | 2015-01-01 | 331 |
Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 267 |
Number of retired or separated participants receiving benefits | 2015-01-01 | 1 |
Total of all active and inactive participants | 2015-01-01 | 268 |
2014: CARLISLE ETCETERA LLC WELFARE AND BENEFIT PLAN 2014 401k membership |
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Total participants, beginning-of-year | 2014-01-01 | 328 |
Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 331 |
Total of all active and inactive participants | 2014-01-01 | 331 |
2013: CARLISLE ETCETERA LLC WELFARE AND BENEFIT PLAN 2013 401k membership |
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Total participants, beginning-of-year | 2013-01-01 | 235 |
Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 328 |
Total of all active and inactive participants | 2013-01-01 | 328 |
2012: CARLISLE ETCETERA LLC WELFARE AND BENEFIT PLAN 2012 401k membership |
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Total participants, beginning-of-year | 2012-01-01 | 312 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 235 |
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 | 235 |
LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 ) |
Policy contract number | 403005628 |
Policy instance | 6 |
Insurance contract or identification number | 403005628 | Number of Individuals Covered | 25 | Insurance policy start date | 2021-06-01 | Insurance policy end date | 2022-05-31 | Total amount of commissions paid to insurance broker | USD $98 | Total amount of fees paid to insurance company | USD $176 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $650 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $98 | Amount paid for insurance broker fees | 110 | Insurance broker organization code? | 3 |
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LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 ) |
Policy contract number | 1D032399 |
Policy instance | 5 |
Insurance contract or identification number | 1D032399 | Number of Individuals Covered | 53 | Insurance policy start date | 2021-06-01 | Insurance policy end date | 2022-05-31 | Total amount of commissions paid to insurance broker | USD $1,977 | Total amount of fees paid to insurance company | USD $2,727 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $38,789 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 2472 | Insurance broker organization code? | 3 | Commission paid to Insurance Broker | USD $1,977 |
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LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 ) |
Policy contract number | 400217072 |
Policy instance | 4 |
Insurance contract or identification number | 400217072 | Number of Individuals Covered | 29 | Insurance policy start date | 2021-06-01 | Insurance policy end date | 2022-05-31 | Total amount of commissions paid to insurance broker | USD $1,336 | Total amount of fees paid to insurance company | USD $1,299 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $7,340 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,336 | Amount paid for insurance broker fees | 188 | Insurance broker organization code? | 3 |
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LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 ) |
Policy contract number | 10217073 |
Policy instance | 3 |
Insurance contract or identification number | 10217073 | Number of Individuals Covered | 23 | Insurance policy start date | 2021-06-01 | Insurance policy end date | 2022-05-31 | Total amount of commissions paid to insurance broker | USD $3,983 | Total amount of fees paid to insurance company | USD $3,577 | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | WEEKLY INCOME | Welfare Benefit Premiums Paid to Carrier | USD $20,851 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,983 | Amount paid for insurance broker fees | 356 | Insurance broker organization code? | 3 |
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LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 ) |
Policy contract number | 10217071 |
Policy instance | 2 |
Insurance contract or identification number | 10217071 | Number of Individuals Covered | 65 | Insurance policy start date | 2021-06-01 | Insurance policy end date | 2022-05-31 | Total amount of commissions paid to insurance broker | USD $1,657 | Total amount of fees paid to insurance company | USD $2,150 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $11,821 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,657 | Amount paid for insurance broker fees | 322 | Insurance broker organization code? | 3 |
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LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 ) |
Policy contract number | 10217070 |
Policy instance | 1 |
Insurance contract or identification number | 10217070 | Number of Individuals Covered | 72 | Insurance policy start date | 2021-06-01 | Insurance policy end date | 2022-05-31 | Total amount of commissions paid to insurance broker | USD $919 | Total amount of fees paid to insurance company | USD $1,377 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $7,520 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $919 | Amount paid for insurance broker fees | 235 | Insurance broker organization code? | 3 |
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LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 ) |
Policy contract number | 10217070 |
Policy instance | 1 |
