BROOKS PIERCE MCLENDON HUMPHREY & LEONARD, LLP has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan BROOKS PIERCE MCLENDON HUMPHREY & LEONARD LLP CAFETERIA PLAN
401k plan membership statisitcs for BROOKS PIERCE MCLENDON HUMPHREY & LEONARD LLP CAFETERIA PLAN
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 ) |
Policy contract number | 010-057204 |
Policy instance | 4 |
Insurance contract or identification number | 010-057204 | Number of Individuals Covered | 139 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $12,141 | Total amount of fees paid to insurance company | USD $5,512 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $121,405 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $12,141 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 5512 |
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PACIFIC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67466 ) |
Policy contract number | M360010000 |
Policy instance | 3 |
Insurance contract or identification number | M360010000 | Number of Individuals Covered | 72 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $20,774 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $224,261 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $20,774 | Insurance broker organization code? | 3 |
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PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
Policy contract number | 60720 |
Policy instance | 2 |
Insurance contract or identification number | 60720 | Number of Individuals Covered | 182 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $50,076 | Total amount of fees paid to insurance company | USD $34 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | VOL LIFE VOL DEP LIFE | Welfare Benefit Premiums Paid to Carrier | USD $249,162 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $33,120 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 34 |
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VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 30042596 |
Policy instance | 1 |
Insurance contract or identification number | 30042596 | Number of Individuals Covered | 110 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $1,252 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $24,902 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,252 | Insurance broker organization code? | 3 |
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VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 30042596 |
Policy instance | 1 |
Insurance contract or identification number | 30042596 | Number of Individuals Covered | 96 | Insurance policy start date | 2020-10-01 | Insurance policy end date | 2021-09-30 | Total amount of commissions paid to insurance broker | USD $1,173 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $22,406 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,173 | Insurance broker organization code? | 3 |
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PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
Policy contract number | 60720 |
Policy instance | 2 |
Insurance contract or identification number | 60720 | Number of Individuals Covered | 161 | Insurance policy start date | 2020-10-01 | Insurance policy end date | 2021-09-30 | Total amount of commissions paid to insurance broker | USD $36,948 | Total amount of fees paid to insurance company | USD $32 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | VOL LIFE VOL DEP LIFE | Welfare Benefit Premiums Paid to Carrier | USD $224,985 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $29,979 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 32 |
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PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
Policy contract number | 1098004 |
Policy instance | 3 |
Insurance contract or identification number | 1098004 | Number of Individuals Covered | 295 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-09-30 | Total amount of commissions paid to insurance broker | USD $960 | Total amount of fees paid to insurance company | USD $1,968 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $95,691 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $960 | Amount paid for insurance broker fees | 1968 | Insurance broker organization code? | 3 |
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PACIFIC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67466 ) |
Policy contract number | M360010000 |
Policy instance | 4 |
Insurance contract or identification number | M360010000 | Number of Individuals Covered | 74 | Insurance policy start date | 2021-01-01 | Insurance policy end date | 2021-12-31 | Total amount of commissions paid to insurance broker | USD $18,621 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $200,756 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $18,621 | Insurance broker organization code? | 3 |
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PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
Policy contract number | 1098004 |
Policy instance | 3 |
Insurance contract or identification number | 1098004 | Number of Individuals Covered | 294 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $1,330 | Total amount of fees paid to insurance company | USD $342 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $127,729 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,330 | Amount paid for insurance broker fees | 342 | Additional information about fees paid to insurance broker | BONUS | Insurance broker organization code? | 3 |
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PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
Policy contract number | 60720 |
Policy instance | 2 |
Insurance contract or identification number | 60720 | Number of Individuals Covered | 162 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $39,860 | Total amount of fees paid to insurance company | USD $35 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | VOL LIFE VOL DEP LIFE | Welfare Benefit Premiums Paid to Carrier | USD $230,032 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $30,715 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 30 | Additional information about fees paid to insurance broker | THIRD PARTY ADMINISTRATION FEES |
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PACIFIC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67466 ) |
Policy contract number | M360010000 |
Policy instance | 4 |
Insurance contract or identification number | M360010000 | Number of Individuals Covered | 79 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $14,562 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $151,258 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $14,562 | 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 | 149174 0001 |
