SCIENCE & ENGINEERING SERVICES, INC. has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan SESI HEALTH AND WELFARE BENEFIT PLAN
Measure | Date | Value |
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2022: SESI HEALTH AND WELFARE BENEFIT PLAN 2022 401k membership |
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Total participants, beginning-of-year | 2022-06-01 | 624 |
Total number of active participants reported on line 7a of the Form 5500 | 2022-06-01 | 601 |
Number of retired or separated participants receiving benefits | 2022-06-01 | 10 |
Number of other retired or separated participants entitled to future benefits | 2022-06-01 | 13 |
Total of all active and inactive participants | 2022-06-01 | 624 |
2021: SESI HEALTH AND WELFARE BENEFIT PLAN 2021 401k membership |
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Total participants, beginning-of-year | 2021-06-01 | 863 |
Total number of active participants reported on line 7a of the Form 5500 | 2021-06-01 | 614 |
Number of retired or separated participants receiving benefits | 2021-06-01 | 10 |
Number of other retired or separated participants entitled to future benefits | 2021-06-01 | 52 |
Total of all active and inactive participants | 2021-06-01 | 676 |
2020: SESI HEALTH AND WELFARE BENEFIT PLAN 2020 401k membership |
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Total participants, beginning-of-year | 2020-06-01 | 1,128 |
Total number of active participants reported on line 7a of the Form 5500 | 2020-06-01 | 820 |
Number of retired or separated participants receiving benefits | 2020-06-01 | 8 |
Number of other retired or separated participants entitled to future benefits | 2020-06-01 | 35 |
Total of all active and inactive participants | 2020-06-01 | 863 |
2019: SESI HEALTH AND WELFARE BENEFIT PLAN 2019 401k membership |
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Total participants, beginning-of-year | 2019-06-01 | 1,010 |
Total number of active participants reported on line 7a of the Form 5500 | 2019-06-01 | 978 |
Number of retired or separated participants receiving benefits | 2019-06-01 | 5 |
Number of other retired or separated participants entitled to future benefits | 2019-06-01 | 145 |
Total of all active and inactive participants | 2019-06-01 | 1,128 |
2018: SESI HEALTH AND WELFARE BENEFIT PLAN 2018 401k membership |
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Total participants, beginning-of-year | 2018-06-01 | 987 |
Total number of active participants reported on line 7a of the Form 5500 | 2018-06-01 | 1,010 |
Number of retired or separated participants receiving benefits | 2018-06-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2018-06-01 | 0 |
Total of all active and inactive participants | 2018-06-01 | 1,010 |
2017: SESI HEALTH AND WELFARE BENEFIT PLAN 2017 401k membership |
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Total participants, beginning-of-year | 2017-06-01 | 872 |
Total number of active participants reported on line 7a of the Form 5500 | 2017-06-01 | 987 |
Number of retired or separated participants receiving benefits | 2017-06-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2017-06-01 | 0 |
Total of all active and inactive participants | 2017-06-01 | 987 |
2016: SESI HEALTH AND WELFARE BENEFIT PLAN 2016 401k membership |
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Total participants, beginning-of-year | 2016-06-01 | 820 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-06-01 | 872 |
Number of retired or separated participants receiving benefits | 2016-06-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2016-06-01 | 0 |
Total of all active and inactive participants | 2016-06-01 | 872 |
2015: SESI HEALTH AND WELFARE BENEFIT PLAN 2015 401k membership |
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Total participants, beginning-of-year | 2015-06-01 | 777 |
Total number of active participants reported on line 7a of the Form 5500 | 2015-06-01 | 830 |
Total of all active and inactive participants | 2015-06-01 | 830 |
2014: SESI HEALTH AND WELFARE BENEFIT PLAN 2014 401k membership |
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Total participants, beginning-of-year | 2014-06-01 | 751 |
Total number of active participants reported on line 7a of the Form 5500 | 2014-06-01 | 777 |
Total of all active and inactive participants | 2014-06-01 | 777 |
2013: SESI HEALTH AND WELFARE BENEFIT PLAN 2013 401k membership |
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Total participants, beginning-of-year | 2013-06-01 | 757 |
Total number of active participants reported on line 7a of the Form 5500 | 2013-06-01 | 751 |
Total of all active and inactive participants | 2013-06-01 | 751 |
2012: SESI HEALTH AND WELFARE BENEFIT PLAN 2012 401k membership |
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Total participants, beginning-of-year | 2012-06-01 | 648 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-06-01 | 757 |
Total of all active and inactive participants | 2012-06-01 | 757 |
2011: SESI HEALTH AND WELFARE BENEFIT PLAN 2011 401k membership |
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Total participants, beginning-of-year | 2011-06-01 | 670 |
Total number of active participants reported on line 7a of the Form 5500 | 2011-06-01 | 648 |
Total of all active and inactive participants | 2011-06-01 | 648 |
2009: SESI HEALTH AND WELFARE BENEFIT PLAN 2009 401k membership |
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Total participants, beginning-of-year | 2009-06-01 | 468 |
Total number of active participants reported on line 7a of the Form 5500 | 2009-06-01 | 602 |
Number of retired or separated participants receiving benefits | 2009-06-01 | 2 |
Total of all active and inactive participants | 2009-06-01 | 604 |
Total participants | 2009-06-01 | 604 |
2022: SESI HEALTH AND WELFARE BENEFIT PLAN 2022 form 5500 responses |