Insurance contract or identification number | 10217070 | Number of Individuals Covered | 86 | Insurance policy start date | 2020-06-01 | Insurance policy end date | 2021-05-31 | Total amount of commissions paid to insurance broker | USD $1,551 | Total amount of fees paid to insurance company | USD $2,018 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $12,214 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,371 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 1165 | Additional information about fees paid to insurance broker | MEMBER SURVEYS, MATERIAL PREP., PREMIUM COLLECT, BILLING |
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LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 ) |
Policy contract number | 10217071 |
Policy instance | 2 |
Insurance contract or identification number | 10217071 | Number of Individuals Covered | 81 | Insurance policy start date | 2020-06-01 | Insurance policy end date | 2021-05-31 | Total amount of commissions paid to insurance broker | USD $2,801 | Total amount of fees paid to insurance company | USD $3,255 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $19,812 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,478 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 1842 | Additional information about fees paid to insurance broker | MEMBER SURVEYS, MATERIAL PREP., PREMIUM COLL. BILLING |
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LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 ) |
Policy contract number | 10217073 |
Policy instance | 3 |
Insurance contract or identification number | 10217073 | Number of Individuals Covered | 32 | Insurance policy start date | 2020-06-01 | Insurance policy end date | 2021-05-31 | Total amount of commissions paid to insurance broker | USD $5,008 | Total amount of fees paid to insurance company | USD $4,241 | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | WEEKLY INCOME | Welfare Benefit Premiums Paid to Carrier | USD $25,916 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,588 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 2435 | Additional information about fees paid to insurance broker | MEMBER SURVEYS, MATERIAL PREP., PREMIUM COLL. BILLING |
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LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 ) |
Policy contract number | 400217072 |
Policy instance | 4 |
Insurance contract or identification number | 400217072 | Number of Individuals Covered | 34 | Insurance policy start date | 2020-06-01 | Insurance policy end date | 2021-05-31 | Total amount of commissions paid to insurance broker | USD $1,640 | Total amount of fees paid to insurance company | USD $1,408 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $8,669 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,470 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 811 | Additional information about fees paid to insurance broker | MEMBER SURVEYS, MATERIAL PREP., PREMIUM COLL. BILLING |
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LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 ) |
Policy contract number | 1D032399 |
Policy instance | 5 |
Insurance contract or identification number | 1D032399 | Number of Individuals Covered | 66 | Insurance policy start date | 2020-06-01 | Insurance policy end date | 2021-05-31 | Total amount of commissions paid to insurance broker | USD $3,103 | Total amount of fees paid to insurance company | USD $4,147 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $60,223 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 4147 | Additional information about fees paid to insurance broker | OVERRIDES, BROKER BONUS | Insurance broker organization code? | 3 | Commission paid to Insurance Broker | USD $2,833 |
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LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 ) |
Policy contract number | 10233632 |
Policy instance | 6 |
Insurance contract or identification number | 10233632 | Number of Individuals Covered | 164 | Insurance policy start date | 2020-06-01 | Insurance policy end date | 2021-05-31 | Total amount of commissions paid to insurance broker | USD $2,644 | Total amount of fees paid to insurance company | USD $0 | Temporary Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | NY DISABILITY/FAMILY LEAVE | Welfare Benefit Premiums Paid to Carrier | USD $24,380 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,535 | Insurance broker organization code? | 3 |
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LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 ) |
Policy contract number | 403005628 |
Policy instance | 7 |
Insurance contract or identification number | 403005628 | Number of Individuals Covered | 26 | Insurance policy start date | 2020-06-01 | Insurance policy end date | 2021-05-31 | Total amount of commissions paid to insurance broker | USD $149 | Total amount of fees paid to insurance company | USD $101 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $1,016 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $135 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 56 | Additional information about fees paid to insurance broker | OVERRIDES, BROKER BONUS |
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LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 ) |
Policy contract number | 10217071 |
Policy instance | 2 |
