REALTY MANAGEMENT SERVICES, INC has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan REALTY MNGMT SERVICES INC HEALTH AND WELFARE PLAN
401k plan membership statisitcs for REALTY MNGMT SERVICES INC HEALTH AND WELFARE PLAN
| Measure | Date | Value |
|---|
| 2021: REALTY MNGMT SERVICES INC HEALTH AND WELFARE PLAN 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-12-01 | 206 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-12-01 | 163 |
| Number of retired or separated participants receiving benefits | 2021-12-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2021-12-01 | 0 |
| Total of all active and inactive participants | 2021-12-01 | 163 |
| 2020: REALTY MNGMT SERVICES INC HEALTH AND WELFARE PLAN 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-12-01 | 194 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-12-01 | 206 |
| Number of retired or separated participants receiving benefits | 2020-12-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2020-12-01 | 0 |
| Total of all active and inactive participants | 2020-12-01 | 206 |
| 2019: REALTY MNGMT SERVICES INC HEALTH AND WELFARE PLAN 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-12-01 | 265 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-12-01 | 194 |
| Number of retired or separated participants receiving benefits | 2019-12-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2019-12-01 | 0 |
| Total of all active and inactive participants | 2019-12-01 | 194 |
| 2018: REALTY MNGMT SERVICES INC HEALTH AND WELFARE PLAN 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-12-01 | 256 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-12-01 | 265 |
| Number of retired or separated participants receiving benefits | 2018-12-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2018-12-01 | 0 |
| Total of all active and inactive participants | 2018-12-01 | 265 |
| 2017: REALTY MNGMT SERVICES INC HEALTH AND WELFARE PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-12-01 | 316 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-12-01 | 256 |
| Number of retired or separated participants receiving benefits | 2017-12-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2017-12-01 | 0 |
| Total of all active and inactive participants | 2017-12-01 | 256 |
| 2016: REALTY MNGMT SERVICES INC HEALTH AND WELFARE PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-12-01 | 295 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-12-01 | 316 |
| Number of retired or separated participants receiving benefits | 2016-12-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2016-12-01 | 0 |
| Total of all active and inactive participants | 2016-12-01 | 316 |
| 2015: REALTY MNGMT SERVICES INC HEALTH AND WELFARE PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-12-01 | 268 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-12-01 | 293 |
| Number of retired or separated participants receiving benefits | 2015-12-01 | 2 |
| Total of all active and inactive participants | 2015-12-01 | 295 |
| Total participants | 2015-12-01 | 295 |
| 2014: REALTY MNGMT SERVICES INC HEALTH AND WELFARE PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-12-01 | 282 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-12-01 | 266 |
| Number of retired or separated participants receiving benefits | 2014-12-01 | 2 |
| Total of all active and inactive participants | 2014-12-01 | 268 |
| Total participants | 2014-12-01 | 268 |
| Total participants, beginning-of-year | 2014-04-01 | 314 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-04-01 | 281 |
| Number of retired or separated participants receiving benefits | 2014-04-01 | 1 |
| Total of all active and inactive participants | 2014-04-01 | 282 |
| Total participants | 2014-04-01 | 282 |
| 2013: REALTY MNGMT SERVICES INC HEALTH AND WELFARE PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-04-01 | 308 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-04-01 | 313 |
| Number of retired or separated participants receiving benefits | 2013-04-01 | 1 |
| Total of all active and inactive participants | 2013-04-01 | 314 |
| Total participants | 2013-04-01 | 314 |
| 2012: REALTY MNGMT SERVICES INC HEALTH AND WELFARE PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-04-01 | 313 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-04-01 | 308 |
| Total of all active and inactive participants | 2012-04-01 | 308 |
| Total participants | 2012-04-01 | 308 |
| 2011: REALTY MNGMT SERVICES INC HEALTH AND WELFARE PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-04-01 | 272 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-04-01 | 313 |
| Total of all active and inactive participants | 2011-04-01 | 313 |
| Total participants | 2011-04-01 | 313 |
| 2010: REALTY MNGMT SERVICES INC HEALTH AND WELFARE PLAN 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-04-01 | 280 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-04-01 | 269 |
| Number of retired or separated participants receiving benefits | 2010-04-01 | 3 |
| Total of all active and inactive participants | 2010-04-01 | 272 |
| Total participants | 2010-04-01 | 272 |
| 2009: REALTY MNGMT SERVICES INC HEALTH AND WELFARE PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-04-01 | 278 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-04-01 | 278 |
| Number of retired or separated participants receiving benefits | 2009-04-01 | 2 |
| Total of all active and inactive participants | 2009-04-01 | 280 |
| Total participants | 2009-04-01 | 280 |