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2022-06-01 | Type of plan entity | Single employer plan |
2022-06-01 | Submission has been amended | No |
2022-06-01 | This submission is the final filing | No |
2022-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2022-06-01 | Plan is a collectively bargained plan | No |
2022-06-01 | Plan funding arrangement – Insurance | Yes |
2022-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2022-06-01 | Plan benefit arrangement – Insurance | Yes |
2022-06-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2021: SESI HEALTH AND WELFARE BENEFIT PLAN 2021 form 5500 responses |
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2021-06-01 | Type of plan entity | Single employer plan |
2021-06-01 | Submission has been amended | No |
2021-06-01 | This submission is the final filing | No |
2021-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2021-06-01 | Plan is a collectively bargained plan | No |
2021-06-01 | Plan funding arrangement – Insurance | Yes |
2021-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2021-06-01 | Plan benefit arrangement – Insurance | Yes |
2021-06-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2020: SESI HEALTH AND WELFARE BENEFIT PLAN 2020 form 5500 responses |
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2020-06-01 | Type of plan entity | Single employer plan |
2020-06-01 | Submission has been amended | No |
2020-06-01 | This submission is the final filing | No |
2020-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2020-06-01 | Plan is a collectively bargained plan | No |
2020-06-01 | Plan funding arrangement – Insurance | Yes |
2020-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2020-06-01 | Plan benefit arrangement – Insurance | Yes |
2020-06-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2019: SESI HEALTH AND WELFARE BENEFIT PLAN 2019 form 5500 responses |
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2019-06-01 | Type of plan entity | Single employer plan |
2019-06-01 | Submission has been amended | No |
2019-06-01 | This submission is the final filing | No |
2019-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2019-06-01 | Plan is a collectively bargained plan | No |
2019-06-01 | Plan funding arrangement – Insurance | Yes |
2019-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2019-06-01 | Plan benefit arrangement – Insurance | Yes |
2019-06-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2018: SESI HEALTH AND WELFARE BENEFIT PLAN 2018 form 5500 responses |
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2018-06-01 | Type of plan entity | Single employer plan |
2018-06-01 | Submission has been amended | No |
2018-06-01 | This submission is the final filing | No |
2018-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2018-06-01 | Plan is a collectively bargained plan | No |
2018-06-01 | Plan funding arrangement – Insurance | Yes |
2018-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2018-06-01 | Plan benefit arrangement – Insurance | Yes |
2018-06-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2017: SESI HEALTH AND WELFARE BENEFIT PLAN 2017 form 5500 responses |
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2017-06-01 | Type of plan entity | Single employer plan |
2017-06-01 | Submission has been amended | No |
2017-06-01 | This submission is the final filing | No |
2017-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2017-06-01 | Plan is a collectively bargained plan | No |
2017-06-01 | Plan funding arrangement – Insurance | Yes |
2017-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2017-06-01 | Plan benefit arrangement – Insurance | Yes |
2017-06-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2016: SESI HEALTH AND WELFARE BENEFIT PLAN 2016 form 5500 responses |
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2016-06-01 | Type of plan entity | Single employer plan |
2016-06-01 | Submission has been amended | No |
2016-06-01 | This submission is the final filing | No |
2016-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2016-06-01 | Plan is a collectively bargained plan | No |
2016-06-01 | Plan funding arrangement – Insurance | Yes |
2016-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2016-06-01 | Plan benefit arrangement – Insurance | Yes |
2016-06-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2015: SESI HEALTH AND WELFARE BENEFIT PLAN 2015 form 5500 responses |
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2015-06-01 | Type of plan entity | Single employer plan |
2015-06-01 | Plan funding arrangement – Insurance | Yes |
2015-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2015-06-01 | Plan benefit arrangement – Insurance | Yes |
2015-06-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2014: SESI HEALTH AND WELFARE BENEFIT PLAN 2014 form 5500 responses |
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2014-06-01 | Type of plan entity | Single employer plan |
2014-06-01 | Plan funding arrangement – Insurance | Yes |
2014-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2014-06-01 | Plan benefit arrangement – Insurance | Yes |
2014-06-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2013: SESI HEALTH AND WELFARE BENEFIT PLAN 2013 form 5500 responses |
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2013-06-01 | Type of plan entity | Single employer plan |
2013-06-01 | Plan funding arrangement – Insurance | Yes |
2013-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2013-06-01 | Plan benefit arrangement – Insurance | Yes |
2013-06-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2012: SESI HEALTH AND WELFARE BENEFIT PLAN 2012 form 5500 responses |
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2012-06-01 | Type of plan entity | Single employer plan |
2012-06-01 | Plan funding arrangement – Insurance | Yes |
2012-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2012-06-01 | Plan benefit arrangement – Insurance | Yes |