Insurance contract or identification number | 10217071 | Number of Individuals Covered | 160 | Insurance policy start date | 2019-06-01 | Insurance policy end date | 2020-05-31 | Total amount of commissions paid to insurance broker | USD $4,031 | Total amount of fees paid to insurance company | USD $4,585 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $29,982 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,031 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 2486 | Additional information about fees paid to insurance broker | OVERRIDES, BROKER BONUS |
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LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 ) |
Policy contract number | 10217070 |
Policy instance | 1 |
Insurance contract or identification number | 10217070 | Number of Individuals Covered | 164 | Insurance policy start date | 2019-06-01 | Insurance policy end date | 2020-05-31 | Total amount of commissions paid to insurance broker | USD $1,952 | Total amount of fees paid to insurance company | USD $2,498 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $16,574 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,952 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 1338 | Additional information about fees paid to insurance broker | OVERRIDES, BROKER BONUS |
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LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 ) |
Policy contract number | 10217073 |
Policy instance | 3 |
Insurance contract or identification number | 10217073 | Number of Individuals Covered | 38 | Insurance policy start date | 2019-06-01 | Insurance policy end date | 2020-05-31 | Total amount of commissions paid to insurance broker | USD $5,150 | Total amount of fees paid to insurance company | USD $4,315 | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | WEEKLY INCOME | Welfare Benefit Premiums Paid to Carrier | USD $28,126 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,150 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 2353 | Additional information about fees paid to insurance broker | OVERRIDES AND BROKER BONUS |
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LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 ) |
Policy contract number | 400217072 |
Policy instance | 4 |
Insurance contract or identification number | 400217072 | Number of Individuals Covered | 51 | Insurance policy start date | 2019-06-01 | Insurance policy end date | 2020-05-31 | Total amount of commissions paid to insurance broker | USD $1,833 | Total amount of fees paid to insurance company | USD $1,640 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $10,438 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,833 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 910 | Additional information about fees paid to insurance broker | OVERRIDES AND BROKER BONUS |
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LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 ) |
Policy contract number | 1D032399 |
Policy instance | 5 |
Insurance contract or identification number | 1D032399 | Number of Individuals Covered | 108 | Insurance policy start date | 2019-06-01 | Insurance policy end date | 2020-05-31 | Total amount of commissions paid to insurance broker | USD $3,027 | Total amount of fees paid to insurance company | USD $4,411 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $61,867 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 4411 | Additional information about fees paid to insurance broker | OVERRIDES AND BROKER BONUS | Insurance broker organization code? | 3 | Commission paid to Insurance Broker | USD $3,027 |
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LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 ) |
Policy contract number | 10233632 |
Policy instance | 6 |
Insurance contract or identification number | 10233632 | Number of Individuals Covered | 206 | Insurance policy start date | 2019-06-01 | Insurance policy end date | 2020-05-31 | Total amount of commissions paid to insurance broker | USD $1,015 | Total amount of fees paid to insurance company | USD $0 | Temporary Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | NY DISABILITY/FAMILY LEAVE | Welfare Benefit Premiums Paid to Carrier | USD $8,675 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,015 | Insurance broker organization code? | 3 |
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LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 ) |
Policy contract number | 403005628 |
Policy instance | 7 |
Insurance contract or identification number | 403005628 | Number of Individuals Covered | 38 | Insurance policy start date | 2019-06-01 | Insurance policy end date | 2020-05-31 | Total amount of commissions paid to insurance broker | USD $151 | Total amount of fees paid to insurance company | USD $127 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $1,336 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $151 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 82 | Additional information about fees paid to insurance broker | OVERRIDES AND BROKER BONUS |
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LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 ) |
Policy contract number | 403005628 |
Policy instance | 7 |
Insurance contract or identification number | 403005628 | Number of Individuals Covered | 30 | Insurance policy start date | 2018-06-01 | Insurance policy end date | 2019-05-31 | Total amount of commissions paid to insurance broker | USD $141 | Total amount of fees paid to insurance company | USD $123 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $1,250 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $141 | Amount paid for insurance broker fees | 39 | Additional information about fees paid to insurance broker | BROKER BONUS | Insurance broker organization code? | 3 |