| 2021: REALTY MNGMT SERVICES INC HEALTH AND WELFARE PLAN 2021 form 5500 responses |
|---|
| 2021-12-01 | Type of plan entity | Single employer plan |
| 2021-12-01 | Submission has been amended | No |
| 2021-12-01 | This submission is the final filing | No |
| 2021-12-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2021-12-01 | Plan is a collectively bargained plan | No |
| 2021-12-01 | Plan funding arrangement – Insurance | Yes |
| 2021-12-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2021-12-01 | Plan benefit arrangement – Insurance | Yes |
| 2021-12-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2020: REALTY MNGMT SERVICES INC HEALTH AND WELFARE PLAN 2020 form 5500 responses |
|---|
| 2020-12-01 | Type of plan entity | Single employer plan |
| 2020-12-01 | Submission has been amended | No |
| 2020-12-01 | This submission is the final filing | No |
| 2020-12-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2020-12-01 | Plan is a collectively bargained plan | No |
| 2020-12-01 | Plan funding arrangement – Insurance | Yes |
| 2020-12-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2020-12-01 | Plan benefit arrangement – Insurance | Yes |
| 2020-12-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2019: REALTY MNGMT SERVICES INC HEALTH AND WELFARE PLAN 2019 form 5500 responses |
|---|
| 2019-12-01 | Type of plan entity | Single employer plan |
| 2019-12-01 | Submission has been amended | No |
| 2019-12-01 | This submission is the final filing | No |
| 2019-12-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2019-12-01 | Plan is a collectively bargained plan | No |
| 2019-12-01 | Plan funding arrangement – Insurance | Yes |
| 2019-12-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2019-12-01 | Plan benefit arrangement – Insurance | Yes |
| 2019-12-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2018: REALTY MNGMT SERVICES INC HEALTH AND WELFARE PLAN 2018 form 5500 responses |
|---|
| 2018-12-01 | Type of plan entity | Single employer plan |
| 2018-12-01 | Submission has been amended | No |
| 2018-12-01 | This submission is the final filing | No |
| 2018-12-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2018-12-01 | Plan is a collectively bargained plan | No |
| 2018-12-01 | Plan funding arrangement – Insurance | Yes |
| 2018-12-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: REALTY MNGMT SERVICES INC HEALTH AND WELFARE PLAN 2017 form 5500 responses |
|---|
| 2017-12-01 | Type of plan entity | Single employer plan |
| 2017-12-01 | Plan funding arrangement – Insurance | Yes |
| 2017-12-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: REALTY MNGMT SERVICES INC HEALTH AND WELFARE PLAN 2016 form 5500 responses |
|---|
| 2016-12-01 | Type of plan entity | Single employer plan |
| 2016-12-01 | Plan funding arrangement – Insurance | Yes |
| 2016-12-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: REALTY MNGMT SERVICES INC HEALTH AND WELFARE PLAN 2015 form 5500 responses |
|---|
| 2015-12-01 | Type of plan entity | Single employer plan |
| 2015-12-01 | Plan funding arrangement – Insurance | Yes |
| 2015-12-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: REALTY MNGMT SERVICES INC HEALTH AND WELFARE PLAN 2014 form 5500 responses |
|---|
| 2014-12-01 | Type of plan entity | Single employer plan |
| 2014-12-01 | Plan funding arrangement – Insurance | Yes |
| 2014-12-01 | Plan benefit arrangement – Insurance | Yes |
| 2014-04-01 | Type of plan entity | Single employer plan |
| 2014-04-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2014-04-01 | Plan funding arrangement – Insurance | Yes |
| 2014-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: REALTY MNGMT SERVICES INC HEALTH AND WELFARE PLAN 2013 form 5500 responses |
|---|
| 2013-04-01 | Type of plan entity | Single employer plan |
| 2013-04-01 | Plan funding arrangement – Insurance | Yes |
| 2013-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: REALTY MNGMT SERVICES INC HEALTH AND WELFARE PLAN 2012 form 5500 responses |
|---|
| 2012-04-01 | Type of plan entity | Single employer plan |
| 2012-04-01 | Plan funding arrangement – Insurance | Yes |
| 2012-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: REALTY MNGMT SERVICES INC HEALTH AND WELFARE PLAN 2011 form 5500 responses |
|---|
| 2011-04-01 | Type of plan entity | Single employer plan |
| 2011-04-01 | Plan funding arrangement – Insurance | Yes |
| 2011-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2010: REALTY MNGMT SERVICES INC HEALTH AND WELFARE PLAN 2010 form 5500 responses |
|---|
| 2010-04-01 | Type of plan entity | Single employer plan |
| 2010-04-01 | Plan funding arrangement – Insurance | Yes |
| 2010-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: REALTY MNGMT SERVICES INC HEALTH AND WELFARE PLAN 2009 form 5500 responses |
|---|
| 2009-04-01 | Type of plan entity | Single employer plan |
| 2009-04-01 | Submission has been amended | Yes |
| 2009-04-01 | Plan funding arrangement – Insurance | Yes |
| 2009-04-01 | Plan benefit arrangement – Insurance | Yes |
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 306559 |
| Policy instance | 1 |
| Insurance contract or identification number | 306559 | | Number of Individuals Covered | 176 | | Insurance policy start date | 2021-12-01 | | Insurance policy end date | 2022-11-30 | | Total amount of commissions paid to insurance broker | USD $13,562 | | Total amount of fees paid to insurance company | USD $32,142 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | AD&D, CRITICAL ILLNESS, ACCIDENT | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $147,113 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $11,590 | | Amount paid for insurance broker fees | 32142 | | Additional information about fees paid to insurance broker | COMMISSIONS | | Insurance broker organization code? | 3 |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 919228 |