2012-06-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2011: SESI HEALTH AND WELFARE BENEFIT PLAN 2011 form 5500 responses |
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2011-06-01 | Type of plan entity | Single employer plan |
2011-06-01 | Plan funding arrangement – Insurance | Yes |
2011-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2011-06-01 | Plan benefit arrangement – Insurance | Yes |
2011-06-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2009: SESI HEALTH AND WELFARE BENEFIT PLAN 2009 form 5500 responses |
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2009-06-01 | Type of plan entity | Single employer plan |
2009-06-01 | This submission is the final filing | No |
2009-06-01 | Plan funding arrangement – Insurance | Yes |
2009-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2009-06-01 | Plan benefit arrangement – Insurance | Yes |
2009-06-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | 12029-35 |
Policy instance | 1 |
Insurance contract or identification number | 12029-35 | Number of Individuals Covered | 1388 | Insurance policy start date | 2022-06-01 | Insurance policy end date | 2023-05-31 | Total amount of commissions paid to insurance broker | USD $3,473 | Total amount of fees paid to insurance company | USD $0 | 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 | 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 $0 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,473 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | COMMISSIONS | Insurance broker organization code? | 3 |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 000010259917 |
Policy instance | 2 |
Insurance contract or identification number | 000010259917 | Number of Individuals Covered | 569 | Insurance policy start date | 2022-06-01 | Insurance policy end date | 2023-05-31 | Total amount of commissions paid to insurance broker | USD $90,883 | Total amount of fees paid to insurance company | USD $6,196 | 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 | 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 $605,886 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $90,883 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | COMMISSIONS | Insurance broker organization code? | 3 |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 000010259917 |
Policy instance | 2 |
Insurance contract or identification number | 000010259917 | Number of Individuals Covered | 614 | Insurance policy start date | 2021-06-01 | Insurance policy end date | 2022-05-31 | Total amount of commissions paid to insurance broker | USD $125,177 | Total amount of fees paid to insurance company | USD $36,620 | 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 | 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 $834,516 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $125,177 | Amount paid for insurance broker fees | 33477 | Additional information about fees paid to insurance broker | COMMISSIONS AND FEES | Insurance broker organization code? | 3 |
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EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | 12029-35 |
Policy instance | 1 |
Insurance contract or identification number | 12029-35 | Number of Individuals Covered | 1576 | Insurance policy start date | 2021-06-01 | Insurance policy end date | 2022-05-31 | Total amount of commissions paid to insurance broker | USD $3,374 | Total amount of fees paid to insurance company | USD $0 | 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 | 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 $0 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,374 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | COMMISSIONS | Insurance broker organization code? | 3 |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 000010259917 |
Policy instance | 2 |
Insurance contract or identification number | 000010259917 | Number of Individuals Covered | 821 | Insurance policy start date | 2020-06-01 | Insurance policy end date | 2021-05-31 | Total amount of commissions paid to insurance broker | USD $137,075 | Total amount of fees paid to insurance company | USD $0 | 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 | 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 $913,836 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $137,075 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | COMMISSIONS | Insurance broker organization code? | 3 |
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EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | 12029-35 |
Policy instance | 1 |
Insurance contract or identification number | 12029-35 | Number of Individuals Covered | 2246 | Insurance policy start date | 2020-06-01 | Insurance policy end date | 2021-05-31 | Total amount of commissions paid to insurance broker | USD $4,951 | Total amount of fees paid to insurance company | USD $0 | 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 | 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 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,951 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | COMMISSIONS | Insurance broker organization code? | 3 |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 000010259917 |
Policy instance | 4 |
Insurance contract or identification number | 000010259917 | Number of Individuals Covered | 978 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-05-31 | Total amount of commissions paid to insurance broker | USD $53,965 | Total amount of fees paid to insurance company | USD $59,268 | 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 | 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 $359,769 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $53,965 | Amount paid for insurance broker fees | 59268 | Additional information about fees paid to insurance broker | COMMISSIONS AND FEES | Insurance broker organization code? | 3 |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 426808 |
