EAGLE PHYSICIANS AND ASSOCIATES, P.A has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan EAGLE PHYSICIANS & ASSOCIATES, EMPLOYEE PLAN OF BENEFITS
401k plan membership statisitcs for EAGLE PHYSICIANS & ASSOCIATES, EMPLOYEE PLAN OF BENEFITS
| Measure | Date | Value |
|---|
| 2022: EAGLE PHYSICIANS & ASSOCIATES, EMPLOYEE PLAN OF BENEFITS 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-07-01 | 293 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-07-01 | 314 |
| Number of retired or separated participants receiving benefits | 2022-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2022-07-01 | 0 |
| Total of all active and inactive participants | 2022-07-01 | 314 |
| 2021: EAGLE PHYSICIANS & ASSOCIATES, EMPLOYEE PLAN OF BENEFITS 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-07-01 | 265 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-07-01 | 285 |
| Number of retired or separated participants receiving benefits | 2021-07-01 | 6 |
| Number of other retired or separated participants entitled to future benefits | 2021-07-01 | 0 |
| Total of all active and inactive participants | 2021-07-01 | 291 |
| 2020: EAGLE PHYSICIANS & ASSOCIATES, EMPLOYEE PLAN OF BENEFITS 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-07-01 | 267 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-07-01 | 265 |
| Total of all active and inactive participants | 2020-07-01 | 265 |
| 2019: EAGLE PHYSICIANS & ASSOCIATES, EMPLOYEE PLAN OF BENEFITS 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-07-01 | 270 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-07-01 | 267 |
| Total of all active and inactive participants | 2019-07-01 | 267 |
| 2018: EAGLE PHYSICIANS & ASSOCIATES, EMPLOYEE PLAN OF BENEFITS 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-07-01 | 271 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-07-01 | 270 |
| Total of all active and inactive participants | 2018-07-01 | 270 |
| 2017: EAGLE PHYSICIANS & ASSOCIATES, EMPLOYEE PLAN OF BENEFITS 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-07-01 | 254 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-07-01 | 271 |
| Total of all active and inactive participants | 2017-07-01 | 271 |
| 2016: EAGLE PHYSICIANS & ASSOCIATES, EMPLOYEE PLAN OF BENEFITS 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-07-01 | 232 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-07-01 | 254 |
| Total of all active and inactive participants | 2016-07-01 | 254 |
| 2014: EAGLE PHYSICIANS & ASSOCIATES, EMPLOYEE PLAN OF BENEFITS 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-07-01 | 202 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-07-01 | 235 |
| Total of all active and inactive participants | 2014-07-01 | 235 |
| 2013: EAGLE PHYSICIANS & ASSOCIATES, EMPLOYEE PLAN OF BENEFITS 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-07-01 | 184 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-07-01 | 202 |
| Total of all active and inactive participants | 2013-07-01 | 202 |
| 2012: EAGLE PHYSICIANS & ASSOCIATES, EMPLOYEE PLAN OF BENEFITS 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-07-01 | 191 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-07-01 | 184 |
| Total of all active and inactive participants | 2012-07-01 | 184 |
| 2011: EAGLE PHYSICIANS & ASSOCIATES, EMPLOYEE PLAN OF BENEFITS 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-07-01 | 233 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-07-01 | 191 |
| Total of all active and inactive participants | 2011-07-01 | 191 |
| 2009: EAGLE PHYSICIANS & ASSOCIATES, EMPLOYEE PLAN OF BENEFITS 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-07-01 | 277 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-07-01 | 262 |
| Total of all active and inactive participants | 2009-07-01 | 262 |
| 2022: EAGLE PHYSICIANS & ASSOCIATES, EMPLOYEE PLAN OF BENEFITS 2022 form 5500 responses |
|---|
| 2022-07-01 | Type of plan entity | Single employer plan |
| 2022-07-01 | Plan funding arrangement – Insurance | Yes |
| 2022-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2022-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2022-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2021: EAGLE PHYSICIANS & ASSOCIATES, EMPLOYEE PLAN OF BENEFITS 2021 form 5500 responses |
|---|
| 2021-07-01 | Type of plan entity | Single employer plan |
| 2021-07-01 | Plan funding arrangement – Insurance | Yes |
| 2021-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2021-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2021-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2020: EAGLE PHYSICIANS & ASSOCIATES, EMPLOYEE PLAN OF BENEFITS 2020 form 5500 responses |
|---|
| 2020-07-01 | Type of plan entity | Single employer plan |
| 2020-07-01 | Plan funding arrangement – Insurance | Yes |
| 2020-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2020-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2020-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2019: EAGLE PHYSICIANS & ASSOCIATES, EMPLOYEE PLAN OF BENEFITS 2019 form 5500 responses |
|---|
| 2019-07-01 | Type of plan entity | Single employer plan |
| 2019-07-01 | Plan funding arrangement – Insurance | Yes |
| 2019-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2019-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2019-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2018: EAGLE PHYSICIANS & ASSOCIATES, EMPLOYEE PLAN OF BENEFITS 2018 form 5500 responses |
