LENOIR-RHYNE UNIVERSITY has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan THE LENOIR-RHYNE UNIVERSITY MASTER WELFARE BENEFIT PLAN
401k plan membership statisitcs for THE LENOIR-RHYNE UNIVERSITY MASTER WELFARE BENEFIT PLAN
Measure | Date | Value |
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2022: THE LENOIR-RHYNE UNIVERSITY MASTER WELFARE BENEFIT PLAN 2022 401k membership |
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Total participants, beginning-of-year | 2022-06-01 | 303 |
Total number of active participants reported on line 7a of the Form 5500 | 2022-06-01 | 311 |
Number of retired or separated participants receiving benefits | 2022-06-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2022-06-01 | 0 |
Total of all active and inactive participants | 2022-06-01 | 311 |
Number of employers contributing to the scheme | 2022-06-01 | 0 |
2021: THE LENOIR-RHYNE UNIVERSITY MASTER WELFARE BENEFIT PLAN 2021 401k membership |
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Total participants, beginning-of-year | 2021-06-01 | 318 |
Total number of active participants reported on line 7a of the Form 5500 | 2021-06-01 | 303 |
Number of retired or separated participants receiving benefits | 2021-06-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2021-06-01 | 0 |
Total of all active and inactive participants | 2021-06-01 | 303 |
Number of employers contributing to the scheme | 2021-06-01 | 0 |
2020: THE LENOIR-RHYNE UNIVERSITY MASTER WELFARE BENEFIT PLAN 2020 401k membership |
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Total participants, beginning-of-year | 2020-06-01 | 318 |
Total number of active participants reported on line 7a of the Form 5500 | 2020-06-01 | 318 |
Number of retired or separated participants receiving benefits | 2020-06-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2020-06-01 | 0 |
Total of all active and inactive participants | 2020-06-01 | 318 |
Number of employers contributing to the scheme | 2020-06-01 | 0 |
2019: THE LENOIR-RHYNE UNIVERSITY MASTER WELFARE BENEFIT PLAN 2019 401k membership |
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Total participants, beginning-of-year | 2019-06-01 | 315 |
Total number of active participants reported on line 7a of the Form 5500 | 2019-06-01 | 318 |
Number of retired or separated participants receiving benefits | 2019-06-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2019-06-01 | 0 |
Total of all active and inactive participants | 2019-06-01 | 318 |
Number of employers contributing to the scheme | 2019-06-01 | 0 |
2018: THE LENOIR-RHYNE UNIVERSITY MASTER WELFARE BENEFIT PLAN 2018 401k membership |
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Total participants, beginning-of-year | 2018-06-01 | 302 |
Total number of active participants reported on line 7a of the Form 5500 | 2018-06-01 | 315 |
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 | 315 |
Number of employers contributing to the scheme | 2018-06-01 | 0 |
2017: THE LENOIR-RHYNE UNIVERSITY MASTER WELFARE BENEFIT PLAN 2017 401k membership |
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Total participants, beginning-of-year | 2017-06-01 | 304 |
Total number of active participants reported on line 7a of the Form 5500 | 2017-06-01 | 302 |
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 | 302 |
2016: THE LENOIR-RHYNE UNIVERSITY MASTER WELFARE BENEFIT PLAN 2016 401k membership |
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Total participants, beginning-of-year | 2016-06-01 | 278 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-06-01 | 304 |
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 | 304 |
2015: THE LENOIR-RHYNE UNIVERSITY MASTER WELFARE BENEFIT PLAN 2015 401k membership |
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Total participants, beginning-of-year | 2015-06-01 | 268 |
Total number of active participants reported on line 7a of the Form 5500 | 2015-06-01 | 278 |
Number of retired or separated participants receiving benefits | 2015-06-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2015-06-01 | 0 |
Total of all active and inactive participants | 2015-06-01 | 278 |
2014: THE LENOIR-RHYNE UNIVERSITY MASTER WELFARE BENEFIT PLAN 2014 401k membership |
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Total participants, beginning-of-year | 2014-06-01 | 209 |
Total number of active participants reported on line 7a of the Form 5500 | 2014-06-01 | 268 |
Number of retired or separated participants receiving benefits | 2014-06-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2014-06-01 | 0 |
Total of all active and inactive participants | 2014-06-01 | 268 |
2013: THE LENOIR-RHYNE UNIVERSITY MASTER WELFARE BENEFIT PLAN 2013 401k membership |
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Total participants, beginning-of-year | 2013-06-01 | 225 |
Total number of active participants reported on line 7a of the Form 5500 | 2013-06-01 | 209 |
Number of retired or separated participants receiving benefits | 2013-06-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2013-06-01 | 0 |
Total of all active and inactive participants | 2013-06-01 | 209 |
2012: THE LENOIR-RHYNE UNIVERSITY MASTER WELFARE BENEFIT PLAN 2012 401k membership |
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Total participants, beginning-of-year | 2012-06-01 | 208 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-06-01 | 225 |
Number of retired or separated participants receiving benefits | 2012-06-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2012-06-01 | 0 |