Policy instance | 3 |
Insurance contract or identification number | 426808 | Number of Individuals Covered | 0 | Insurance policy start date | 2019-06-01 | Insurance policy end date | 2020-05-31 | Total amount of commissions paid to insurance broker | USD $11,154 | Total amount of fees paid to insurance company | USD $6,387 | 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 | No | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | 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 $190,553 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $11,154 | Amount paid for insurance broker fees | 6387 | Additional information about fees paid to insurance broker | COMMISSIONS AND FEES | Insurance broker organization code? | 3 |
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EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | 12029-35 |
Policy instance | 1 |
Insurance contract or identification number | 12029-35 | Number of Individuals Covered | 2470 | Insurance policy start date | 2019-06-01 | Insurance policy end date | 2020-05-31 | Total amount of commissions paid to insurance broker | USD $5,176 | Total amount of fees paid to insurance company | USD $0 | 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 | 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 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,176 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | COMMISSIONS | Insurance broker organization code? | 3 |
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HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 878341G |
Policy instance | 2 |
Insurance contract or identification number | 878341G | Number of Individuals Covered | 806 | Insurance policy start date | 2019-06-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $22,449 | Total amount of fees paid to insurance company | USD $0 | 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 | No | Long Term Disability Insurance Welfare Benefit | No | 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 $186,037 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $22,449 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | COMMISSIONS | Insurance broker organization code? | 3 |
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HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 878341G |
Policy instance | 2 |
Insurance contract or identification number | 878341G | Number of Individuals Covered | 997 | Insurance policy start date | 2018-06-01 | Insurance policy end date | 2019-05-31 | Total amount of commissions paid to insurance broker | USD $33,460 | Total amount of fees paid to insurance company | USD $1,618 | 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 | 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 $354,506 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $30,169 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | COMMISSIONS | Insurance broker organization code? | 3 |
|
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | 12029-35 |
Policy instance | 1 |
Insurance contract or identification number | 12029-35 | Number of Individuals Covered | 2518 | Insurance policy start date | 2018-06-01 | Insurance policy end date | 2019-05-31 | Total amount of commissions paid to insurance broker | USD $10,677 | Total amount of fees paid to insurance company | USD $0 | 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 | 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 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,442 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | COMMISSIONS | Insurance broker organization code? | 3 |
|
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 426808 |
Policy instance | 3 |
Insurance contract or identification number | 426808 | Number of Individuals Covered | 1010 | Insurance policy start date | 2018-08-01 | Insurance policy end date | 2019-05-31 | Total amount of commissions paid to insurance broker | USD $15,663 | Total amount of fees paid to insurance company | USD $15,663 | 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 | No | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | 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 $345,783 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $15,663 | Amount paid for insurance broker fees | 15663 | Additional information about fees paid to insurance broker | COMMISSIONS AND FEES | Insurance broker organization code? | 3 |
|
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 878341G |
Policy instance | 2 |
Insurance contract or identification number | 878341G | Number of Individuals Covered | 1294 | Insurance policy start date | 2017-06-01 | Insurance policy end date | 2018-05-31 | Total amount of commissions paid to insurance broker | USD $44,468 | Total amount of fees paid to insurance company | USD $0 | 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 | 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 $845,644 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $44,468 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | COMMISSIONS | Insurance broker organization code? | 3 | Insurance broker name | TOWN & COUNTRY INSURANCE AGENCY |
|
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | 12029-35 |
Policy instance | 1 |
Insurance contract or identification number | 12029-35 | Number of Individuals Covered | 2546 | Insurance policy start date | 2017-06-01 | Insurance policy end date | 2018-05-31 | Total amount of commissions paid to insurance broker | USD $4,842 | Total amount of fees paid to insurance company | USD $0 | 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 | 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 $0 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,842 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | COMMISSIONS | Insurance broker organization code? | 3 | Insurance broker name | WILLIAM F SPOTTS |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G0000AANL |