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LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 ) |
Policy contract number | 10233632 |
Policy instance | 6 |
Insurance contract or identification number | 10233632 | Number of Individuals Covered | 189 | Insurance policy start date | 2018-06-01 | Insurance policy end date | 2019-05-31 | Total amount of commissions paid to insurance broker | USD $2,430 | Total amount of fees paid to insurance company | USD $202 | Other welfare benefits provided | NY DISABILITY/FAMILY LEAVE | Welfare Benefit Premiums Paid to Carrier | USD $20,699 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,430 | Amount paid for insurance broker fees | 202 | Additional information about fees paid to insurance broker | BROKER BONUS | Insurance broker organization code? | 3 |
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LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 ) |
Policy contract number | 1D032399 |
Policy instance | 5 |
Insurance contract or identification number | 1D032399 | Number of Individuals Covered | 104 | Insurance policy start date | 2018-06-01 | Insurance policy end date | 2019-05-31 | Total amount of commissions paid to insurance broker | USD $2,325 | Total amount of fees paid to insurance company | USD $3,805 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $48,646 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,325 | Amount paid for insurance broker fees | 744 | Additional information about fees paid to insurance broker | BROKER BONUS | Insurance broker organization code? | 3 |
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LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 ) |
Policy contract number | 400217072 |
Policy instance | 4 |
Insurance contract or identification number | 400217072 | Number of Individuals Covered | 50 | Insurance policy start date | 2018-06-01 | Insurance policy end date | 2019-05-31 | Total amount of commissions paid to insurance broker | USD $1,922 | Total amount of fees paid to insurance company | USD $2,094 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $11,089 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,922 | Amount paid for insurance broker fees | 364 | Additional information about fees paid to insurance broker | BROKER BONUS | Insurance broker organization code? | 3 |
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LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 ) |
Policy contract number | 10217073 |
Policy instance | 3 |
Insurance contract or identification number | 10217073 | Number of Individuals Covered | 39 | Insurance policy start date | 2018-06-01 | Insurance policy end date | 2019-05-31 | Total amount of commissions paid to insurance broker | USD $4,753 | Total amount of fees paid to insurance company | USD $4,643 | Other welfare benefits provided | WEEKLY INCOME | Welfare Benefit Premiums Paid to Carrier | USD $26,552 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,753 | Amount paid for insurance broker fees | 740 | Additional information about fees paid to insurance broker | BROKER BONUS | Insurance broker organization code? | 3 |
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LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 ) |
Policy contract number | 10217071 |
Policy instance | 2 |
Insurance contract or identification number | 10217071 | Number of Individuals Covered | 162 | Insurance policy start date | 2018-06-01 | Insurance policy end date | 2019-05-31 | Total amount of commissions paid to insurance broker | USD $3,519 | Total amount of fees paid to insurance company | USD $4,786 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $26,794 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,519 | Amount paid for insurance broker fees | 761 | Additional information about fees paid to insurance broker | BROKER BONUS | Insurance broker organization code? | 3 |
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LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 ) |
Policy contract number | 10217070 |
Policy instance | 1 |
Insurance contract or identification number | 10217070 | Number of Individuals Covered | 166 | Insurance policy start date | 2018-06-01 | Insurance policy end date | 2019-05-31 | Total amount of commissions paid to insurance broker | USD $1,736 | Total amount of fees paid to insurance company | USD $2,609 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $14,933 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,736 | Amount paid for insurance broker fees | 431 | Additional information about fees paid to insurance broker | BROKER BONUS | Insurance broker organization code? | 3 |
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LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 ) |
Policy contract number | 10217070 |
Policy instance | 1 |
Insurance contract or identification number | 10217070 | Number of Individuals Covered | 202 | Insurance policy start date | 2017-06-01 | Insurance policy end date | 2018-05-31 | Total amount of commissions paid to insurance broker | USD $19,004 | Total amount of fees paid to insurance company | USD $22,006 | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $166,469 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $19,004 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Additional information about fees paid to insurance broker | OVERRIDES |
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LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 ) |