Total of all active and inactive participants | 2012-06-01 | 225 |
2011: THE LENOIR-RHYNE UNIVERSITY MASTER WELFARE BENEFIT PLAN 2011 401k membership |
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Total participants, beginning-of-year | 2011-06-01 | 208 |
Total number of active participants reported on line 7a of the Form 5500 | 2011-06-01 | 208 |
Number of retired or separated participants receiving benefits | 2011-06-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2011-06-01 | 0 |
Total of all active and inactive participants | 2011-06-01 | 208 |
2009: THE LENOIR-RHYNE UNIVERSITY MASTER WELFARE BENEFIT PLAN 2009 401k membership |
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Total participants, beginning-of-year | 2009-06-01 | 218 |
Total number of active participants reported on line 7a of the Form 5500 | 2009-06-01 | 205 |
Number of retired or separated participants receiving benefits | 2009-06-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2009-06-01 | 0 |
Total of all active and inactive participants | 2009-06-01 | 205 |
2022: THE LENOIR-RHYNE UNIVERSITY MASTER WELFARE BENEFIT PLAN 2022 form 5500 responses |
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2022-06-01 | Type of plan entity | Single employer plan |
2022-06-01 | Plan funding arrangement – Insurance | Yes |
2022-06-01 | Plan benefit arrangement – Insurance | Yes |
2021: THE LENOIR-RHYNE UNIVERSITY MASTER WELFARE BENEFIT PLAN 2021 form 5500 responses |
---|
2021-06-01 | Type of plan entity | Single employer plan |
2021-06-01 | Plan funding arrangement – Insurance | Yes |
2021-06-01 | Plan benefit arrangement – Insurance | Yes |
2020: THE LENOIR-RHYNE UNIVERSITY MASTER WELFARE BENEFIT PLAN 2020 form 5500 responses |
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2020-06-01 | Type of plan entity | Single employer plan |
2020-06-01 | Plan funding arrangement – Insurance | Yes |
2020-06-01 | Plan benefit arrangement – Insurance | Yes |
2019: THE LENOIR-RHYNE UNIVERSITY MASTER WELFARE BENEFIT PLAN 2019 form 5500 responses |
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2019-06-01 | Type of plan entity | Single employer plan |
2019-06-01 | Plan funding arrangement – Insurance | Yes |
2019-06-01 | Plan benefit arrangement – Insurance | Yes |
2018: THE LENOIR-RHYNE UNIVERSITY MASTER WELFARE BENEFIT PLAN 2018 form 5500 responses |
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2018-06-01 | Type of plan entity | Single employer plan |
2018-06-01 | Plan funding arrangement – Insurance | Yes |
2018-06-01 | Plan benefit arrangement – Insurance | Yes |
2017: THE LENOIR-RHYNE UNIVERSITY MASTER WELFARE BENEFIT PLAN 2017 form 5500 responses |
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2017-06-01 | Type of plan entity | Single employer plan |
2017-06-01 | Plan funding arrangement – Insurance | Yes |
2017-06-01 | Plan benefit arrangement – Insurance | Yes |
2016: THE LENOIR-RHYNE UNIVERSITY MASTER 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 benefit arrangement – Insurance | Yes |
2015: THE LENOIR-RHYNE UNIVERSITY MASTER WELFARE BENEFIT PLAN 2015 form 5500 responses |
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2015-06-01 | Type of plan entity | Single employer plan |
2015-06-01 | Submission has been amended | No |
2015-06-01 | This submission is the final filing | No |
2015-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2015-06-01 | Plan is a collectively bargained plan | No |
2015-06-01 | Plan funding arrangement – Insurance | Yes |
2015-06-01 | Plan benefit arrangement – Insurance | Yes |
2014: THE LENOIR-RHYNE UNIVERSITY MASTER WELFARE BENEFIT PLAN 2014 form 5500 responses |
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2014-06-01 | Type of plan entity | Single employer plan |
2014-06-01 | Submission has been amended | No |
2014-06-01 | This submission is the final filing | No |
2014-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2014-06-01 | Plan is a collectively bargained plan | No |
2014-06-01 | Plan funding arrangement – Insurance | Yes |
2014-06-01 | Plan benefit arrangement – Insurance | Yes |
2013: THE LENOIR-RHYNE UNIVERSITY MASTER WELFARE BENEFIT PLAN 2013 form 5500 responses |
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2013-06-01 | Type of plan entity | Single employer plan |
2013-06-01 | Submission has been amended | No |
2013-06-01 | This submission is the final filing | No |
2013-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2013-06-01 | Plan is a collectively bargained plan | No |
2013-06-01 | Plan funding arrangement – Insurance | Yes |
2013-06-01 | Plan benefit arrangement – Insurance | Yes |
2012: THE LENOIR-RHYNE UNIVERSITY MASTER WELFARE BENEFIT PLAN 2012 form 5500 responses |
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2012-06-01 | Type of plan entity | Single employer plan |
2012-06-01 | Submission has been amended | No |
2012-06-01 | This submission is the final filing | No |
2012-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2012-06-01 | Plan is a collectively bargained plan | No |
2012-06-01 | Plan funding arrangement – Insurance | Yes |
2012-06-01 | Plan benefit arrangement – Insurance | Yes |
2011: THE LENOIR-RHYNE UNIVERSITY MASTER WELFARE BENEFIT PLAN 2011 form 5500 responses |
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2011-06-01 | Type of plan entity | Single employer plan |
2011-06-01 | Submission has been amended | No |
2011-06-01 | This submission is the final filing | No |
2011-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2011-06-01 | Plan is a collectively bargained plan | No |