Policy instance | 6 |
Insurance contract or identification number | G0000AANL | Number of Individuals Covered | 314 | Insurance policy start date | 2015-06-01 | Insurance policy end date | 2016-05-31 | Total amount of commissions paid to insurance broker | USD $29,343 | Total amount of fees paid to insurance company | USD $12,410 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | LIFE AD&D - VOLUNTARY | Welfare Benefit Premiums Paid to Carrier | USD $195,619 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $29,343 | Amount paid for insurance broker fees | 12410 | Insurance broker organization code? | 3 | Insurance broker name | ANTHONY PATRICK, LLC |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G0000AANL |
Policy instance | 5 |
Insurance contract or identification number | G0000AANL | Number of Individuals Covered | 820 | Insurance policy start date | 2015-06-01 | Insurance policy end date | 2016-05-31 | Total amount of commissions paid to insurance broker | USD $22,669 | Total amount of fees paid to insurance company | USD $9,168 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $151,127 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $22,669 | Amount paid for insurance broker fees | 9168 | Insurance broker organization code? | 3 | Insurance broker name | ANTHONY PATRICK, LLC |
|
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G0000AANL |
Policy instance | 4 |
Insurance contract or identification number | G0000AANL | Number of Individuals Covered | 820 | Insurance policy start date | 2015-06-01 | Insurance policy end date | 2016-05-31 | Total amount of commissions paid to insurance broker | USD $27,491 | Total amount of fees paid to insurance company | USD $11,290 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $183,274 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $27,491 | Amount paid for insurance broker fees | 11290 | Insurance broker organization code? | 3 | Insurance broker name | ANTHONY PATRICK, LLC |
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EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | 12029-35 |
Policy instance | 1 |
Insurance contract or identification number | 12029-35 | Number of Individuals Covered | 2003 | Insurance policy start date | 2015-06-01 | Insurance policy end date | 2016-05-31 | Total amount of commissions paid to insurance broker | USD $4,147 | Total amount of fees paid to insurance company | USD $13,967 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $82,931 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,147 | Amount paid for insurance broker fees | 13967 | Insurance broker organization code? | 3 | Insurance broker name | BARBARA STARR |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00321591 |
Policy instance | 2 |
Insurance contract or identification number | 00321591 | Number of Individuals Covered | 830 | Insurance policy start date | 2015-06-01 | Insurance policy end date | 2016-05-31 | Total amount of commissions paid to insurance broker | USD $26,758 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $69,681 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $26,758 | Insurance broker organization code? | 3 | Insurance broker name | WILLIAM F. SPOTTS |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G0000AANL |
Policy instance | 3 |
Insurance contract or identification number | G0000AANL | Number of Individuals Covered | 820 | Insurance policy start date | 2015-06-01 | Insurance policy end date | 2016-05-31 | Total amount of commissions paid to insurance broker | USD $10,191 | Total amount of fees paid to insurance company | USD $4,244 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | LIFE AD&D | Welfare Benefit Premiums Paid to Carrier | USD $67,939 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $10,191 | Amount paid for insurance broker fees | 4244 | Insurance broker organization code? | 3 | Insurance broker name | ANTHONY PATRICK, LLC |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G0000AANL |
Policy instance | 6 |
Insurance contract or identification number | G0000AANL | Number of Individuals Covered | 309 | Insurance policy start date | 2014-06-01 | Insurance policy end date | 2015-05-31 | Total amount of commissions paid to insurance broker | USD $28,913 | Total amount of fees paid to insurance company | USD $8,898 | 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 | Other welfare benefits provided | LIFE AD&D - VOLUNTARY | Welfare Benefit Premiums Paid to Carrier | USD $192,751 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $28,913 | Amount paid for insurance broker fees | 8898 | Additional information about fees paid to insurance broker | ADMINISTRATIVE | Insurance broker organization code? | 3 | Insurance broker name | ANTHONY PATRICK, LLC |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G0000AANL |
Policy instance | 5 |
Insurance contract or identification number | G0000AANL | Number of Individuals Covered | 777 | Insurance policy start date | 2014-06-01 | Insurance policy end date | 2015-05-31 | Total amount of commissions paid to insurance broker | USD $20,354 | Total amount of fees paid to insurance company | USD $6,242 | 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 $135,692 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $20,354 | Amount paid for insurance broker fees | 6242 | Additional information about fees paid to insurance broker | ADMINISTRATIVE | Insurance broker organization code? | 3 | Insurance broker name | ANTHONY PATRICK, LLC |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G0000AANL |
Policy instance | 4 |