Policy contract number | 10217070 |
Policy instance | 1 |
Insurance contract or identification number | 10217070 | Number of Individuals Covered | 241 | Insurance policy start date | 2016-06-01 | Insurance policy end date | 2017-05-31 | Total amount of commissions paid to insurance broker | USD $19,745 | Total amount of fees paid to insurance company | USD $28,174 | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $192,553 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
Policy contract number | 23028 |
Policy instance | 1 |
Insurance contract or identification number | 23028 | Number of Individuals Covered | 288 | Insurance policy start date | 2015-06-01 | Insurance policy end date | 2016-05-31 | Total amount of commissions paid to insurance broker | USD $4,385 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | Yes | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $36,692 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,007 | Additional information about fees paid to insurance broker | SALES AND SERVICE COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | AXA ASSISTANCE, USA |
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PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
Policy contract number | 23028 |
Policy instance | 2 |
Insurance contract or identification number | 23028 | Number of Individuals Covered | 269 | Insurance policy start date | 2015-06-01 | Insurance policy end date | 2016-05-31 | Total amount of commissions paid to insurance broker | USD $446 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $3,912 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $407 | Additional information about fees paid to insurance broker | SALES AND SERVICE COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | AXA ASSISTANCE, USA |
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PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
Policy contract number | 23028 |
Policy instance | 3 |
Insurance contract or identification number | 23028 | Number of Individuals Covered | 158 | Insurance policy start date | 2015-06-01 | Insurance policy end date | 2016-05-31 | Total amount of commissions paid to insurance broker | USD $1,988 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | Yes | Other welfare benefits provided | SHORT TERM DISABILITY | Welfare Benefit Premiums Paid to Carrier | USD $13,252 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,833 | Additional information about fees paid to insurance broker | SALES AND SERVICE COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | AXA ASSISTANCE, USA |
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PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
Policy contract number | 23028 |
Policy instance | 4 |
Insurance contract or identification number | 23028 | Number of Individuals Covered | 254 | Insurance policy start date | 2015-06-01 | Insurance policy end date | 2016-05-31 | Total amount of commissions paid to insurance broker | USD $6,379 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $41,932 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,868 | Additional information about fees paid to insurance broker | SALES AND SERVICE COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | AXA ASSISTANCE, USA |
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FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
Policy contract number | 221092 |
Policy instance | 6 |
Insurance contract or identification number | 221092 | Number of Individuals Covered | 8 | Insurance policy start date | 2015-06-01 | Insurance policy end date | 2016-06-01 | Total amount of commissions paid to insurance broker | USD $4,045 | Total amount of fees paid to insurance company | USD $269 | Are there contracts with allocated funds for individual policies? | Yes | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $27,476 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,982 | Amount paid for insurance broker fees | 269 | Additional information about fees paid to insurance broker | SALES AND SERVICE COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | PETER JONES |
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PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
Policy contract number | 23028 |
Policy instance | 5 |
Insurance contract or identification number | 23028 | Number of Individuals Covered | 165 | Insurance policy start date | 2015-06-01 | Insurance policy end date | 2016-05-31 | Total amount of commissions paid to insurance broker | USD $1,871 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | Yes | Other welfare benefits provided | NEW YORK DBL | Welfare Benefit Premiums Paid to Carrier | USD $12,471 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,716 | Additional information about fees paid to insurance broker | SALES AND SERVICE COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | AXA ASSISTANCE, USA |
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AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 0847845-SL |
Policy instance | 7 |
Insurance contract or identification number | 0847845-SL | Number of Individuals Covered | 147 | Insurance policy start date | 2015-06-01 | Insurance policy end date | 2016-05-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | 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 name | |
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PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
Policy contract number | 23028 |
Policy instance | 1 |