Policy instance | 5 |
Insurance contract or identification number | 149174 0001 | Number of Individuals Covered | 6 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2021-01-01 | Total amount of commissions paid to insurance broker | USD $1,836 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | GROUP LONG TERM CARE | Welfare Benefit Premiums Paid to Carrier | USD $12,242 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,836 | Insurance broker organization code? | 4 |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 149174 0800 |
Policy instance | 6 |
Insurance contract or identification number | 149174 0800 | Number of Individuals Covered | 6 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2021-01-01 | Total amount of commissions paid to insurance broker | USD $425 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | GROUP LONG TERM CARE | Welfare Benefit Premiums Paid to Carrier | USD $2,530 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $425 | Insurance broker organization code? | 4 |
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VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 30042596 |
Policy instance | 1 |
Insurance contract or identification number | 30042596 | Number of Individuals Covered | 88 | Insurance policy start date | 2020-01-01 | Insurance policy end date | 2020-12-31 | Total amount of commissions paid to insurance broker | USD $1,206 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $23,307 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,206 | Insurance broker organization code? | 3 |
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VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 30042596 |
Policy instance | 1 |
Insurance contract or identification number | 30042596 | Number of Individuals Covered | 96 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $655 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $23,163 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $655 | Insurance broker organization code? | 3 |
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PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
Policy contract number | 1098004 |
Policy instance | 3 |
Insurance contract or identification number | 1098004 | Number of Individuals Covered | 306 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $1,372 | Total amount of fees paid to insurance company | USD $13,746 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $136,833 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,372 | Amount paid for insurance broker fees | 13746 | Insurance broker organization code? | 3 |
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PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
Policy contract number | 60720 |
Policy instance | 2 |
Insurance contract or identification number | 60720 | Number of Individuals Covered | 171 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $43,742 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | VOL LIFE VOL DEP LIFE | Welfare Benefit Premiums Paid to Carrier | USD $217,898 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 43682 | Insurance broker organization code? | 3 |
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PACIFIC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67466 ) |
Policy contract number | M360010000 |
Policy instance | 4 |
Insurance contract or identification number | M360010000 | Number of Individuals Covered | 80 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Total amount of commissions paid to insurance broker | USD $14,443 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $169,551 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $14,443 | Insurance broker organization code? | 3 |
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SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 245837 |
Policy instance | 6 |
Insurance contract or identification number | 245837 | Number of Individuals Covered | 170 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $9,591 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | VOL LIFE VOL DEP LIFE | Welfare Benefit Premiums Paid to Carrier | USD $64,091 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $9,591 | Insurance broker organization code? | 3 | Insurance broker name | MORGAN JAMES |
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AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 ) |
Policy contract number | 010-042387 |
Policy instance | 5 |
Insurance contract or identification number | 010-042387 | Number of Individuals Covered | 141 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $5,158 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $143,094 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,727 | Insurance broker organization code? | 3 | Insurance broker name | BB&T INSURANCE SERVICES INC |
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NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 ) |
Policy contract number | 658545 |
Policy instance | 2 |
Insurance contract or identification number | 658545 | Number of Individuals Covered | 100 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $2,746 | Total amount of fees paid to insurance company | USD $642 | Temporary Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,088 | Amount paid for insurance broker fees | 533 | Insurance broker organization code? | 3 | Insurance broker name | CAROLINA CONDREY GROUP |
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BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 ) |
Policy contract number | 009105 |
Policy instance | 3 |
Insurance contract or identification number | 009105 | Number of Individuals Covered | 276 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $39,000 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $39,000 | Insurance broker organization code? | 3 | Insurance broker name | BB&T INSURANCE SERVICES INC |
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NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 ) |
Policy contract number | 658545 |
Policy instance | 1 |
Insurance contract or identification number | 658545 | Number of Individuals Covered | 169 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $6,232 | Total amount of fees paid to insurance company | USD $1,458 | Long Term Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,742 | Amount paid for insurance broker fees | 1209 | Insurance broker organization code? | 3 | Insurance broker name | CAROLINA CONDREY GROUP |
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VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 30042596 |
Policy instance | 4 |