|---|
| 2018-07-01 | Type of plan entity | Single employer plan |
| 2018-07-01 | Plan funding arrangement – Insurance | Yes |
| 2018-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2018-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2018-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2017: EAGLE PHYSICIANS & ASSOCIATES, EMPLOYEE PLAN OF BENEFITS 2017 form 5500 responses |
|---|
| 2017-07-01 | Type of plan entity | Single employer plan |
| 2017-07-01 | Plan funding arrangement – Insurance | Yes |
| 2017-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2017-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2017-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2016: EAGLE PHYSICIANS & ASSOCIATES, EMPLOYEE PLAN OF BENEFITS 2016 form 5500 responses |
|---|
| 2016-07-01 | Type of plan entity | Single employer plan |
| 2016-07-01 | Plan funding arrangement – Insurance | Yes |
| 2016-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2016-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2016-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2014: EAGLE PHYSICIANS & ASSOCIATES, EMPLOYEE PLAN OF BENEFITS 2014 form 5500 responses |
|---|
| 2014-07-01 | Type of plan entity | Single employer plan |
| 2014-07-01 | Plan funding arrangement – Insurance | Yes |
| 2014-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2014-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2014-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2013: EAGLE PHYSICIANS & ASSOCIATES, EMPLOYEE PLAN OF BENEFITS 2013 form 5500 responses |
|---|
| 2013-07-01 | Type of plan entity | Single employer plan |
| 2013-07-01 | Plan funding arrangement – Insurance | Yes |
| 2013-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2013-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2013-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2012: EAGLE PHYSICIANS & ASSOCIATES, EMPLOYEE PLAN OF BENEFITS 2012 form 5500 responses |
|---|
| 2012-07-01 | Type of plan entity | Single employer plan |
| 2012-07-01 | Plan funding arrangement – Insurance | Yes |
| 2012-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2012-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2012-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2011: EAGLE PHYSICIANS & ASSOCIATES, EMPLOYEE PLAN OF BENEFITS 2011 form 5500 responses |
|---|
| 2011-07-01 | Type of plan entity | Single employer plan |
| 2011-07-01 | Plan funding arrangement – Insurance | Yes |
| 2011-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2011-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2011-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2009: EAGLE PHYSICIANS & ASSOCIATES, EMPLOYEE PLAN OF BENEFITS 2009 form 5500 responses |
|---|
| 2009-07-01 | Type of plan entity | Single employer plan |
| 2009-07-01 | This submission is the final filing | No |
| 2009-07-01 | Plan funding arrangement – Insurance | Yes |
| 2009-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2009-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2009-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 0399420999 |
| Policy instance | 4 |
| Insurance contract or identification number | 0399420999 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2022-07-01 | | Insurance policy end date | 2023-06-30 | | Total amount of commissions paid to insurance broker | USD $455 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | GROUP INDIVIDUAL LONG-TERM CARE | | Welfare Benefit Premiums Paid to Carrier | USD $2,275 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $455 | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 0399420800 |
| Policy instance | 3 |
| Insurance contract or identification number | 0399420800 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2022-07-01 | | Insurance policy end date | 2023-06-30 | | Total amount of commissions paid to insurance broker | USD $3,967 | | 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 $20,223 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,967 | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 0399420001 |
| Policy instance | 2 |
| Insurance contract or identification number | 0399420001 | | Number of Individuals Covered | 60 | | Insurance policy start date | 2022-07-01 | | Insurance policy end date | 2023-06-30 | | Total amount of commissions paid to insurance broker | USD $5,166 | | 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 $25,832 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,166 | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 115152 |
| Policy instance | 1 |
| Insurance contract or identification number | 115152 | | Number of Individuals Covered | 292 | | Insurance policy start date | 2022-07-01 | | Insurance policy end date | 2023-06-30 | | Total amount of commissions paid to insurance broker | USD $25,186 | | Total amount of fees paid to insurance company | USD $2,254 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $268,144 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $25,186 | | Amount paid for insurance broker fees | 1630 | | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | | Insurance broker organization code? | 3 |
|
| PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) |
| Policy contract number | 0000159871 |
| Policy instance | 1 |
