ACW MANAGEMENT CORPORATION has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan GROUP INSURANCE BENEFITS FOR EMPLOYEES OF A CLEANER WORLD
401k plan membership statisitcs for GROUP INSURANCE BENEFITS FOR EMPLOYEES OF A CLEANER WORLD
Measure | Date | Value |
---|
2019: GROUP INSURANCE BENEFITS FOR EMPLOYEES OF A CLEANER WORLD 2019 401k membership |
---|
Total participants, beginning-of-year | 2019-01-01 | 118 |
Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 132 |
Total of all active and inactive participants | 2019-01-01 | 132 |
2018: GROUP INSURANCE BENEFITS FOR EMPLOYEES OF A CLEANER WORLD 2018 401k membership |
---|
Total participants, beginning-of-year | 2018-01-01 | 128 |
Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 118 |
Total of all active and inactive participants | 2018-01-01 | 118 |
2017: GROUP INSURANCE BENEFITS FOR EMPLOYEES OF A CLEANER WORLD 2017 401k membership |
---|
Total participants, beginning-of-year | 2017-01-01 | 156 |
Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 147 |
Number of retired or separated participants receiving benefits | 2017-01-01 | 1 |
Total of all active and inactive participants | 2017-01-01 | 148 |
2016: GROUP INSURANCE BENEFITS FOR EMPLOYEES OF A CLEANER WORLD 2016 401k membership |
---|
Total participants, beginning-of-year | 2016-01-01 | 141 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 156 |
Number of retired or separated participants receiving benefits | 2016-01-01 | 1 |
Number of other retired or separated participants entitled to future benefits | 2016-01-01 | 0 |
Total of all active and inactive participants | 2016-01-01 | 157 |
2015: GROUP INSURANCE BENEFITS FOR EMPLOYEES OF A CLEANER WORLD 2015 401k membership |
---|
Total participants, beginning-of-year | 2015-01-01 | 147 |
Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 141 |
Total of all active and inactive participants | 2015-01-01 | 141 |
2014: GROUP INSURANCE BENEFITS FOR EMPLOYEES OF A CLEANER WORLD 2014 401k membership |
---|
Total participants, beginning-of-year | 2014-01-01 | 142 |
Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 147 |
Total of all active and inactive participants | 2014-01-01 | 147 |
2013: GROUP INSURANCE BENEFITS FOR EMPLOYEES OF A CLEANER WORLD 2013 401k membership |
---|
Total participants, beginning-of-year | 2013-01-01 | 138 |
Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 142 |
Total of all active and inactive participants | 2013-01-01 | 142 |
2012: GROUP INSURANCE BENEFITS FOR EMPLOYEES OF A CLEANER WORLD 2012 401k membership |
---|
Total participants, beginning-of-year | 2012-01-01 | 127 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 138 |
Total of all active and inactive participants | 2012-01-01 | 138 |
Total participants | 2012-01-01 | 138 |
2011: GROUP INSURANCE BENEFITS FOR EMPLOYEES OF A CLEANER WORLD 2011 401k membership |
---|
Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 126 |
Number of retired or separated participants receiving benefits | 2011-01-01 | 1 |
Total of all active and inactive participants | 2011-01-01 | 127 |
2009: GROUP INSURANCE BENEFITS FOR EMPLOYEES OF A CLEANER WORLD 2009 401k membership |
---|
Total participants, beginning-of-year | 2009-01-01 | 107 |
Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 136 |
Total of all active and inactive participants | 2009-01-01 | 136 |
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) |
Policy contract number | 27575 |
Policy instance | 4 |
Insurance contract or identification number | 27575 | Number of Individuals Covered | 27 | Insurance policy start date | 2019-03-01 | Insurance policy end date | 2020-02-28 | Total amount of commissions paid to insurance broker | USD $1,094 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | ACCIDENT | Welfare Benefit Premiums Paid to Carrier | USD $7,928 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,094 | Insurance broker organization code? | 3 |
|
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 883389G |
Policy instance | 3 |
Insurance contract or identification number | 883389G | Number of Individuals Covered | 134 | Insurance policy start date | 2019-03-01 | Insurance policy end date | 2020-02-28 | Total amount of commissions paid to insurance broker | USD $4,408 | Total amount of fees paid to insurance company | USD $2,536 | 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 $36,233 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,408 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 2536 |
|
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 ) |
Policy contract number | 010-040474 |
Policy instance | 2 |
Insurance contract or identification number | 010-040474 | Number of Individuals Covered | 79 | Insurance policy start date | 2019-03-01 | Insurance policy end date | 2020-02-28 | Total amount of commissions paid to insurance broker | USD $4,623 | Total amount of fees paid to insurance company | USD $1,397 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $46,228 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,623 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 1397 |
|
BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 ) |
Policy contract number | 14157792-1001 |
Policy instance | 1 |
Insurance contract or identification number | 14157792-1001 | Number of Individuals Covered | 85 | Insurance policy start date | 2019-03-01 | Insurance policy end date | 2020-02-28 | Total amount of commissions paid to insurance broker | USD $26,454 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $605,336 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $26,281 | Insurance broker organization code? | 3 |