Insurance contract or identification number | G0000AANL | Number of Individuals Covered | 777 | Insurance policy start date | 2014-06-01 | Insurance policy end date | 2015-05-31 | Total amount of commissions paid to insurance broker | USD $25,195 | Total amount of fees paid to insurance company | USD $7,570 | 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 $167,966 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $25,195 | Amount paid for insurance broker fees | 7570 | Additional information about fees paid to insurance broker | ADMINISTRATIVE | Insurance broker organization code? | 3 | Insurance broker name | ANTHONY PATRICK, LLC |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G0000AANL |
Policy instance | 3 |
Insurance contract or identification number | G0000AANL | Number of Individuals Covered | 777 | Insurance policy start date | 2014-06-01 | Insurance policy end date | 2015-05-31 | Total amount of commissions paid to insurance broker | USD $9,622 | Total amount of fees paid to insurance company | USD $2,879 | 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 | Other welfare benefits provided | LIFE AD&D | Welfare Benefit Premiums Paid to Carrier | USD $64,146 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $9,622 | Amount paid for insurance broker fees | 2879 | Additional information about fees paid to insurance broker | ADMINISTRATIVE | Insurance broker organization code? | 3 | Insurance broker name | ANTHONY PATRICK, LLC |
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EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | 12029-35 |
Policy instance | 1 |
Insurance contract or identification number | 12029-35 | Number of Individuals Covered | 1894 | Insurance policy start date | 2014-06-01 | Insurance policy end date | 2015-05-31 | Total amount of commissions paid to insurance broker | USD $3,911 | Total amount of fees paid to insurance company | USD $12,428 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $78,226 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,911 | Amount paid for insurance broker fees | 12428 | Additional information about fees paid to insurance broker | ADMINISTRATIVE | Insurance broker organization code? | 3 | Insurance broker name | JOHN HOOPER |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00321591 |
Policy instance | 2 |
Insurance contract or identification number | 00321591 | Number of Individuals Covered | 776 | Insurance policy start date | 2014-06-01 | Insurance policy end date | 2015-05-31 | Total amount of commissions paid to insurance broker | USD $25,512 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $64,423 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $25,512 | Insurance broker organization code? | 3 | Insurance broker name | WILLIAM F. SPOTTS |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000AANL |
Policy instance | 3 |
Insurance contract or identification number | G000AANL | Number of Individuals Covered | 746 | Insurance policy start date | 2013-06-01 | Insurance policy end date | 2014-06-01 | Total amount of commissions paid to insurance broker | USD $24,972 | Total amount of fees paid to insurance company | USD $8,539 | 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 $166,481 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $24,972 | Amount paid for insurance broker fees | 8539 | Additional information about fees paid to insurance broker | ADMINISTRATIVE FEES | Insurance broker organization code? | 3 | Insurance broker name | ANTHONY PATRICK, LLC |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000AANL |
Policy instance | 4 |
Insurance contract or identification number | G000AANL | Number of Individuals Covered | 746 | Insurance policy start date | 2013-06-01 | Insurance policy end date | 2014-06-01 | Total amount of commissions paid to insurance broker | USD $20,617 | Total amount of fees paid to insurance company | USD $7,014 | 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 $137,445 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $20,617 | Amount paid for insurance broker fees | 7014 | Additional information about fees paid to insurance broker | ADMINISTRATIVE FEES | Insurance broker organization code? | 3 | Insurance broker name | ANTHONY PATRICK, LLC |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00321591 |
Policy instance | 5 |
Insurance contract or identification number | 00321591 | Number of Individuals Covered | 752 | Insurance policy start date | 2013-06-01 | Insurance policy end date | 2014-05-31 | Total amount of commissions paid to insurance broker | USD $24,727 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $62,442 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $24,727 | Insurance broker organization code? | 3 | Insurance broker name | WILLIAM F. SPOTTS |
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EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | 12029-35 |
Policy instance | 6 |
Insurance contract or identification number | 12029-35 | Number of Individuals Covered | 1851 | Insurance policy start date | 2013-06-01 | Insurance policy end date | 2014-05-31 | Total amount of commissions paid to insurance broker | USD $3,851 | Total amount of fees paid to insurance company | USD $12,322 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $77,014 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,851 | Amount paid for insurance broker fees | 12322 | Additional information about fees paid to insurance broker | ADMINISTRATIVE FEES | Insurance broker organization code? | 3 | Insurance broker name | WILLIAM F. SPOTTS |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000AANL |
Policy instance | 2 |
Insurance contract or identification number | G000AANL | Number of Individuals Covered | 296 | Insurance policy start date | 2013-06-01 | Insurance policy end date | 2014-06-01 | Total amount of commissions paid to insurance broker | USD $29,002 | Total amount of fees paid to insurance company | USD $9,764 | 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 | Other welfare benefits provided | LIFE & AD&D - VOLUNTARY | Welfare Benefit Premiums Paid to Carrier | USD $193,350 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $29,002 | Amount paid for insurance broker fees | 9764 | Additional information about fees paid to insurance broker | ADMINISTRATIVE FEES | Insurance broker organization code? | 3 | Insurance broker name | ANTHONY PATRICK, LLC |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000AANL |
