DAVIS TRANSFER COMPANY, INC. has sponsored the creation of one or more 401k plans.
Measure | Date | Value |
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2016: DAVIS TRANSFER HEALTH PLAN 2016 401k membership |
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Total participants, beginning-of-year | 2016-05-01 | 180 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-05-01 | 172 |
Number of retired or separated participants receiving benefits | 2016-05-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2016-05-01 | 0 |
Total of all active and inactive participants | 2016-05-01 | 172 |
2015: DAVIS TRANSFER HEALTH PLAN 2015 401k membership |
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Total participants, beginning-of-year | 2015-05-01 | 180 |
Total number of active participants reported on line 7a of the Form 5500 | 2015-05-01 | 172 |
Number of retired or separated participants receiving benefits | 2015-05-01 | 0 |
Total of all active and inactive participants | 2015-05-01 | 172 |
2014: DAVIS TRANSFER HEALTH PLAN 2014 401k membership |
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Total participants, beginning-of-year | 2014-05-01 | 183 |
Total number of active participants reported on line 7a of the Form 5500 | 2014-05-01 | 179 |
Number of retired or separated participants receiving benefits | 2014-05-01 | 1 |
Total of all active and inactive participants | 2014-05-01 | 180 |
2013: DAVIS TRANSFER HEALTH PLAN 2013 401k membership |
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Total participants, beginning-of-year | 2013-05-01 | 166 |
Total number of active participants reported on line 7a of the Form 5500 | 2013-05-01 | 183 |
Number of retired or separated participants receiving benefits | 2013-05-01 | 0 |
Total of all active and inactive participants | 2013-05-01 | 183 |
2012: DAVIS TRANSFER HEALTH PLAN 2012 401k membership |
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Total participants, beginning-of-year | 2012-05-01 | 151 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-05-01 | 166 |
Number of retired or separated participants receiving benefits | 2012-05-01 | 0 |
Total of all active and inactive participants | 2012-05-01 | 166 |
2011: DAVIS TRANSFER HEALTH PLAN 2011 401k membership |
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Total participants, beginning-of-year | 2011-05-01 | 127 |
Total number of active participants reported on line 7a of the Form 5500 | 2011-05-01 | 151 |
Number of retired or separated participants receiving benefits | 2011-05-01 | 0 |
Total of all active and inactive participants | 2011-05-01 | 151 |
2010: DAVIS TRANSFER HEALTH PLAN 2010 401k membership |
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Total participants, beginning-of-year | 2010-05-01 | 111 |
Total number of active participants reported on line 7a of the Form 5500 | 2010-05-01 | 124 |
Number of retired or separated participants receiving benefits | 2010-05-01 | 3 |
Total of all active and inactive participants | 2010-05-01 | 127 |
2009: DAVIS TRANSFER HEALTH PLAN 2009 401k membership |
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Total participants, beginning-of-year | 2009-05-01 | 100 |
Total number of active participants reported on line 7a of the Form 5500 | 2009-05-01 | 108 |
Number of retired or separated participants receiving benefits | 2009-05-01 | 3 |
Total of all active and inactive participants | 2009-05-01 | 111 |
BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 ) |
Policy contract number | GA7221 |
Policy instance | 7 |
Insurance contract or identification number | GA7221 | Number of Individuals Covered | 232 | Insurance policy start date | 2015-05-01 | Insurance policy end date | 2016-04-30 | Total amount of commissions paid to insurance broker | USD $61,243 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,542,807 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $61,243 | Insurance broker organization code? | 3 | Insurance broker name | TIFFANY DAVIS |
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UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 ) |
Policy contract number | 7007237 |
Policy instance | 2 |
Insurance contract or identification number | 7007237 | Number of Individuals Covered | 109 | Insurance policy start date | 2015-05-01 | Insurance policy end date | 2016-04-30 | Total amount of commissions paid to insurance broker | USD $10,012 | Total amount of fees paid to insurance company | USD $2,460 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $35,203 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,963 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 1514 | Additional information about fees paid to insurance broker | CLAIMS ADMINISTRATIVE SERVICES | Insurance broker name | COTTINGHAM & BUTLER INS SEV INC |
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UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 ) |
Policy contract number | 7007238 |
Policy instance | 3 |
Insurance contract or identification number | 7007238 | Number of Individuals Covered | 59 | Insurance policy start date | 2015-05-01 | Insurance policy end date | 2016-04-30 | Total amount of commissions paid to insurance broker | USD $5,370 | Total amount of fees paid to insurance company | USD $1,567 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $23,299 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,821 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 1002 | Additional information about fees paid to insurance broker | CLAIMS ADMINISTRATIVE SERVICES | Insurance broker name | COTTINGHAM & BUTLER INS SEV INC |
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COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
Policy contract number | E3100716 |
Policy instance | 4 |
Insurance contract or identification number | E3100716 | Number of Individuals Covered | 25 | Insurance policy start date | 2015-05-01 | Insurance policy end date | 2016-04-30 | Total amount of commissions paid to insurance broker | USD $1,902 | Total amount of fees paid to insurance company | USD $212 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $15,071 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $735 | Amount paid for insurance broker fees | 98 | Additional information about fees paid to insurance broker | OTHER FEES | Insurance broker organization code? | 3 | Insurance broker name | KAREN PICCININI |