| Policy instance | 2 |
| Insurance contract or identification number | 919228 | | Number of Individuals Covered | 163 | | Insurance policy start date | 2021-12-01 | | Insurance policy end date | 2022-11-30 | | Total amount of commissions paid to insurance broker | USD $6,622 | | Total amount of fees paid to insurance company | USD $46,869 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $868,259 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,558 | | Amount paid for insurance broker fees | 32142 | | Additional information about fees paid to insurance broker | COMMISSIONS AND FEES | | Insurance broker organization code? | 3 |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 306559 |
| Policy instance | 1 |
| Insurance contract or identification number | 306559 | | Number of Individuals Covered | 206 | | Insurance policy start date | 2020-12-01 | | Insurance policy end date | 2021-11-30 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | AD&D, CRITICAL ILLNESS,AND ACCIDENT | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $153,882 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 0919228 |
| Policy instance | 2 |
| Insurance contract or identification number | 0919228 | | Number of Individuals Covered | 208 | | Insurance policy start date | 2020-12-01 | | Insurance policy end date | 2021-11-30 | | Total amount of commissions paid to insurance broker | USD $53,042 | | Total amount of fees paid to insurance company | USD $44,653 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $935,168 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $53,042 | | Amount paid for insurance broker fees | 44653 | | Additional information about fees paid to insurance broker | FEES PAID | | Insurance broker organization code? | 3 |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 0919228 |
| Policy instance | 2 |
| Insurance contract or identification number | 0919228 | | Number of Individuals Covered | 190 | | Insurance policy start date | 2019-12-01 | | Insurance policy end date | 2020-11-30 | | Total amount of commissions paid to insurance broker | USD $6,953 | | Total amount of fees paid to insurance company | USD $45,714 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $791,401 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 8292 | | Additional information about fees paid to insurance broker | BONUS | | Insurance broker organization code? | 3 | | Commission paid to Insurance Broker | USD $6,953 |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 306559 |
| Policy instance | 1 |
| Insurance contract or identification number | 306559 | | Number of Individuals Covered | 194 | | Insurance policy start date | 2019-12-01 | | Insurance policy end date | 2020-11-30 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | AD&D, CRITICAL ILLNESS,AND ACCIDENT | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $145,631 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 5947683 |
| Policy instance | 1 |
| Insurance contract or identification number | 5947683 | | Number of Individuals Covered | 265 | | Insurance policy start date | 2018-12-01 | | Insurance policy end date | 2019-11-30 | | Total amount of commissions paid to insurance broker | USD $9,115 | | Total amount of fees paid to insurance company | USD $3,885 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | 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 | AD&D | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $194,502 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $9,115 | | Amount paid for insurance broker fees | 609 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | | Insurance broker organization code? | 3 |
|
| KAISER FOUNDATION HEALTH PLANS OF MID-ATLANTIC (National Association of Insurance Commissioners NAIC id number: 95639 ) |
| Policy contract number | 24898 |
| Policy instance | 2 |
| Insurance contract or identification number | 24898 | | Number of Individuals Covered | 126 | | Insurance policy start date | 2018-12-01 | | Insurance policy end date | 2019-11-30 | | Total amount of commissions paid to insurance broker | USD $50,154 | | Total amount of fees paid to insurance company | USD $10,800 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $731,561 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $25,160 | | Amount paid for insurance broker fees | 10800 | | Additional information about fees paid to insurance broker | BONUS | | Insurance broker organization code? | 3 |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 5947683 |
| Policy instance | 1 |
| Insurance contract or identification number | 5947683 | | Number of Individuals Covered | 107 | | Insurance policy start date | 2017-12-01 | | Insurance policy end date | 2018-11-30 | | Total amount of commissions paid to insurance broker | USD $24,791 | | Total amount of fees paid to insurance company | USD $13,369 | | Vision Insurance Welfare Benefit | Yes | | 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 $151,986 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| KAISER FOUNDATION HEALTH PLANS OF MID-ATLANTIC (National Association of Insurance Commissioners NAIC id number: 95639 ) |
| Policy contract number | 24898 |
| Policy instance | 2 |