Insurance contract or identification number | 23028 | Number of Individuals Covered | 263 | Insurance policy start date | 2014-06-01 | Insurance policy end date | 2015-05-31 | Total amount of commissions paid to insurance broker | USD $2,166 | Total amount of fees paid to insurance company | USD $18 | Are there contracts with allocated funds for individual policies? | Yes | 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 | Welfare Benefit Premiums Paid to Carrier | USD $21,658 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,166 | Additional information about fees paid to insurance broker | SALES AND SERVICE COMPENSATION | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 18 | Insurance broker name | AXA ASSISTANCE, USA |
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PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
Policy contract number | 23028 |
Policy instance | 2 |
Insurance contract or identification number | 23028 | Number of Individuals Covered | 263 | Insurance policy start date | 2014-06-01 | Insurance policy end date | 2015-05-31 | Total amount of commissions paid to insurance broker | USD $274 | Total amount of fees paid to insurance company | USD $2 | Are there contracts with allocated funds for individual policies? | Yes | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,745 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $274 | Additional information about fees paid to insurance broker | SALES AND SERVICE COMPENSATION | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 2 | Insurance broker name | AXA ASSISTANCE, USA |
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PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
Policy contract number | 23028 |
Policy instance | 3 |
Insurance contract or identification number | 23028 | Number of Individuals Covered | 169 | Insurance policy start date | 2014-06-01 | Insurance policy end date | 2014-05-31 | Total amount of commissions paid to insurance broker | USD $3,257 | Total amount of fees paid to insurance company | USD $19 | Are there contracts with allocated funds for individual policies? | Yes | 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 | NEW YORK DBL | Welfare Benefit Premiums Paid to Carrier | USD $21,715 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,257 | Additional information about fees paid to insurance broker | SALES AND SERVICE COMPENSATION | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 19 | Insurance broker name | AXA ASSISTANCE, USA |
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AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | STOP LOSS |
Policy instance | 4 |
Insurance contract or identification number | STOP LOSS | Number of Individuals Covered | 149 | Insurance policy start date | 2014-06-01 | Insurance policy end date | 2015-05-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | Yes | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Welfare Benefit Premiums Paid to Carrier | USD $105,993 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
Policy contract number | 23028 |
Policy instance | 6 |
Insurance contract or identification number | 23028 | Number of Individuals Covered | 162 | Insurance policy start date | 2014-06-01 | Insurance policy end date | 2015-05-31 | Total amount of commissions paid to insurance broker | USD $1,812 | Total amount of fees paid to insurance company | USD $10 | 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 | SHORT TERM DISABILITY | Welfare Benefit Premiums Paid to Carrier | USD $12,081 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,812 | Additional information about fees paid to insurance broker | SALES AND SERVICE COMPENSATION | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 10 | Insurance broker name | AXA ASSISTANCE, USA |
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FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
Policy contract number | 221092 |
Policy instance | 5 |
Insurance contract or identification number | 221092 | Number of Individuals Covered | 10 | Insurance policy start date | 2014-06-01 | Insurance policy end date | 2015-06-01 | Total amount of commissions paid to insurance broker | USD $4,368 | 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 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $29,117 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,368 | Additional information about fees paid to insurance broker | SALES AND SERVICE COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | JONES, PETER C |
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PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
Policy contract number | 23028 |
Policy instance | 7 |
Insurance contract or identification number | 23028 | Number of Individuals Covered | 263 | Insurance policy start date | 2014-06-01 | Insurance policy end date | 2015-05-31 | Total amount of commissions paid to insurance broker | USD $6,254 | Total amount of fees paid to insurance company | USD $36 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $41,693 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,254 | Additional information about fees paid to insurance broker | SALES AND SERVICE COMPENSATION | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 36 | Insurance broker name | AXA ASSISTANCE, USA |
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PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
Policy contract number | 23028 |
Policy instance | 1 |