|
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) |
Policy contract number | 27575 |
Policy instance | 5 |
Insurance contract or identification number | 27575 | Number of Individuals Covered | 16 | Insurance policy start date | 2019-03-01 | Insurance policy end date | 2020-02-28 | Total amount of commissions paid to insurance broker | USD $621 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | CANCER | Welfare Benefit Premiums Paid to Carrier | USD $6,211 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $621 | Insurance broker organization code? | 3 |
|
BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 ) |
Policy contract number | 076751 |
Policy instance | 1 |
Insurance contract or identification number | 076751 | Number of Individuals Covered | 90 | Insurance policy start date | 2017-03-01 | Insurance policy end date | 2018-02-28 | Total amount of commissions paid to insurance broker | USD $24,427 | Total amount of fees paid to insurance company | USD $500 | 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 $24,427 | Amount paid for insurance broker fees | 500 | Insurance broker organization code? | 3 | Insurance broker name | BLAKE V WELLER |
|
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 ) |
Policy contract number | 010-040474 |
Policy instance | 2 |
Insurance contract or identification number | 010-040474 | Number of Individuals Covered | 167 | Insurance policy start date | 2017-03-01 | Insurance policy end date | 2018-02-28 | Total amount of commissions paid to insurance broker | USD $4,355 | Total amount of fees paid to insurance company | USD $1,325 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $43,550 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,355 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 1325 | Insurance broker name | BB&T INSURANCE SERVICES INC |
|
USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
Policy contract number | 50009793 |
Policy instance | 3 |
Insurance contract or identification number | 50009793 | Number of Individuals Covered | 124 | Insurance policy start date | 2017-03-01 | Insurance policy end date | 2018-02-28 | Total amount of commissions paid to insurance broker | USD $1,441 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $9,609 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $961 | Insurance broker organization code? | 3 | Insurance broker name | MOSAIC GROUP |
|
BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 ) |
Policy contract number | V76761 |
Policy instance | 4 |
Insurance contract or identification number | V76761 | Number of Individuals Covered | 100 | Insurance policy start date | 2017-03-01 | Insurance policy end date | 2018-02-28 | Total amount of commissions paid to insurance broker | USD $966 | Total amount of fees paid to insurance company | USD $0 | Vision 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 $966 | Insurance broker organization code? | 3 | Insurance broker name | BB&T INSURANCE SERVICES INC |
|
USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
Policy contract number | 50009793 |
Policy instance | 5 |
Insurance contract or identification number | 50009793 | Number of Individuals Covered | 64 | Insurance policy start date | 2017-03-01 | Insurance policy end date | 2018-02-28 | Total amount of commissions paid to insurance broker | USD $2,257 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | VOLUNTARY GROUP TERM LIFE | Welfare Benefit Premiums Paid to Carrier | USD $9,030 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,354 | Insurance broker organization code? | 3 | Insurance broker name | MOSAIC GROUP |
|
USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
Policy contract number | 50009793 |
Policy instance | 6 |
Insurance contract or identification number | 50009793 | Number of Individuals Covered | 64 | Insurance policy start date | 2017-03-01 | Insurance policy end date | 2018-02-28 | Total amount of commissions paid to insurance broker | USD $308 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | VOLUNTARY AD&D | Welfare Benefit Premiums Paid to Carrier | USD $1,235 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $185 | Insurance broker organization code? | 3 | Insurance broker name | MOSAIC GROUP |
|
USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
Policy contract number | 50009793 |
Policy instance | 6 |
Insurance contract or identification number | 50009793 | Number of Individuals Covered | 68 | Insurance policy start date | 2015-03-01 | Insurance policy end date | 2016-02-29 | Total amount of commissions paid to insurance broker | USD $255 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | VOLUNTARY AD&D | Welfare Benefit Premiums Paid to Carrier | USD $1,019 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $153 | Insurance broker name | MOSAIC GROUP |
|
USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
Policy contract number | 50009793 |
Policy instance | 5 |
Insurance contract or identification number | 50009793 | Number of Individuals Covered | 56 | Insurance policy start date | 2015-03-01 | Insurance policy end date | 2016-02-29 | Total amount of commissions paid to insurance broker | USD $2,147 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | VOLUNTARY GROUP TERM LIFE | Welfare Benefit Premiums Paid to Carrier | USD $8,587 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,288 | Insurance broker name | MOSAIC GROUP |
|
BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 ) |
Policy contract number | V76761 |
Policy instance | 4 |
Insurance contract or identification number | V76761 | Number of Individuals Covered | 87 | Insurance policy start date | 2015-03-01 | Insurance policy end date | 2016-02-29 | Total amount of commissions paid to insurance broker | USD $780 | Total amount of fees paid to insurance company | USD $0 | Vision 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 $780 | Insurance broker organization code? | 3 | Insurance broker name | BLAKE V WELLER |
|
USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
Policy contract number | 50009793 |
Policy instance | 3 |
Insurance contract or identification number | 50009793 | Number of Individuals Covered | 141 | Insurance policy start date | 2015-03-01 | Insurance policy end date | 2016-02-28 | Total amount of commissions paid to insurance broker | USD $1,428 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $8,643 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $944 | Insurance broker organization code? | 3 | Insurance broker name | MOSAIC GROUP |
|
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 ) |
Policy contract number | 010-040474 |
Policy instance | 2 |
Insurance contract or identification number | 010-040474 | Number of Individuals Covered | 79 | Insurance policy start date | 2015-03-01 | Insurance policy end date | 2016-02-28 | Total amount of commissions paid to insurance broker | USD $3,719 | Total amount of fees paid to insurance company | USD $1,464 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $37,194 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,719 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 1464 | Insurance broker name | BB&T INSURANCE SERVICES INC |
|
BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 ) |
Policy contract number | 076751 |
Policy instance | 1 |
Insurance contract or identification number | 076751 | Number of Individuals Covered | 93 | Insurance policy start date | 2015-03-01 | Insurance policy end date | 2016-02-28 | Total amount of commissions paid to insurance broker | USD $17,629 | Total amount of fees paid to insurance company | USD $1,000 | 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 $17,629 | Amount paid for insurance broker fees | 1000 | Insurance broker organization code? | 3 | Insurance broker name | BLAKE V WELLER |
|
USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
Policy contract number | 50009793 |
Policy instance | 4 |
Insurance contract or identification number | 50009793 | Number of Individuals Covered | 147 | Insurance policy start date | 2014-03-01 | Insurance policy end date | 2015-02-28 | Total amount of commissions paid to insurance broker | USD $1,541 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $10,296 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $963 | Insurance broker organization code? | 3 | Insurance broker name | MOSAIC GROUP |
|
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
Policy contract number | LTD 123009 |
Policy instance | 3 |
Insurance contract or identification number | LTD 123009 | Number of Individuals Covered | 42 | Insurance policy start date | 2014-03-01 | Insurance policy end date | 2015-02-28 | Total amount of commissions paid to insurance broker | USD $614 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $6,407 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $614 | Insurance broker organization code? | 3 | Insurance broker name | BB&T INSURANCE SERVICES INC |
|
BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 ) |
Policy contract number | 076751 |
Policy instance | 1 |
Insurance contract or identification number | 076751 | Number of Individuals Covered | 91 | Insurance policy start date | 2014-03-01 | Insurance policy end date | 2015-02-28 | Total amount of commissions paid to insurance broker | USD $857 | 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 | Vision 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 $857 | Insurance broker organization code? | 3 | Insurance broker name | BLAKE V WELLER |
|
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 ) |
Policy contract number | 010-040474 |
Policy instance | 2 |
Insurance contract or identification number | 010-040474 | Number of Individuals Covered | 70 | Insurance policy start date | 2014-03-01 | Insurance policy end date | 2015-02-28 | Total amount of commissions paid to insurance broker | USD $3,663 | Total amount of fees paid to insurance company | USD $556 | 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 $36,632 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,663 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 556 | Insurance broker name | BB&T INSURANCE SERVICES INC |
|
USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
Policy contract number | 50009793 |
Policy instance | 4 |
Insurance contract or identification number | 50009793 | Number of Individuals Covered | 142 | Insurance policy start date | 2013-03-01 | Insurance policy end date | 2014-02-28 | Total amount of commissions paid to insurance broker | USD $1,205 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $8,042 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $801 | Insurance broker organization code? | 3 | Insurance broker name | MOSAIC GROUP |
|
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
Policy contract number | LTD 123009 |
Policy instance | 3 |