| Insurance contract or identification number | 24898 | | Number of Individuals Covered | 136 | | Insurance policy start date | 2017-12-01 | | Insurance policy end date | 2018-11-30 | | Total amount of commissions paid to insurance broker | USD $55,415 | | Total amount of fees paid to insurance company | USD $17,033 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $654,500 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 ) |
| Policy contract number | 12282286 |
| Policy instance | 1 |
| Insurance contract or identification number | 12282286 | | Number of Individuals Covered | 120 | | Insurance policy start date | 2014-12-01 | | Insurance policy end date | 2015-11-30 | | Total amount of commissions paid to insurance broker | USD $946 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $15,513 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $946 | | Insurance broker organization code? | 3 | | Insurance broker name | GOLDEN & COHEN, LLC |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 293257 |
| Policy instance | 2 |
| Insurance contract or identification number | 293257 | | Number of Individuals Covered | 9 | | Insurance policy start date | 2014-12-01 | | Insurance policy end date | 2015-12-01 | | Total amount of commissions paid to insurance broker | USD $1,045 | | Total amount of fees paid to insurance company | USD $143 | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $8,154 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,045 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 143 | | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | | Insurance broker name | GOLDEN & COHEN, LLC |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 212634 |
| Policy instance | 3 |
| Insurance contract or identification number | 212634 | | Number of Individuals Covered | 120 | | Insurance policy start date | 2014-12-01 | | Insurance policy end date | 2015-12-01 | | Total amount of commissions paid to insurance broker | USD $6,142 | | Total amount of fees paid to insurance company | USD $717 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $40,943 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,142 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 717 | | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | | Insurance broker name | GOLDEN & COHEN, LLC |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 212635 |
| Policy instance | 4 |
| Insurance contract or identification number | 212635 | | Number of Individuals Covered | 251 | | Insurance policy start date | 2014-12-01 | | Insurance policy end date | 2015-12-01 | | Total amount of commissions paid to insurance broker | USD $8,689 | | Total amount of fees paid to insurance company | USD $2,033 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $116,165 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,689 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 2033 | | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | | Insurance broker name | GOLDEN & COHEN, LLC |
|
| PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) |
| Policy contract number | 0007513684 |
| Policy instance | 6 |
| Insurance contract or identification number | 0007513684 | | Number of Individuals Covered | 266 | | Insurance policy start date | 2014-12-01 | | Insurance policy end date | 2015-12-01 | | Total amount of commissions paid to insurance broker | USD $4,249 | | Total amount of fees paid to insurance company | USD $590 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | CRITICAL ILLNESS, SICKNESS/ACCIDENT | | Welfare Benefit Premiums Paid to Carrier | USD $70,437 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,289 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 43 | | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | | Insurance broker name | CUSTOM BENEFIT PROGRAMS INC |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 837782-HNO |
| Policy instance | 7 |
| Insurance contract or identification number | 837782-HNO | | Number of Individuals Covered | 192 | | Insurance policy start date | 2014-12-01 | | Insurance policy end date | 2015-11-30 | | Total amount of commissions paid to insurance broker | USD $28,861 | | Total amount of fees paid to insurance company | USD $28,861 | | Welfare Benefit Premiums Paid to Carrier | USD $1,127,092 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $28,861 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 28861 | | Additional information about fees paid to insurance broker | WHOLESALER FEE | | Insurance broker name | POTOMAC BASIC GROUP ASSOC LLC |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00485569 |
| Policy instance | 5 |
| Insurance contract or identification number | 00485569 | | Number of Individuals Covered | 176 | | Insurance policy start date | 2014-12-01 | | Insurance policy end date | 2015-11-30 | | Total amount of commissions paid to insurance broker | USD $3,070 | | Total amount of fees paid to insurance company | USD $4,367 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $71,348 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,070 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 4367 | | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | | Insurance broker name | POTOMAC BASIN GFROUP ASSOC INC |
|
| PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) |
| Policy contract number | 0007513684 |
| Policy instance | 6 |