2011-06-01 | Plan funding arrangement – Insurance | Yes |
2011-06-01 | Plan benefit arrangement – Insurance | Yes |
2009: THE LENOIR-RHYNE UNIVERSITY MASTER WELFARE BENEFIT PLAN 2009 form 5500 responses |
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2009-06-01 | Type of plan entity | Single employer plan |
2009-06-01 | Submission has been amended | No |
2009-06-01 | This submission is the final filing | No |
2009-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2009-06-01 | Plan is a collectively bargained plan | 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 |
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 163097 |
Policy instance | 3 |
Insurance contract or identification number | 163097 | Number of Individuals Covered | 311 | Insurance policy start date | 2022-03-01 | Insurance policy end date | 2023-02-28 | Total amount of commissions paid to insurance broker | USD $15,107 | Total amount of fees paid to insurance company | USD $1,101 | 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 | Yes | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $15,107 | Amount paid for insurance broker fees | 1101 | Additional information about fees paid to insurance broker | CONTINGENT COMPENSATION | Insurance broker organization code? | 3 |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 5936698 |
Policy instance | 1 |
Insurance contract or identification number | 5936698 | Number of Individuals Covered | 679 | Insurance policy start date | 2022-06-01 | Insurance policy end date | 2023-05-31 | Total amount of commissions paid to insurance broker | USD $18,020 | Total amount of fees paid to insurance company | USD $4,196 | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $280,159 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $18,020 | Amount paid for insurance broker fees | 4196 | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | Insurance broker organization code? | 3 |
|
BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 ) |
Policy contract number | 14161700-1001 |
Policy instance | 2 |
Insurance contract or identification number | 14161700-1001 | Number of Individuals Covered | 475 | Insurance policy start date | 2022-06-01 | Insurance policy end date | 2023-05-31 | Total amount of commissions paid to insurance broker | USD $86,750 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $3,194,712 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $86,750 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 |
|
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 163097 |
Policy instance | 3 |
Insurance contract or identification number | 163097 | Number of Individuals Covered | 303 | Insurance policy start date | 2021-03-01 | Insurance policy end date | 2022-02-28 | Total amount of commissions paid to insurance broker | USD $14,596 | Total amount of fees paid to insurance company | USD $1,300 | 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 | Yes | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | 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 $14,596 | Amount paid for insurance broker fees | 1300 | Additional information about fees paid to insurance broker | CONTINGENT COMPENSATION | Insurance broker organization code? | 3 |
|
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 5936698 |
Policy instance | 1 |
Insurance contract or identification number | 5936698 | Number of Individuals Covered | 692 | Insurance policy start date | 2021-06-01 | Insurance policy end date | 2022-05-31 | Total amount of commissions paid to insurance broker | USD $18,023 | Total amount of fees paid to insurance company | USD $4,472 | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $280,833 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $18,023 | Amount paid for insurance broker fees | 4205 | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION, NON-MONETARY COMPENSATION | Insurance broker organization code? | 3 |
|
BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 ) |
Policy contract number | 14161700-1001 |
Policy instance | 2 |
Insurance contract or identification number | 14161700-1001 | Number of Individuals Covered | 491 | Insurance policy start date | 2021-06-01 | Insurance policy end date | 2022-05-31 | Total amount of commissions paid to insurance broker | USD $47,789 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $3,231,710 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $47,789 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 |
|
BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 ) |
Policy contract number | 14161700-1001 |
Policy instance | 2 |
Insurance contract or identification number | 14161700-1001 | Number of Individuals Covered | 501 | Insurance policy start date | 2020-06-01 | Insurance policy end date | 2021-05-31 | Total amount of commissions paid to insurance broker | USD $70,743 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $3,372,464 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $70,743 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 |
|
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 163097 |
Policy instance | 3 |
Insurance contract or identification number | 163097 | Number of Individuals Covered | 318 | Insurance policy start date | 2020-03-01 | Insurance policy end date | 2021-02-28 | Total amount of commissions paid to insurance broker | USD $12,216 | Total amount of fees paid to insurance company | USD $1,208 | 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 | Yes | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | 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 $12,216 | Amount paid for insurance broker fees | 1208 | Additional information about fees paid to insurance broker | CONTINGENT COMPENSATION | Insurance broker organization code? | 3 |