Insurance contract or identification number | 30042596 | Number of Individuals Covered | 101 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $1,171 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $21,362 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,171 | Insurance broker organization code? | 3 | Insurance broker name | BB&T INSURANCE SERVICES INC |
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SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 ) |
Policy contract number | 454-4257-00 |
Policy instance | 3 |
Insurance contract or identification number | 454-4257-00 | Number of Individuals Covered | 166 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2016-01-01 | Total amount of commissions paid to insurance broker | USD $8,398 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | VOL LIFE VOL DEP LIFE | Welfare Benefit Premiums Paid to Carrier | USD $60,797 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $8,398 | Insurance broker organization code? | 3 | Insurance broker name | JAMES M. MORGAN III |
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BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 ) |
Policy contract number | 009105 |
Policy instance | 4 |
Insurance contract or identification number | 009105 | Number of Individuals Covered | 267 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $39,000 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 39000 | Insurance broker organization code? | 3 | Insurance broker name | BB&T INSURANCE SERVICES INC |
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NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 ) |
Policy contract number | 658545 |
Policy instance | 2 |
Insurance contract or identification number | 658545 | Number of Individuals Covered | 166 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $2,333 | Total amount of fees paid to insurance company | USD $545 | Temporary Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,774 | Amount paid for insurance broker fees | 452 | Insurance broker organization code? | 3 | Insurance broker name | CAROLINA CONDREY GROUP |
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VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 30042596 |
Policy instance | 6 |
Insurance contract or identification number | 30042596 | Number of Individuals Covered | 85 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $1,070 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $18,513 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,070 | Insurance broker organization code? | 3 | Insurance broker name | BB&T INSURANCE SERVICES, INC. |
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AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 ) |
Policy contract number | 010-042387 |
Policy instance | 7 |
Insurance contract or identification number | 010-042387 | Number of Individuals Covered | 142 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $296 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $29,588 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $296 | Insurance broker organization code? | 3 | Insurance broker name | BB & T INSURANCE SERVICES |
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NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 ) |
Policy contract number | 658545 |
Policy instance | 1 |
Insurance contract or identification number | 658545 | Number of Individuals Covered | 166 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $6,065 | Total amount of fees paid to insurance company | USD $1,417 | Long Term Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,593 | Amount paid for insurance broker fees | 1171 | Insurance broker organization code? | 3 | Insurance broker name | CAROLINA CONDREY GROUP |
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UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 ) |
Policy contract number | 5468736 |
Policy instance | 5 |
Insurance contract or identification number | 5468736 | Number of Individuals Covered | 139 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $855 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $85,500 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $855 | Insurance broker organization code? | 3 | Insurance broker name | BB&T - PBM |
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VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 30042596 |
Policy instance | 7 |
Insurance contract or identification number | 30042596 | Number of Individuals Covered | 81 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $1,006 | 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 $16,574 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,006 | Insurance broker organization code? | 3 | Insurance broker name | BB&T INSURANCE SERVICES INC |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 149174 |
Policy instance | 6 |
Insurance contract or identification number | 149174 | Number of Individuals Covered | 69 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2015-01-01 | Total amount of commissions paid to insurance broker | USD $1,621 | 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 | Other welfare benefits provided | LONG-TERM CARE | Welfare Benefit Premiums Paid to Carrier | USD $10,825 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,621 | Insurance broker organization code? | 3 | Insurance broker name | THOMAS L DELEOT |
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UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 ) |
Policy contract number | 5468736 |
Policy instance | 5 |
Insurance contract or identification number | 5468736 | Number of Individuals Covered | 139 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $297 | Total amount of fees paid to insurance company | USD $190 | 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 $113,402 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $297 | Amount paid for insurance broker fees | 190 | Insurance broker organization code? | 3 | Insurance broker name | BB&T PBM |
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BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 ) |
Policy contract number | 009105 |
Policy instance | 4 |
Insurance contract or identification number | 009105 | Number of Individuals Covered | 285 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $39,750 | 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 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $39,750 | Insurance broker organization code? | 3 | Insurance broker name | BB&T INSURANCE SERVICES INC |
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SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 ) |
Policy contract number | 454-4257-00 |
Policy instance | 3 |