| Insurance contract or identification number | 0000159871 | | Number of Individuals Covered | 16 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2022-06-30 | | Total amount of commissions paid to insurance broker | USD $6,578 | | Total amount of fees paid to insurance company | USD $0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $33,200 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,578 | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 115152 |
| Policy instance | 2 |
| Insurance contract or identification number | 115152 | | Number of Individuals Covered | 267 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2022-06-30 | | Total amount of commissions paid to insurance broker | USD $27,671 | | Total amount of fees paid to insurance company | USD $2,196 | | 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 $292,756 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $27,671 | | Amount paid for insurance broker fees | 2196 | | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 0399420001 |
| Policy instance | 3 |
| Insurance contract or identification number | 0399420001 | | Number of Individuals Covered | 58 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2022-06-30 | | Total amount of commissions paid to insurance broker | USD $5,198 | | 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 $25,991 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,198 | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 0399420800 |
| Policy instance | 4 |
| Insurance contract or identification number | 0399420800 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2022-06-30 | | Total amount of commissions paid to insurance broker | USD $4,464 | | 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 $20,837 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,464 | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 0399420999 |
| Policy instance | 5 |
| Insurance contract or identification number | 0399420999 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2022-06-30 | | Total amount of commissions paid to insurance broker | USD $493 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | GROUP INDIVIDUAL LONG-TERM CARE | | Welfare Benefit Premiums Paid to Carrier | USD $2,275 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $493 | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 039942 |
| Policy instance | 5 |
| Insurance contract or identification number | 039942 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2021-01-01 | | Total amount of commissions paid to insurance broker | USD $493 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | GROUP INDIV LTC | | Welfare Benefit Premiums Paid to Carrier | USD $2,275 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $493 | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 039942 |
| Policy instance | 4 |
| Insurance contract or identification number | 039942 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2021-01-01 | | Total amount of commissions paid to insurance broker | USD $3,763 | | 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 $16,762 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,763 | | Insurance broker organization code? | 3 |
|
| UNIMERICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 91529 ) |
| Policy contract number | UNI-201728 |
| Policy instance | 3 |
| Insurance contract or identification number | UNI-201728 | | Number of Individuals Covered | 278 | | Insurance policy start date | 2020-07-01 | | Insurance policy end date | 2021-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $394,762 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 039942 |
| Policy instance | 2 |
| Insurance contract or identification number | 039942 | | Number of Individuals Covered | 61 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2021-01-01 | | Total amount of commissions paid to insurance broker | USD $4,391 | | 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 $21,954 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,391 | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 115152 |
| Policy instance | 1 |
| Insurance contract or identification number | 115152 | | Number of Individuals Covered | 253 | | Insurance policy start date | 2020-07-01 | | Insurance policy end date | 2021-07-01 | | Total amount of commissions paid to insurance broker | USD $25,164 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | SHORT TERM DISABILITY | | Welfare Benefit Premiums Paid to Carrier | USD $241,788 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $25,164 | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 039942 |
| Policy instance | 4 |
| Insurance contract or identification number | 039942 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2020-01-01 | | Total amount of commissions paid to insurance broker | USD $3,569 | | 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 $18,811 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,569 | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 115152 |
| Policy instance | 1 |
| Insurance contract or identification number | 115152 | | Number of Individuals Covered | 256 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2020-07-01 | | Total amount of commissions paid to insurance broker | USD $25,289 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | SHORT TERM DISABILITY | | Welfare Benefit Premiums Paid to Carrier | USD $287,129 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $25,289 | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 039942 |
| Policy instance | 2 |