| Insurance contract or identification number | 0007513684 | | Number of Individuals Covered | 281 | | Insurance policy start date | 2014-04-01 | | Insurance policy end date | 2014-11-30 | | Total amount of commissions paid to insurance broker | USD $3,030 | | Total amount of fees paid to insurance company | USD $632 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | CRITICAL ILLNESS, SICKNESS/ACCIDENT | | Welfare Benefit Premiums Paid to Carrier | USD $48,707 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,634 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 41 | | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | | Insurance broker name | CUSTOM BENEFIT PROGRAMS INC |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 837782-HNO |
| Policy instance | 7 |
| Insurance contract or identification number | 837782-HNO | | Number of Individuals Covered | 215 | | Insurance policy start date | 2013-12-01 | | Insurance policy end date | 2014-11-30 | | Total amount of commissions paid to insurance broker | USD $27,745 | | Total amount of fees paid to insurance company | USD $34,175 | | Welfare Benefit Premiums Paid to Carrier | USD $1,075,002 | | Commission paid to Insurance Broker | USD $27,745 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 34175 | | Additional information about fees paid to insurance broker | WHOLESALER FEE | | Insurance broker name | POTOMAC BASIC GROUP ASSOC LLC |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00485569 |
| Policy instance | 5 |
| Insurance contract or identification number | 00485569 | | Number of Individuals Covered | 176 | | Insurance policy start date | 2014-04-01 | | Insurance policy end date | 2014-11-30 | | Total amount of commissions paid to insurance broker | USD $2,593 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $43,728 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,593 | | Insurance broker organization code? | 3 | | Insurance broker name | GOLDEN & COHEN LLC |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 212635 |
| Policy instance | 4 |
| Insurance contract or identification number | 212635 | | Number of Individuals Covered | 261 | | Insurance policy start date | 2014-04-01 | | Insurance policy end date | 2014-11-30 | | Total amount of commissions paid to insurance broker | USD $6,712 | | Total amount of fees paid to insurance company | USD $1,254 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $71,682 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,712 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 1254 | | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | | Insurance broker name | GOLDEN & COHEN, LLC |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 212634 |
| Policy instance | 3 |
| Insurance contract or identification number | 212634 | | Number of Individuals Covered | 122 | | Insurance policy start date | 2014-04-01 | | Insurance policy end date | 2014-11-30 | | Total amount of commissions paid to insurance broker | USD $3,539 | | Total amount of fees paid to insurance company | USD $413 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $23,596 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,539 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 413 | | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | | Insurance broker name | GOLDEN & COHEN, LLC |
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| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 293257 |
| Policy instance | 2 |
| Insurance contract or identification number | 293257 | | Number of Individuals Covered | 9 | | Insurance policy start date | 2014-04-01 | | Insurance policy end date | 2014-11-30 | | Total amount of commissions paid to insurance broker | USD $697 | | Total amount of fees paid to insurance company | USD $95 | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $5,436 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $697 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 95 | | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | | Insurance broker name | GOLDEN & COHEN, LLC |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 ) |
| Policy contract number | 12282286 |
| Policy instance | 1 |
| Insurance contract or identification number | 12282286 | | Number of Individuals Covered | 124 | | Insurance policy start date | 2014-04-01 | | Insurance policy end date | 2014-11-30 | | Total amount of commissions paid to insurance broker | USD $765 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $10,424 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $765 | | Insurance broker organization code? | 3 | | Insurance broker name | GOLDEN & COHEN, LLC |
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| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | TM05586249 |
| Policy instance | 2 |
| Insurance contract or identification number | TM05586249 | | Insurance policy start date | 2012-04-01 | | Insurance policy end date | 2013-03-31 | | Total amount of commissions paid to insurance broker | USD $373 | | Total amount of fees paid to insurance company | USD $44 | | 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 $103 | | Additional information about fees paid to insurance broker | BASE COMMISSIONS | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 44 | | Insurance broker name | NFP INS SERVICES INC |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 ) |
| Policy contract number | 12282286 |
| Policy instance | 1 |
| Insurance contract or identification number | 12282286 | | Number of Individuals Covered | 125 | | Insurance policy start date | 2013-04-01 | | Insurance policy end date | 2014-03-31 | | Total amount of commissions paid to insurance broker | USD $956 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $15,780 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $956 | | Insurance broker organization code? | 3 | | Insurance broker name | GOLDEN & COHEN, LLC |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 293257 |