Insurance contract or identification number | 454-4257-00 | Number of Individuals Covered | 161 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2015-01-01 | Total amount of commissions paid to insurance broker | USD $7,629 | 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 | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $55,529 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,722 | Insurance broker organization code? | 3 | Insurance broker name | JAMES M. MORGAN III |
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NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 ) |
Policy contract number | 658545 |
Policy instance | 2 |
Insurance contract or identification number | 658545 | Number of Individuals Covered | 161 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $2,398 | Total amount of fees paid to insurance company | USD $466 | 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 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,823 | Amount paid for insurance broker fees | 379 | Insurance broker organization code? | 3 | Insurance broker name | CAROLINA CONDREY GROUP |
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NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 ) |
Policy contract number | 658545 |
Policy instance | 1 |
Insurance contract or identification number | 658545 | Number of Individuals Covered | 161 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $6,126 | Total amount of fees paid to insurance company | USD $1,191 | 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 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,660 | Amount paid for insurance broker fees | 969 | Insurance broker organization code? | 3 | Insurance broker name | CAROLINA CONDREY GROUP |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 149174 |
Policy instance | 7 |
Insurance contract or identification number | 149174 | Number of Individuals Covered | 66 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2014-01-01 | Total amount of commissions paid to insurance broker | USD $1,687 | 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 | Other welfare benefits provided | LONG-TERM CARE | Welfare Benefit Premiums Paid to Carrier | USD $10,422 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,687 | Insurance broker organization code? | 3 | Insurance broker name | THOMAS L DELEOT |
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NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 ) |
Policy contract number | 413A49 |
Policy instance | 5 |
Insurance contract or identification number | 413A49 | Number of Individuals Covered | 338 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-09-30 | Total amount of commissions paid to insurance broker | USD $0 | 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 $85,129 | 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 | 009105 |
Policy instance | 4 |
Insurance contract or identification number | 009105 | Number of Individuals Covered | 287 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $40,000 | 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 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $40,000 | Insurance broker organization code? | 3 | Insurance broker name | BB&T INSURANCE SERVICES INC |
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SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 ) |
Policy contract number | 454-4257-00 |
Policy instance | 3 |
Insurance contract or identification number | 454-4257-00 | Number of Individuals Covered | 165 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2014-01-01 | Total amount of commissions paid to insurance broker | USD $7,421 | 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 | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $54,429 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,566 | Insurance broker organization code? | 3 | Insurance broker name | JAMES M. MORGAN III |
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NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 ) |
Policy contract number | 658545 |
Policy instance | 1 |
Insurance contract or identification number | 658545 | Number of Individuals Covered | 164 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $6,151 | Total amount of fees paid to insurance company | USD $1,196 | 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 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,385 | Amount paid for insurance broker fees | 496 | Insurance broker organization code? | 3 | Insurance broker name | CAROLINA CONDREY GROUP |
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NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 ) |
Policy contract number | 658545 |
Policy instance | 2 |
Insurance contract or identification number | 658545 | Number of Individuals Covered | 164 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $2,526 | Total amount of fees paid to insurance company | USD $492 | 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 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,009 | Amount paid for insurance broker fees | 210 | Insurance broker organization code? | 3 | Insurance broker name | CAROLINA CONDREY GROUP |
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UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 ) |
Policy contract number | 5468736 |
Policy instance | 6 |
Insurance contract or identification number | 5468736 | Number of Individuals Covered | 143 | Insurance policy start date | 2013-10-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $52 | 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 $28,551 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 52 | Insurance broker organization code? | 3 | Insurance broker name | BB&T PBM |
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UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 149174 |
Policy instance | 7 |
Insurance contract or identification number | 149174 | Number of Individuals Covered | 63 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2013-01-01 | Total amount of commissions paid to insurance broker | USD $1,422 | 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 | Other welfare benefits provided | LONG-TERM CARE | Welfare Benefit Premiums Paid to Carrier | USD $10,302 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,422 | Insurance broker organization code? | 3 | Insurance broker name | THOMAS DELEOT |
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NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 ) |
Policy contract number | 413A49 |
Policy instance | 6 |
Insurance contract or identification number | 413A49 | Number of Individuals Covered | 329 | Insurance policy start date | 2012-07-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $0 | 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 $55,085 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 ) |