Insurance contract or identification number | LTD 123009 | Number of Individuals Covered | 39 | Insurance policy start date | 2013-03-01 | Insurance policy end date | 2014-02-28 | Total amount of commissions paid to insurance broker | USD $734 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $6,601 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $734 | Insurance broker organization code? | 3 | Insurance broker name | BB&T INSURANCE SERVICES INC |
|
BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 ) |
Policy contract number | 076751 |
Policy instance | 1 |
Insurance contract or identification number | 076751 | Number of Individuals Covered | 116 | Insurance policy start date | 2013-03-01 | Insurance policy end date | 2014-02-28 | Total amount of commissions paid to insurance broker | USD $21,738 | 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 | Dental Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $21,738 | Insurance broker organization code? | 3 | Insurance broker name | BLAKE V WELLER |
|
BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 ) |
Policy contract number | 20032 |
Policy instance | 2 |
Insurance contract or identification number | 20032 | Number of Individuals Covered | 89 | Insurance policy start date | 2013-03-01 | Insurance policy end date | 2014-02-28 | Total amount of commissions paid to insurance broker | USD $1,066 | 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 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,066 | Insurance broker organization code? | 3 | Insurance broker name | BLAKE V WELLER |
|
USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
Policy contract number | 50009793 |
Policy instance | 5 |
Insurance contract or identification number | 50009793 | Number of Individuals Covered | 23 | Insurance policy start date | 2013-03-01 | Insurance policy end date | 2014-02-28 | Total amount of commissions paid to insurance broker | USD $77 | 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 | DEPENDENT LIFE | Welfare Benefit Premiums Paid to Carrier | USD $504 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $51 | Insurance broker organization code? | 3 | Insurance broker name | MOSAIC GROUP |
|
USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
Policy contract number | 50009793 |
Policy instance | 5 |
Insurance contract or identification number | 50009793 | Number of Individuals Covered | 65 | Insurance policy start date | 2012-03-01 | Insurance policy end date | 2013-02-28 | Total amount of commissions paid to insurance broker | USD $1,969 | 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 | 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 | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | VOLUNTARY GROUP TERM LIFE | 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 $7,875 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $788 | Insurance broker organization code? | 3 | Insurance broker name | BB&T INSURANCE SERVICES INC |
|
BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 ) |
Policy contract number | 20032 |
Policy instance | 2 |
Insurance contract or identification number | 20032 | Number of Individuals Covered | 90 | Insurance policy start date | 2012-03-01 | Insurance policy end date | 2013-02-28 | Total amount of commissions paid to insurance broker | USD $1,032 | 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 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,032 | Insurance broker organization code? | 3 | Insurance broker name | BLAKE V WELLER |
|
USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
Policy contract number | 50009793 |
Policy instance | 6 |
Insurance contract or identification number | 50009793 | Number of Individuals Covered | 65 | Insurance policy start date | 2012-03-01 | Insurance policy end date | 2013-02-28 | Total amount of commissions paid to insurance broker | USD $300 | 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 | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | VOLUNTARY AD&D | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $1,199 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $120 | Insurance broker organization code? | 3 | Insurance broker name | BB&T INSURANCE SERVICS INC |
|
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
Policy contract number | LTD 123009 |
Policy instance | 3 |
Insurance contract or identification number | LTD 123009 | Number of Individuals Covered | 39 | Insurance policy start date | 2012-03-01 | Insurance policy end date | 2013-02-28 | Total amount of commissions paid to insurance broker | USD $454 | 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 $6,481 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $454 | Insurance broker organization code? | 3 | Insurance broker name | BB&T INSURANCE SERVICES INC |
|
BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 ) |
Policy contract number | 076751 |
Policy instance | 1 |
Insurance contract or identification number | 076751 | Number of Individuals Covered | 120 | Insurance policy start date | 2012-03-01 | Insurance policy end date | 2013-02-28 | Total amount of commissions paid to insurance broker | USD $21,404 | 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 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $21,404 | Insurance broker organization code? | 3 | Insurance broker name | BLAKE V WELLER |
|
USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
Policy contract number | 50009793 |
Policy instance | 4 |