Policy instance | 1 |
Insurance contract or identification number | G000AANL | Number of Individuals Covered | 751 | Insurance policy start date | 2013-06-01 | Insurance policy end date | 2014-06-01 | Total amount of commissions paid to insurance broker | USD $9,466 | Total amount of fees paid to insurance company | USD $3,272 | 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 | Other welfare benefits provided | LIFE & AD&D | Welfare Benefit Premiums Paid to Carrier | USD $63,106 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $9,466 | Amount paid for insurance broker fees | 3272 | Additional information about fees paid to insurance broker | ADMINISTRATIVE FEES | Insurance broker organization code? | 3 | Insurance broker name | ANTHONY PATRICK, LLC |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000AANL |
Policy instance | 1 |
Insurance contract or identification number | G000AANL | Number of Individuals Covered | 757 | Insurance policy start date | 2012-06-01 | Insurance policy end date | 2013-06-01 | Total amount of commissions paid to insurance broker | USD $10,397 | Total amount of fees paid to insurance company | USD $3,334 | 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 | Other welfare benefits provided | LIFE & AD&D | Welfare Benefit Premiums Paid to Carrier | USD $69,313 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $10,397 | Amount paid for insurance broker fees | 3334 | Additional information about fees paid to insurance broker | ADMINISTRATIVE FEES | Insurance broker organization code? | 3 | Insurance broker name | ANTHONY PATRICK, LLC |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000AANL |
Policy instance | 2 |
Insurance contract or identification number | G000AANL | Number of Individuals Covered | 296 | Insurance policy start date | 2012-06-01 | Insurance policy end date | 2013-06-01 | Total amount of commissions paid to insurance broker | USD $30,047 | Total amount of fees paid to insurance company | USD $8,537 | 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 | Other welfare benefits provided | LIFE - VOLUNTARY | Welfare Benefit Premiums Paid to Carrier | USD $200,317 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $30,047 | Amount paid for insurance broker fees | 8537 | Insurance broker organization code? | 3 | Insurance broker name | ANTHONY PATRICK, LLC |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000AANL |
Policy instance | 3 |
Insurance contract or identification number | G000AANL | Number of Individuals Covered | 753 | Insurance policy start date | 2012-06-01 | Insurance policy end date | 2013-06-01 | Total amount of commissions paid to insurance broker | USD $26,351 | Total amount of fees paid to insurance company | USD $8,270 | 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 $175,670 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $26,351 | Amount paid for insurance broker fees | 8270 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | ANTHONY PATRICK, LLC |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000AANL |
Policy instance | 4 |
Insurance contract or identification number | G000AANL | Number of Individuals Covered | 753 | Insurance policy start date | 2012-06-01 | Insurance policy end date | 2013-06-01 | Total amount of commissions paid to insurance broker | USD $21,578 | Total amount of fees paid to insurance company | USD $6,784 | 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 $143,853 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $21,578 | Amount paid for insurance broker fees | 6784 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | ANTHONY PATRICK, LLC |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00321591 |
Policy instance | 5 |
Insurance contract or identification number | 00321591 | Number of Individuals Covered | 774 | Insurance policy start date | 2012-06-01 | Insurance policy end date | 2013-05-31 | Total amount of commissions paid to insurance broker | USD $24,931 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $62,958 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $24,931 | Insurance broker name | WILLIAM F. SPOTTS |
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EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | 12029-35 |
Policy instance | 6 |
Insurance contract or identification number | 12029-35 | Number of Individuals Covered | 1832 | Insurance policy start date | 2012-06-01 | Insurance policy end date | 2013-05-31 | Total amount of commissions paid to insurance broker | USD $4,249 | Total amount of fees paid to insurance company | USD $13,596 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $84,973 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,249 | Amount paid for insurance broker fees | 13596 | Additional information about fees paid to insurance broker | ADMINISTRATIVE FEES | Insurance broker organization code? | 3 | Insurance broker name | WILLIAM F. SPOTTS |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000AANL |
Policy instance | 5 |
Insurance contract or identification number | G000AANL | Number of Individuals Covered | 850 | Insurance policy start date | 2011-06-01 | Insurance policy end date | 2012-06-01 | Total amount of commissions paid to insurance broker | USD $25,759 | 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 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $131,509 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 ) |
Policy contract number | 12277418 |
Policy instance | 1 |