Insurance contract or identification number | 23028 | Number of Individuals Covered | 328 | Insurance policy start date | 2013-06-01 | Insurance policy end date | 2014-05-31 | Total amount of commissions paid to insurance broker | USD $3,493 | Total amount of fees paid to insurance company | USD $608 | Are there contracts with allocated funds for individual policies? | Yes | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $23,283 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,493 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Additional information about fees paid to insurance broker | PRINTING SERVICES | Insurance broker name | HARVARD PRINTING GROUP |
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PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
Policy contract number | 23028 |
Policy instance | 2 |
Insurance contract or identification number | 23028 | Number of Individuals Covered | 108 | Insurance policy start date | 2013-06-01 | Insurance policy end date | 2014-05-31 | Total amount of commissions paid to insurance broker | USD $3,493 | Total amount of fees paid to insurance company | USD $608 | Are there contracts with allocated funds for individual policies? | Yes | 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 | SHORT TERM DISABILITY | Welfare Benefit Premiums Paid to Carrier | USD $6,863 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,493 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Additional information about fees paid to insurance broker | PRINTING SERVICES | Insurance broker name | HARVARD PRINTING GROUP |
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PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
Policy contract number | 23028 |
Policy instance | 3 |
Insurance contract or identification number | 23028 | Number of Individuals Covered | 220 | Insurance policy start date | 2013-06-01 | Insurance policy end date | 2013-05-31 | Total amount of commissions paid to insurance broker | USD $3,493 | Total amount of fees paid to insurance company | USD $608 | Are there contracts with allocated funds for individual policies? | Yes | 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 | NEW YORK DBL | Welfare Benefit Premiums Paid to Carrier | USD $16,421 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,493 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Additional information about fees paid to insurance broker | PRINTING SERVICES | Insurance broker name | HARVARD PRINTING GROUP |
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FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
Policy contract number | 221092 |
Policy instance | 4 |
Insurance contract or identification number | 221092 | Number of Individuals Covered | 15 | Insurance policy start date | 2012-08-01 | Insurance policy end date | 2013-07-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | Yes | 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 | Other welfare benefits provided | LONG TERM CARE | Welfare Benefit Premiums Paid to Carrier | USD $7,863 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
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FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
Policy contract number | 224162 |
Policy instance | 3 |
Insurance contract or identification number | 224162 | Number of Individuals Covered | 211 | Insurance policy start date | 2012-02-01 | Insurance policy end date | 2013-02-01 | Total amount of commissions paid to insurance broker | USD $1,355 | Total amount of fees paid to insurance company | USD $86 | Are there contracts with allocated funds for individual policies? | Yes | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $10,724 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $537 | Amount paid for insurance broker fees | 86 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker name | BUCK CONSULTANTS LLC |
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FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
Policy contract number | 224163 |
Policy instance | 2 |
Insurance contract or identification number | 224163 | Number of Individuals Covered | 235 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2013-01-01 | Total amount of commissions paid to insurance broker | USD $5,523 | Total amount of fees paid to insurance company | USD $332 | Are there contracts with allocated funds for individual policies? | Yes | 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 $54,701 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,092 | Amount paid for insurance broker fees | 332 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker name | PETER C. JONES |
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FEDERAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 20281 ) |
Policy contract number | 000064776938 |
Policy instance | 1 |
Insurance contract or identification number | 000064776938 | Number of Individuals Covered | 3 | Insurance policy start date | 2011-09-25 | Insurance policy end date | 2012-09-25 | Total amount of commissions paid to insurance broker | USD $214 | Total amount of fees paid to insurance company | USD $15 | Are there contracts with allocated funds for individual policies? | Yes | 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 | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $1,425 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $214 | Amount paid for insurance broker fees | 15 | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | Insurance broker name | REUBEN WARNER ASSOCIATES, INC. |
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