Insurance contract or identification number | 50009793 | Number of Individuals Covered | 138 | Insurance policy start date | 2012-03-01 | Insurance policy end date | 2013-02-28 | Total amount of commissions paid to insurance broker | USD $1,224 | 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 | Other welfare benefits provided | AD&D | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $8,160 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $388 | Insurance broker organization code? | 3 | Insurance broker name | BB&T INSURANCE SERVICES INC |
|
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 476859 |
Policy instance | 1 |
Insurance contract or identification number | 476859 | Number of Individuals Covered | 80 | Insurance policy start date | 2011-03-01 | Insurance policy end date | 2012-02-29 | Total amount of commissions paid to insurance broker | USD $23,885 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $477,694 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $23,885 | Insurance broker organization code? | 3 | Insurance broker name | BB&T INSURANCE SERVICES INC |
|
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 ) |
Policy contract number | 4001462035 |
Policy instance | 3 |
Insurance contract or identification number | 4001462035 | Number of Individuals Covered | 60 | Insurance policy start date | 2011-01-01 | Insurance policy end date | 2012-02-29 | Total amount of commissions paid to insurance broker | USD $3,724 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $36,205 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,724 | Insurance broker organization code? | 3 | Insurance broker name | BB&T INSURANCE SERVICES INC |
|
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) |
Policy contract number | 9814021 |
Policy instance | 4 |
Insurance contract or identification number | 9814021 | Number of Individuals Covered | 70 | Insurance policy start date | 2011-03-01 | Insurance policy end date | 2012-02-29 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $6,879 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 10089319 |
Policy instance | 5 |
Insurance contract or identification number | 10089319 | Number of Individuals Covered | 42 | Insurance policy start date | 2011-03-01 | Insurance policy end date | 2012-02-29 | Total amount of commissions paid to insurance broker | USD $632 | Total amount of fees paid to insurance company | USD $0 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $6,318 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $632 | Insurance broker organization code? | 3 | Insurance broker name | BB&T INSURANCE SERVICES INC |
|
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 302839 |
Policy instance | 2 |
Insurance contract or identification number | 302839 | Number of Individuals Covered | 126 | Insurance policy start date | 2011-03-01 | Insurance policy end date | 2012-02-29 | Total amount of commissions paid to insurance broker | USD $1,661 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $16,611 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,661 | Insurance broker organization code? | 3 | Insurance broker name | BB&T INSURANCE SERVICES INC |
|
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 000010089318 |
Policy instance | 1 |
Insurance contract or identification number | 000010089318 | Number of Individuals Covered | 92 | Insurance policy start date | 2009-03-01 | Insurance policy end date | 2010-02-28 | Total amount of commissions paid to insurance broker | USD $812 | Total amount of fees paid to insurance company | USD $220 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $8,115 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $812 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 220 | Additional information about fees paid to insurance broker | BROKER BONUS | Insurance broker name | BB&T INSURANCE SERVICES, INC. |
|
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 ) |
Policy contract number | 4001462035 |
Policy instance | 4 |
Insurance contract or identification number | 4001462035 | Number of Individuals Covered | 34 | Insurance policy start date | 2010-03-01 | Insurance policy end date | 2011-02-28 | Total amount of commissions paid to insurance broker | USD $2,189 | 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 $14,674 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,189 | Insurance broker organization code? | 3 | Insurance broker name | BB&T INSURANCE SERVICES, INC. |
|
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 000010089319 |
Policy instance | 2 |
Insurance contract or identification number | 000010089319 | Number of Individuals Covered | 47 | Insurance policy start date | 2009-03-01 | Insurance policy end date | 2010-02-28 | Total amount of commissions paid to insurance broker | USD $543 | Total amount of fees paid to insurance company | USD $134 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $5,431 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $543 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 134 | Additional information about fees paid to insurance broker | BROKER BONUS | Insurance broker name | BB&T INSURANCE SERVICES, INC. |
|
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 476859 |
Policy instance | 3 |
Insurance contract or identification number | 476859 | Number of Individuals Covered | 94 | Insurance policy start date | 2010-03-01 | Insurance policy end date | 2011-02-28 | Total amount of commissions paid to insurance broker | USD $24,956 | 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 | Welfare Benefit Premiums Paid to Carrier | USD $457,750 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $24,956 | Insurance broker name | BB&T INSURANCE SERVICES, INC. |
|