Insurance contract or identification number | 12277418 | Number of Individuals Covered | 850 | Insurance policy start date | 2011-06-01 | Insurance policy end date | 2012-05-31 | Total amount of commissions paid to insurance broker | USD $2,616 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $96,766 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000AANL |
Policy instance | 2 |
Insurance contract or identification number | G000AANL | Number of Individuals Covered | 852 | Insurance policy start date | 2011-06-01 | Insurance policy end date | 2012-06-01 | Total amount of commissions paid to insurance broker | USD $12,724 | 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 | Other welfare benefits provided | LIFE & AD&D | Welfare Benefit Premiums Paid to Carrier | USD $64,921 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000AANL |
Policy instance | 3 |
Insurance contract or identification number | G000AANL | Number of Individuals Covered | 273 | Insurance policy start date | 2011-06-01 | Insurance policy end date | 2012-06-01 | Total amount of commissions paid to insurance broker | USD $28,357 | 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 | Other welfare benefits provided | LIFE & AD&D - VOLUNTARY | Welfare Benefit Premiums Paid to Carrier | USD $145,358 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNIMERICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 91529 ) |
Policy contract number | UNI-201376 |
Policy instance | 7 |
Insurance contract or identification number | UNI-201376 | Number of Individuals Covered | 642 | Insurance policy start date | 2011-06-01 | Insurance policy end date | 2012-05-31 | Total amount of commissions paid to insurance broker | USD $79,194 | 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 | Welfare Benefit Premiums Paid to Carrier | USD $415,844 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000AANL |
Policy instance | 4 |
Insurance contract or identification number | G000AANL | Number of Individuals Covered | 850 | Insurance policy start date | 2011-06-01 | Insurance policy end date | 2012-06-01 | Total amount of commissions paid to insurance broker | USD $31,374 | 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 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $160,248 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00321591 |
Policy instance | 6 |
Insurance contract or identification number | 00321591 | Number of Individuals Covered | 860 | Insurance policy start date | 2011-06-01 | Insurance policy end date | 2012-05-31 | Total amount of commissions paid to insurance broker | USD $27,752 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $67,147 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 ) |
Policy contract number | 12277418 |
Policy instance | 1 |
Insurance contract or identification number | 12277418 | Number of Individuals Covered | 666 | Insurance policy start date | 2010-06-01 | Insurance policy end date | 2010-05-31 | Total amount of commissions paid to insurance broker | USD $2,402 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $80,761 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000AANL |
Policy instance | 2 |
Insurance contract or identification number | G000AANL | Number of Individuals Covered | 663 | Insurance policy start date | 2010-06-01 | Insurance policy end date | 2011-06-01 | Total amount of commissions paid to insurance broker | USD $8,160 | 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 | Other welfare benefits provided | LIFE & AD&D | Welfare Benefit Premiums Paid to Carrier | USD $54,398 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000AANL |
Policy instance | 3 |
Insurance contract or identification number | G000AANL | Number of Individuals Covered | 223 | Insurance policy start date | 2010-06-01 | Insurance policy end date | 2011-06-01 | Total amount of commissions paid to insurance broker | USD $17,187 | 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 | Other welfare benefits provided | LIFE & AD&D - VOLUNTARY | Welfare Benefit Premiums Paid to Carrier | USD $114,580 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNIMERICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 91529 ) |
Policy contract number | UNI-201129 |
Policy instance | 7 |
Insurance contract or identification number | UNI-201129 | Number of Individuals Covered | 491 | Insurance policy start date | 2010-06-01 | Insurance policy end date | 2011-05-31 | Total amount of commissions paid to insurance broker | USD $72,741 | 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 | Welfare Benefit Premiums Paid to Carrier | USD $388,482 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00321591 |
Policy instance | 6 |
Insurance contract or identification number | 00321591 | Number of Individuals Covered | 666 | Insurance policy start date | 2010-06-01 | Insurance policy end date | 2011-05-31 | Total amount of commissions paid to insurance broker | USD $21,056 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $50,737 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000AANL |
Policy instance | 5 |
Insurance contract or identification number | G000AANL | Number of Individuals Covered | 666 | Insurance policy start date | 2010-06-01 | Insurance policy end date | 2011-06-01 | Total amount of commissions paid to insurance broker | USD $15,953 | 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 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $106,355 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000AANL |
Policy instance | 4 |
Insurance contract or identification number | G000AANL | Number of Individuals Covered | 663 | Insurance policy start date | 2010-06-01 | Insurance policy end date | 2011-06-01 | Total amount of commissions paid to insurance broker | USD $19,409 | 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 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $129,391 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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