|
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 5936698 |
Policy instance | 1 |
Insurance contract or identification number | 5936698 | Number of Individuals Covered | 723 | Insurance policy start date | 2020-06-01 | Insurance policy end date | 2021-05-31 | Total amount of commissions paid to insurance broker | USD $17,147 | Total amount of fees paid to insurance company | USD $3,008 | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $259,170 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $17,147 | Amount paid for insurance broker fees | 1418 | Additional information about fees paid to insurance broker | NON-MONETARY COMPENSATION ADDITIONAL COMPENSATION SUPPLEMENTAL COMPENSATION | Insurance broker organization code? | 3 |
|
BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 ) |
Policy contract number | 082856 |
Policy instance | 2 |
Insurance contract or identification number | 082856 | Number of Individuals Covered | 527 | Insurance policy start date | 2019-06-01 | Insurance policy end date | 2020-05-31 | Total amount of commissions paid to insurance broker | USD $75,628 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $3,042,247 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $75,628 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 |
|
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 5936698 |
Policy instance | 1 |
Insurance contract or identification number | 5936698 | Number of Individuals Covered | 762 | Insurance policy start date | 2019-06-01 | Insurance policy end date | 2020-05-31 | Total amount of commissions paid to insurance broker | USD $17,369 | Total amount of fees paid to insurance company | USD $4,050 | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $270,346 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $11,278 | Amount paid for insurance broker fees | 41 | Additional information about fees paid to insurance broker | NON-MONETARY COMPENSATION | Insurance broker organization code? | 3 |
|
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 163097 |
Policy instance | 3 |
Insurance contract or identification number | 163097 | Number of Individuals Covered | 318 | Insurance policy start date | 2019-03-01 | Insurance policy end date | 2020-02-29 | Total amount of commissions paid to insurance broker | USD $13,338 | Total amount of fees paid to insurance company | USD $0 | 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 | Yes | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $13,338 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 |
|
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | 5936698 |
Policy instance | 1 |
Insurance contract or identification number | 5936698 | Number of Individuals Covered | 734 | Insurance policy start date | 2018-06-01 | Insurance policy end date | 2019-05-31 | Total amount of commissions paid to insurance broker | USD $14,210 | Total amount of fees paid to insurance company | USD $2,917 | Dental Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $230,627 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $14,210 | Amount paid for insurance broker fees | 2917 | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION NON-MONETARY COMPENSATION | Insurance broker organization code? | 3 |
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 911310 |
Policy instance | 2 |
Insurance contract or identification number | 911310 | Number of Individuals Covered | 527 | Insurance policy start date | 2018-06-01 | Insurance policy end date | 2019-05-31 | Total amount of commissions paid to insurance broker | USD $2,567 | Total amount of fees paid to insurance company | USD $76,232 | Health Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $3,003,475 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,701 | Amount paid for insurance broker fees | 50358 | Additional information about fees paid to insurance broker | SERVICE FEE AGREEMENT | Insurance broker organization code? | 3 |
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STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 163097 |
Policy instance | 3 |
Insurance contract or identification number | 163097 | Number of Individuals Covered | 315 | Insurance policy start date | 2018-06-01 | Insurance policy end date | 2019-02-28 | Total amount of commissions paid to insurance broker | USD $9,625 | Total amount of fees paid to insurance company | USD $0 | 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 | Yes | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | 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 $9,625 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 |
|
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 163097 |
Policy instance | 3 |
Insurance contract or identification number | 163097 | Number of Individuals Covered | 302 | Insurance policy start date | 2017-06-01 | Insurance policy end date | 2018-05-31 | Total amount of commissions paid to insurance broker | USD $20,496 | Total amount of fees paid to insurance company | USD $0 | 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 | Yes | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | 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 $20,496 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Insurance broker name | EDUCATIONAL & INSTITUTIONAL INS ADM |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | TM05936698 |
Policy instance | 1 |