| Policy instance | 3 |
| Insurance contract or identification number | 293257 | | Number of Individuals Covered | 9 | | Insurance policy start date | 2013-04-01 | | Insurance policy end date | 2014-03-31 | | Total amount of commissions paid to insurance broker | USD $1,045 | | Total amount of fees paid to insurance company | USD $143 | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $8,154 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,045 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 143 | | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | | Insurance broker name | GOLDEN & COHEN, LLC |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00485569 |
| Policy instance | 6 |
| Insurance contract or identification number | 00485569 | | Number of Individuals Covered | 182 | | Insurance policy start date | 2013-04-01 | | Insurance policy end date | 2014-03-31 | | Total amount of commissions paid to insurance broker | USD $2,409 | | Total amount of fees paid to insurance company | USD $2,930 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $59,283 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,409 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 2930 | | Additional information about fees paid to insurance broker | OTHER FEES | | Insurance broker name | POTOMAC BASIN GROUP ASSOC INC |
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| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 212634 |
| Policy instance | 4 |
| Insurance contract or identification number | 212634 | | Number of Individuals Covered | 118 | | Insurance policy start date | 2013-04-01 | | Insurance policy end date | 2014-03-31 | | Total amount of commissions paid to insurance broker | USD $6,116 | | Total amount of fees paid to insurance company | USD $714 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $36,828 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,116 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 714 | | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | | Insurance broker name | GOLDEN & COHEN, LLC |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 212635 |
| Policy instance | 5 |
| Insurance contract or identification number | 212635 | | Number of Individuals Covered | 256 | | Insurance policy start date | 2013-04-01 | | Insurance policy end date | 2014-03-31 | | Total amount of commissions paid to insurance broker | USD $8,409 | | Total amount of fees paid to insurance company | USD $1,985 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $103,908 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,409 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 1985 | | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | | Insurance broker name | GOLDEN & COHEN, LLC |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | 837782-HNO |
| Policy instance | 8 |
| Insurance contract or identification number | 837782-HNO | | Number of Individuals Covered | 237 | | Insurance policy start date | 2013-04-01 | | Insurance policy end date | 2014-03-31 | | Total amount of commissions paid to insurance broker | USD $16,076 | | Total amount of fees paid to insurance company | USD $15,456 | | Welfare Benefit Premiums Paid to Carrier | USD $1,116,885 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $16,076 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 15456 | | Additional information about fees paid to insurance broker | WHOLESALER FEE | | Insurance broker name | POTOMAC BASIC GROUP ASSOC LLC |
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| PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) |
| Policy contract number | 0007513684 |
| Policy instance | 7 |
| Insurance contract or identification number | 0007513684 | | Number of Individuals Covered | 313 | | Insurance policy start date | 2013-04-01 | | Insurance policy end date | 2014-03-31 | | Total amount of commissions paid to insurance broker | USD $7,285 | | Total amount of fees paid to insurance company | USD $854 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | CRITICAL ILLNESS, SICKNESS/ACCIDENT | | Welfare Benefit Premiums Paid to Carrier | USD $75,453 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,001 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 225 | | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | | Insurance broker name | CUSTOM BENEFIT PROGRAMS INC |
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| PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) |
| Policy contract number | 0007513684 |
| Policy instance | 6 |
| Insurance contract or identification number | 0007513684 | | Number of Individuals Covered | 277 | | Insurance policy start date | 2012-04-01 | | Insurance policy end date | 2013-03-31 | | Total amount of commissions paid to insurance broker | USD $6,639 | | Total amount of fees paid to insurance company | USD $322 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $66,591 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,624 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 164 | | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | | Insurance broker name | NFP INSURANCE SERVICES, INC. |
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| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 212635 |
| Policy instance | 7 |