| Insurance contract or identification number | 039942 | | Number of Individuals Covered | 64 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2020-01-01 | | Total amount of commissions paid to insurance broker | USD $4,023 | | 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 $20,114 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,023 | | Insurance broker organization code? | 3 |
|
| UNIMERICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 91529 ) |
| Policy contract number | UNI-201728 |
| Policy instance | 3 |
| Insurance contract or identification number | UNI-201728 | | Number of Individuals Covered | 277 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2020-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $341,903 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 039942 |
| Policy instance | 5 |
| Insurance contract or identification number | 039942 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2020-01-01 | | Total amount of commissions paid to insurance broker | USD $455 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | GROUP INDIV LTC | | Welfare Benefit Premiums Paid to Carrier | USD $2,275 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $455 | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 039942 |
| Policy instance | 5 |
| Insurance contract or identification number | 039942 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2018-07-01 | | Insurance policy end date | 2019-07-01 | | Total amount of commissions paid to insurance broker | USD $455 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | GROUP INDIV LTC | | Welfare Benefit Premiums Paid to Carrier | USD $2,275 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $455 | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 115152 |
| Policy instance | 1 |
| Insurance contract or identification number | 115152 | | Number of Individuals Covered | 258 | | Insurance policy start date | 2018-07-01 | | Insurance policy end date | 2019-07-01 | | Total amount of commissions paid to insurance broker | USD $24,418 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | SHORT TERM DISABILITY | | Welfare Benefit Premiums Paid to Carrier | USD $256,971 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $24,418 | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 039942 |
| Policy instance | 2 |
| Insurance contract or identification number | 039942 | | Number of Individuals Covered | 64 | | Insurance policy start date | 2018-07-01 | | Insurance policy end date | 2019-07-01 | | Total amount of commissions paid to insurance broker | USD $3,887 | | 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 $19,433 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,887 | | Insurance broker organization code? | 3 |
|
| UNIMERICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 91529 ) |
| Policy contract number | UNI-201728 |
| Policy instance | 3 |
| Insurance contract or identification number | UNI-201728 | | Number of Individuals Covered | 281 | | Insurance policy start date | 2018-07-01 | | Insurance policy end date | 2019-06-30 | | Total amount of commissions paid to insurance broker | USD $43,056 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $181,737 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $43,056 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 039942 |
| Policy instance | 4 |
| Insurance contract or identification number | 039942 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2018-07-01 | | Insurance policy end date | 2019-07-01 | | Total amount of commissions paid to insurance broker | USD $3,558 | | 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 $17,808 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,558 | | Insurance broker organization code? | 3 |
|
| UNIMERICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 91529 ) |
| Policy contract number | UNI-201728 |
| Policy instance | 3 |
| Insurance contract or identification number | UNI-201728 | | Number of Individuals Covered | 277 | | Insurance policy start date | 2017-07-01 | | Insurance policy end date | 2018-06-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $174,413 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 039942 |
| Policy instance | 2 |
| Insurance contract or identification number | 039942 | | Number of Individuals Covered | 53 | | Insurance policy start date | 2017-07-01 | | Insurance policy end date | 2018-07-01 | | Total amount of commissions paid to insurance broker | USD $8,006 | | 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 $40,030 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,006 | | Insurance broker name | WILLIFORD INSURANCE GROUP INC. |
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| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 115152 |
| Policy instance | 1 |
| Insurance contract or identification number | 115152 | | Number of Individuals Covered | 265 | | Insurance policy start date | 2017-07-01 | | Insurance policy end date | 2018-07-01 | | Total amount of commissions paid to insurance broker | USD $24,314 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | SHORT TERM DISABILITY | | Welfare Benefit Premiums Paid to Carrier | USD $256,700 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $24,314 | | Insurance broker organization code? | 3 | | Insurance broker name | WILLIFORD INSURANCE GROUP INC. |
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