Insurance contract or identification number | TM05936698 | Number of Individuals Covered | 659 | Insurance policy start date | 2017-06-01 | Insurance policy end date | 2018-05-31 | Total amount of commissions paid to insurance broker | USD $12,191 | Total amount of fees paid to insurance company | USD $3,630 | Dental Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $201,510 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $12,191 | Amount paid for insurance broker fees | 3630 | Additional information about fees paid to insurance broker | SUPPLEMENTAL NON-MONETARY COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | USI INSURANCE SERVICES, LLC |
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 911310 |
Policy instance | 2 |
Insurance contract or identification number | 911310 | Number of Individuals Covered | 511 | Insurance policy start date | 2017-06-01 | Insurance policy end date | 2018-05-31 | Total amount of commissions paid to insurance broker | USD $2,486 | Total amount of fees paid to insurance company | USD $69,790 | Health Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,751,024 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,486 | Amount paid for insurance broker fees | 69790 | Additional information about fees paid to insurance broker | SERVICE FEE AGREEMENT | Insurance broker organization code? | 3 | Insurance broker name | USI INSURANCE SERVICES, LL |
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BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 ) |
Policy contract number | 74331 |
Policy instance | 1 |
Insurance contract or identification number | 74331 | Number of Individuals Covered | 455 | Insurance policy start date | 2015-06-01 | Insurance policy end date | 2016-05-31 | Total amount of commissions paid to insurance broker | USD $49,407 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | No | 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 | 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 $2,223,770 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $49,407 | Insurance broker organization code? | 3 | Insurance broker name | DAVID D. SIMAS |
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PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
Policy contract number | 1041154 |
Policy instance | 4 |
Insurance contract or identification number | 1041154 | Number of Individuals Covered | 278 | Insurance policy start date | 2015-06-01 | Insurance policy end date | 2016-05-31 | Total amount of commissions paid to insurance broker | USD $11,460 | Total amount of fees paid to insurance company | USD $606 | Are there contracts with allocated funds for individual policies? | No | 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 | Yes | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | 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 $88,700 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $11,460 | Amount paid for insurance broker fees | 606 | Additional information about fees paid to insurance broker | BONUS | Insurance broker organization code? | 3 | Insurance broker name | EDUCATIONAL AND INSTITUTIONAL INS. |
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COMMUNITY EYE CARE (National Association of Insurance Commissioners NAIC id number: 52429 ) |
Policy contract number | TP035012 |
Policy instance | 3 |
Insurance contract or identification number | TP035012 | Number of Individuals Covered | 301 | Insurance policy start date | 2015-06-01 | Insurance policy end date | 2016-05-31 | Total amount of commissions paid to insurance broker | USD $2,127 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | No | 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 $21,268 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,127 | Insurance broker organization code? | 3 | Insurance broker name | WELLS FARGO INSURANCE |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 487305 |
Policy instance | 2 |
Insurance contract or identification number | 487305 | Number of Individuals Covered | 226 | Insurance policy start date | 2015-06-01 | Insurance policy end date | 2016-05-31 | Total amount of commissions paid to insurance broker | USD $5,337 | Total amount of fees paid to insurance company | USD $5,564 | Are there contracts with allocated funds for individual policies? | No | 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 | 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 $177,898 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,887 | Amount paid for insurance broker fees | 5564 | Additional information about fees paid to insurance broker | FEES | Insurance broker organization code? | 3 | Insurance broker name | WELLS FARGO INSURANCE |
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PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
Policy contract number | 1041154 |
Policy instance | 4 |
Insurance contract or identification number | 1041154 | Number of Individuals Covered | 268 | Insurance policy start date | 2014-06-01 | Insurance policy end date | 2015-05-31 | Total amount of commissions paid to insurance broker | USD $10,649 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | No | 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 | Yes | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | 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 $82,475 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $10,649 | Insurance broker organization code? | 3 | Insurance broker name | EDUCATIONAL AND INSTITUTIONAL INS. |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 487305 |
Policy instance | 2 |