| Insurance contract or identification number | 212635 | | Number of Individuals Covered | 249 | | Insurance policy start date | 2012-04-01 | | Insurance policy end date | 2013-03-31 | | Total amount of commissions paid to insurance broker | USD $8,514 | | Total amount of fees paid to insurance company | USD $1,583 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $115,654 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,514 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 1583 | | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | | Insurance broker name | GOLDEN & COHEN, LLC |
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| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 212634 |
| Policy instance | 5 |
| Insurance contract or identification number | 212634 | | Number of Individuals Covered | 138 | | Insurance policy start date | 2012-04-01 | | Insurance policy end date | 2013-03-31 | | Total amount of commissions paid to insurance broker | USD $6,340 | | Total amount of fees paid to insurance company | USD $578 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $42,263 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,340 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 578 | | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | | Insurance broker name | GOLDEN & COHEN, LLC |
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| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 293257 |
| Policy instance | 4 |
| Insurance contract or identification number | 293257 | | Number of Individuals Covered | 9 | | Insurance policy start date | 2012-04-01 | | Insurance policy end date | 2013-03-31 | | Total amount of commissions paid to insurance broker | USD $1,045 | | Total amount of fees paid to insurance company | USD $112 | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $8,154 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,045 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 112 | | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | | Insurance broker name | GOLDEN & COHEN, LLC |
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| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | TM05586249 |
| Policy instance | 3 |
| Insurance contract or identification number | TM05586249 | | Number of Individuals Covered | 308 | | Insurance policy start date | 2012-04-01 | | Insurance policy end date | 2013-03-31 | | Total amount of commissions paid to insurance broker | USD $3,617 | | Total amount of fees paid to insurance company | USD $850 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $45,606 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,950 | | Additional information about fees paid to insurance broker | BASE COMMISSIONS | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 850 | | Insurance broker name | NFP INS SERVICES INC |
|
| GHMSI (National Association of Insurance Commissioners NAIC id number: 53007 ) |
| Policy contract number | 6U00 |
| Policy instance | 1 |
| Insurance contract or identification number | 6U00 | | Number of Individuals Covered | 198 | | Insurance policy start date | 2012-04-01 | | Insurance policy end date | 2013-03-31 | | Total amount of commissions paid to insurance broker | USD $29,307 | | Total amount of fees paid to insurance company | USD $33,141 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,172,287 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $29,307 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 17681 | | Additional information about fees paid to insurance broker | MEDICAL CONTRACTS | | Insurance broker name | POTOMAC BASIN GROUP ASSOC. |
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| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 ) |
| Policy contract number | 12282286 |
| Policy instance | 2 |
| Insurance contract or identification number | 12282286 | | Number of Individuals Covered | 135 | | Insurance policy start date | 2012-04-01 | | Insurance policy end date | 2013-03-31 | | Total amount of commissions paid to insurance broker | USD $1,067 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $18,895 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,067 | | Insurance broker organization code? | 3 | | Insurance broker name | GOLDEN & COHEN, LLC |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 293257 |
| Policy instance | 7 |
| Insurance contract or identification number | 293257 | | Number of Individuals Covered | 9 | | Insurance policy start date | 2011-04-01 | | Insurance policy end date | 2012-03-31 | | Total amount of commissions paid to insurance broker | USD $1,071 | | Total amount of fees paid to insurance company | USD $105 | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $8,371 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) |
| Policy contract number | 0007513684 |
| Policy instance | 6 |
| Insurance contract or identification number | 0007513684 | | Number of Individuals Covered | 217 | | Insurance policy start date | 2011-04-01 | | Insurance policy end date | 2012-04-01 | | Total amount of commissions paid to insurance broker | USD $9,359 | | Total amount of fees paid to insurance company | USD $1,613 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $60,305 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 212635 |
| Policy instance | 4 |
| Insurance contract or identification number | 212635 | | Number of Individuals Covered | 289 | | Insurance policy start date | 2011-04-01 | | Insurance policy end date | 2012-04-01 | | Total amount of commissions paid to insurance broker | USD $7,223 | | Total amount of fees paid to insurance company | USD $959 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $76,728 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 212634 |