Policy contract number | 413A49 |
Policy instance | 5 |
Insurance contract or identification number | 413A49 | Number of Individuals Covered | 318 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-06-30 | Total amount of commissions paid to insurance broker | USD $0 | 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 $55,124 | 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 | 009105 |
Policy instance | 4 |
Insurance contract or identification number | 009105 | Number of Individuals Covered | 287 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $0 | 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 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 ) |
Policy contract number | 454-4257-00 |
Policy instance | 3 |
Insurance contract or identification number | 454-4257-00 | Number of Individuals Covered | 167 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2013-01-01 | Total amount of commissions paid to insurance broker | USD $6,643 | 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 | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $48,950 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,261 | Insurance broker organization code? | 3 | Insurance broker name | CAROLINA CONSULTING |
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NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 ) |
Policy contract number | 658545 |
Policy instance | 2 |
Insurance contract or identification number | 658545 | Number of Individuals Covered | 97 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $2,422 | Total amount of fees paid to insurance company | USD $471 | 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 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $921 | Amount paid for insurance broker fees | 192 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | CAROLINA CONDREY GROUP |
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NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 ) |
Policy contract number | 658545 |
Policy instance | 1 |
Insurance contract or identification number | 658545 | Number of Individuals Covered | 154 | Insurance policy start date | 2012-01-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $6,063 | Total amount of fees paid to insurance company | USD $1,180 | 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 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,306 | Amount paid for insurance broker fees | 480 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | CAROLINA CONDREY GROUP |
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BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 ) |
Policy contract number | 009105 |
Policy instance | 5 |
Insurance contract or identification number | 009105 | Number of Individuals Covered | 284 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $0 | 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 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 26921 ) |
Policy contract number | 889486-000/099 |
Policy instance | 4 |
Insurance contract or identification number | 889486-000/099 | Number of Individuals Covered | 299 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-09-30 | Total amount of commissions paid to insurance broker | USD $15,318 | 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 $81,106 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 ) |
Policy contract number | 454-4257-00 |
Policy instance | 3 |
Insurance contract or identification number | 454-4257-00 | Number of Individuals Covered | 158 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2012-01-01 | Total amount of commissions paid to insurance broker | USD $6,202 | 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 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $45,611 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 ) |
Policy contract number | 658545 |
Policy instance | 2 |
Insurance contract or identification number | 658545 | Number of Individuals Covered | 97 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $1,822 | 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 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 ) |
Policy contract number | 658545 |
Policy instance | 1 |
Insurance contract or identification number | 658545 | Number of Individuals Covered | 154 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $4,532 | 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 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 ) |
Policy contract number | 413A49 |
Policy instance | 6 |
Insurance contract or identification number | 413A49 | Number of Individuals Covered | 317 | Insurance policy start date | 2011-10-01 | Insurance policy end date | 2011-12-31 | Total amount of commissions paid to insurance broker | USD $0 | 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 $18,367 | 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 | 009105 |
Policy instance | 5 |
Insurance contract or identification number | 009105 | Number of Individuals Covered | 260 | 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 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 ) |
Policy contract number | 454-4257-00 |
Policy instance | 3 |
Insurance contract or identification number | 454-4257-00 | Number of Individuals Covered | 153 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2011-01-01 | Total amount of commissions paid to insurance broker | USD $5,844 | 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 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $43,133 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 ) |
Policy contract number | 658545 |
Policy instance | 2 |
Insurance contract or identification number | 658545 | Number of Individuals Covered | 93 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $1,792 | 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 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 ) |
Policy contract number | 658545 |
Policy instance | 1 |
Insurance contract or identification number | 658545 | Number of Individuals Covered | 148 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $4,524 | 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 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 26921 ) |
Policy contract number | 889486-000/099 |
Policy instance | 4 |
Insurance contract or identification number | 889486-000/099 | Number of Individuals Covered | 311 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $15,780 | 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 $105,394 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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