Insurance contract or identification number | 487305 | Number of Individuals Covered | 216 | Insurance policy start date | 2014-06-01 | Insurance policy end date | 2015-05-31 | Total amount of commissions paid to insurance broker | USD $4,560 | Total amount of fees paid to insurance company | USD $4,331 | Are there contracts with allocated funds for individual policies? | No | 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 | 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 $151,993 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,560 | Amount paid for insurance broker fees | 4331 | Additional information about fees paid to insurance broker | FEES | Insurance broker organization code? | 3 | Insurance broker name | WELLS FARGO INSURANCE SERVICES |
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BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 ) |
Policy contract number | 74331 |
Policy instance | 1 |
Insurance contract or identification number | 74331 | Number of Individuals Covered | 382 | Insurance policy start date | 2014-06-01 | Insurance policy end date | 2015-05-31 | Total amount of commissions paid to insurance broker | USD $43,222 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | No | 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 | 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 $1,934,830 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $43,222 | Insurance broker organization code? | 3 | Insurance broker name | WELLS FARGO INSURANCE SERVICES |
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COMMUNITY EYE CARE (National Association of Insurance Commissioners NAIC id number: 52429 ) |
Policy contract number | TP035012 |
Policy instance | 3 |
Insurance contract or identification number | TP035012 | Number of Individuals Covered | 252 | Insurance policy start date | 2014-06-01 | Insurance policy end date | 2015-05-31 | Total amount of commissions paid to insurance broker | USD $1,835 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | No | 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 $18,347 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,835 | Insurance broker organization code? | 3 | Insurance broker name | WELLS FARGO INSURANCE SERVICES |
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HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 696910G |
Policy instance | 2 |
Insurance contract or identification number | 696910G | Number of Individuals Covered | 261 | Insurance policy start date | 2013-06-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $6,636 | Total amount of fees paid to insurance company | USD $1,859 | Are there contracts with allocated funds for individual policies? | No | 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 | Yes | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | 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 $51,296 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,636 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 1859 | Additional information about fees paid to insurance broker | BONUS | Insurance broker name | BB AND T INSURANCE SERVICES, INC. |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 487305 |
Policy instance | 3 |
Insurance contract or identification number | 487305 | Number of Individuals Covered | 213 | Insurance policy start date | 2013-06-01 | Insurance policy end date | 2014-05-31 | Total amount of commissions paid to insurance broker | USD $4,113 | Total amount of fees paid to insurance company | USD $1,617 | Are there contracts with allocated funds for individual policies? | No | 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 | 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 $137,092 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,113 | Amount paid for insurance broker fees | 1617 | Additional information about fees paid to insurance broker | FEES | Insurance broker organization code? | 3 | Insurance broker name | WELLS FARGO INSURANCE SERVICES |
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COMMUNITY EYE CARE (National Association of Insurance Commissioners NAIC id number: 52429 ) |
Policy contract number | TP035012 |
Policy instance | 4 |
Insurance contract or identification number | TP035012 | Number of Individuals Covered | 155 | Insurance policy start date | 2013-06-01 | Insurance policy end date | 2014-05-31 | Total amount of commissions paid to insurance broker | USD $1,075 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | No | 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 $10,746 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,075 | Insurance broker organization code? | 3 | Insurance broker name | WELLS FARGO INSURANCE SERVICES |
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PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
Policy contract number | 1041154 |
Policy instance | 5 |
Insurance contract or identification number | 1041154 | Number of Individuals Covered | 259 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-05-31 | Total amount of commissions paid to insurance broker | USD $4,173 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | No | 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 | Yes | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | 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 $32,309 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,173 | Insurance broker organization code? | 3 | Insurance broker name | EDUCATIONAL AND INSTITUTIONAL ADM |
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BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 ) |