| Policy instance | 5 |
| Insurance contract or identification number | 212634 | | Number of Individuals Covered | 150 | | Insurance policy start date | 2011-04-01 | | Insurance policy end date | 2012-03-31 | | Total amount of commissions paid to insurance broker | USD $4,234 | | Total amount of fees paid to insurance company | USD $353 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $28,224 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| GHMSI (National Association of Insurance Commissioners NAIC id number: 53007 ) |
| Policy contract number | 6U00 |
| Policy instance | 1 |
| Insurance contract or identification number | 6U00 | | Number of Individuals Covered | 210 | | Insurance policy start date | 2011-04-01 | | Insurance policy end date | 2012-03-31 | | Total amount of commissions paid to insurance broker | USD $29,499 | | Total amount of fees paid to insurance company | USD $33,312 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,178,042 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 ) |
| Policy contract number | 12282286 |
| Policy instance | 2 |
| Insurance contract or identification number | 12282286 | | Number of Individuals Covered | 151 | | Insurance policy start date | 2011-04-01 | | Insurance policy end date | 2012-03-31 | | Total amount of commissions paid to insurance broker | USD $1,048 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $18,376 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | TM05586249 |
| Policy instance | 3 |
| Insurance contract or identification number | TM05586249 | | Number of Individuals Covered | 313 | | Insurance policy start date | 2011-04-01 | | Insurance policy end date | 2012-03-31 | | Total amount of commissions paid to insurance broker | USD $3,614 | | Total amount of fees paid to insurance company | USD $1,456 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $72,363 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 293257 |
| Policy instance | 7 |
| Insurance contract or identification number | 293257 | | Number of Individuals Covered | 10 | | Insurance policy start date | 2010-04-01 | | Insurance policy end date | 2011-04-01 | | Total amount of commissions paid to insurance broker | USD $1,074 | | Total amount of fees paid to insurance company | USD $105 | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $8,409 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) |
| Policy contract number | 0007513684 |
| Policy instance | 6 |
| Insurance contract or identification number | 0007513684 | | Number of Individuals Covered | 224 | | Insurance policy start date | 2010-04-01 | | Insurance policy end date | 2011-04-01 | | Total amount of commissions paid to insurance broker | USD $14,172 | | Total amount of fees paid to insurance company | USD $2,119 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $60,898 | | 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 | 212635 |
| Policy instance | 4 |
| Insurance contract or identification number | 212635 | | Number of Individuals Covered | 248 | | Insurance policy start date | 2010-04-01 | | Insurance policy end date | 2011-04-01 | | Total amount of commissions paid to insurance broker | USD $6,238 | | Total amount of fees paid to insurance company | USD $803 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $64,235 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | TM05586249 |
| Policy instance | 3 |
| Insurance contract or identification number | TM05586249 | | Number of Individuals Covered | 272 | | Insurance policy start date | 2010-04-01 | | Insurance policy end date | 2011-03-31 | | Total amount of commissions paid to insurance broker | USD $3,695 | | Total amount of fees paid to insurance company | USD $1,156 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $63,087 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 ) |
| Policy contract number | 12282286 |
| Policy instance | 2 |
| Insurance contract or identification number | 12282286 | | Number of Individuals Covered | 118 | | Insurance policy start date | 2010-04-01 | | Insurance policy end date | 2011-03-31 | | Total amount of commissions paid to insurance broker | USD $930 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $15,053 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| GHMSI (National Association of Insurance Commissioners NAIC id number: 53007 ) |
| Policy contract number | 6U00 |
| Policy instance | 1 |
| Insurance contract or identification number | 6U00 | | Number of Individuals Covered | 175 | | Insurance policy start date | 2010-04-01 | | Insurance policy end date | 2011-03-31 | | Total amount of commissions paid to insurance broker | USD $27,688 | | Total amount of fees paid to insurance company | USD $31,669 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $922,933 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 212634 |
| Policy instance | 5 |
| Insurance contract or identification number | 212634 | | Number of Individuals Covered | 78 | | Insurance policy start date | 2010-04-01 | | Insurance policy end date | 2011-04-01 | | Total amount of commissions paid to insurance broker | USD $3,509 | | Total amount of fees paid to insurance company | USD $292 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $23,395 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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