Policy contract number | 74331 |
Policy instance | 1 |
Insurance contract or identification number | 74331 | Number of Individuals Covered | 367 | Insurance policy start date | 2013-06-01 | Insurance policy end date | 2014-05-31 | Total amount of commissions paid to insurance broker | USD $44,317 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | No | 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 | 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 $2,157,644 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $44,317 | Insurance broker organization code? | 3 | Insurance broker name | WELLS FARGO INSURANCE SERVICES |
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BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 ) |
Policy contract number | 74331 |
Policy instance | 1 |
Insurance contract or identification number | 74331 | Number of Individuals Covered | 404 | Insurance policy start date | 2012-06-01 | Insurance policy end date | 2013-05-31 | Total amount of commissions paid to insurance broker | USD $58,957 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | No | 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 $1,940,112 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $58,957 | Insurance broker organization code? | 3 | Insurance broker name | WELLS FARGO INSURANCE SERVICES |
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HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 696910G |
Policy instance | 2 |
Insurance contract or identification number | 696910G | Number of Individuals Covered | 264 | Insurance policy start date | 2012-06-01 | Insurance policy end date | 2013-05-31 | Total amount of commissions paid to insurance broker | USD $16,711 | Total amount of fees paid to insurance company | USD $1,776 | Are there contracts with allocated funds for individual policies? | No | 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 | Yes | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | 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 $95,003 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $12,285 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 1776 | Additional information about fees paid to insurance broker | BONUS | Insurance broker name | BB AND T INSURANCE SERVICES, INC. |
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HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 696910G |
Policy instance | 2 |
Insurance contract or identification number | 696910G | Number of Individuals Covered | 251 | Insurance policy start date | 2011-06-01 | Insurance policy end date | 2012-05-31 | Total amount of commissions paid to insurance broker | USD $10,317 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | No | 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 | Yes | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | 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 $79,778 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 ) |
Policy contract number | 74331 |
Policy instance | 1 |
Insurance contract or identification number | 74331 | Number of Individuals Covered | 366 | Insurance policy start date | 2011-06-01 | Insurance policy end date | 2012-05-31 | Total amount of commissions paid to insurance broker | USD $65,954 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | No | 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 $1,777,594 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 696910G |
Policy instance | 4 |
Insurance contract or identification number | 696910G | Number of Individuals Covered | 235 | Insurance policy start date | 2010-12-01 | Insurance policy end date | 2011-05-31 | Total amount of commissions paid to insurance broker | USD $4,223 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | No | 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 | Yes | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | 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 $32,691 | 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 | 335731 |
Policy instance | 3 |
Insurance contract or identification number | 335731 | Number of Individuals Covered | 220 | Insurance policy start date | 2010-06-01 | Insurance policy end date | 2010-11-30 | Total amount of commissions paid to insurance broker | USD $1,856 | Total amount of fees paid to insurance company | USD $466 | Are there contracts with allocated funds for individual policies? | No | 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 | No | 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 $10,879 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 ) |
Policy contract number | SA384143199601 |
Policy instance | 2 |
Insurance contract or identification number | SA384143199601 | Number of Individuals Covered | 10898 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | No | 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 | 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 $434,310 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 ) |
Policy contract number | 3307636 |
Policy instance | 1 |
Insurance contract or identification number | 3307636 | Number of Individuals Covered | 198 | Insurance policy start date | 2010-06-01 | Insurance policy end date | 2011-05-31 | Total amount of commissions paid to insurance broker | USD $54,423 | Total amount of fees paid to insurance company | USD $2,969 | Are there contracts with allocated funds for individual policies? | No | 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 $1,814,107 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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