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GREATER GEORGIA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97217 ) |
Policy contract number | GA7221 |
Policy instance | 1 |
Insurance contract or identification number | GA7221 | Number of Individuals Covered | 155 | Insurance policy start date | 2015-05-01 | Insurance policy end date | 2016-04-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $15,987 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC/ (G0385) (National Association of Insurance Commissioners NAIC id number: 54801 ) |
Policy contract number | GA7221 |
Policy instance | 6 |
Insurance contract or identification number | GA7221 | Number of Individuals Covered | 277 | Insurance policy start date | 2015-05-01 | Insurance policy end date | 2016-04-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $88,245 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
Policy contract number | E3100708 |
Policy instance | 5 |
Insurance contract or identification number | E3100708 | Number of Individuals Covered | 5 | Insurance policy start date | 2015-05-01 | Insurance policy end date | 2016-04-30 | Total amount of commissions paid to insurance broker | USD $89 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,220 | 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 | Insurance broker organization code? | 3 | Insurance broker name | JOYCE HERNDON-GARVIN |
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BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 ) |
Policy contract number | GA7221 |
Policy instance | 3 |
Insurance contract or identification number | GA7221 | Number of Individuals Covered | 239 | Insurance policy start date | 2014-05-01 | Insurance policy end date | 2015-04-30 | Total amount of commissions paid to insurance broker | USD $63,969 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Welfare Benefit Premiums Paid to Carrier | USD $1,546,757 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $63,969 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Insurance broker name | TIFFANY S DAVIS |
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COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
Policy contract number | E3100708 |
Policy instance | 7 |
Insurance contract or identification number | E3100708 | Number of Individuals Covered | 6 | Insurance policy start date | 2014-05-01 | Insurance policy end date | 2015-04-30 | Total amount of commissions paid to insurance broker | USD $89 | 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 | Welfare Benefit Premiums Paid to Carrier | USD $1,346 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $38 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Insurance broker name | BRENDA KNIGHT |
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COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
Policy contract number | E3100716 |
Policy instance | 6 |
Insurance contract or identification number | E3100716 | Number of Individuals Covered | 28 | Insurance policy start date | 2014-05-01 | Insurance policy end date | 2015-04-30 | Total amount of commissions paid to insurance broker | USD $1,974 | Total amount of fees paid to insurance company | USD $185 | 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 | Welfare Benefit Premiums Paid to Carrier | USD $20,615 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $811 | Amount paid for insurance broker fees | 82 | Additional information about fees paid to insurance broker | OTHER FEES | Insurance broker organization code? | 3 | Insurance broker name | NICHOLAS WEBER |
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UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 ) |
Policy contract number | 7007238 |
Policy instance | 5 |
Insurance contract or identification number | 7007238 | Number of Individuals Covered | 54 | Insurance policy start date | 2014-05-01 | Insurance policy end date | 2015-04-30 | Total amount of commissions paid to insurance broker | USD $5,246 | Total amount of fees paid to insurance company | USD $1,578 | 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 $23,819 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,861 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Additional information about fees paid to insurance broker | CLAIMS ADMINISTRATIVE SERVICES | Insurance broker name | THE ABACUS GROUP LLC |
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UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 ) |
Policy contract number | 7007237 |
Policy instance | 4 |
Insurance contract or identification number | 7007237 | Number of Individuals Covered | 108 | Insurance policy start date | 2014-05-01 | Insurance policy end date | 2015-04-30 | Total amount of commissions paid to insurance broker | USD $10,147 | Total amount of fees paid to insurance company | USD $2,472 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $35,278 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,099 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Additional information about fees paid to insurance broker | CLAIMS ADMINISTRATIVE SERVICES | Insurance broker name | THE ABACUS GROUP LLC |
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GREATER GEORGIA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97217 ) |
Policy contract number | GA7221 |
Policy instance | 2 |
Insurance contract or identification number | GA7221 | Number of Individuals Covered | 157 | Insurance policy start date | 2014-05-01 | Insurance policy end date | 2015-04-30 | 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 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $15,981 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC/ (G0385) (National Association of Insurance Commissioners NAIC id number: 54801 ) |
Policy contract number | GA7221 |
Policy instance | 1 |
Insurance contract or identification number | GA7221 | Number of Individuals Covered | 276 | Insurance policy start date | 2014-05-01 | Insurance policy end date | 2015-04-30 | 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 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $84,295 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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GREATER GEORGIA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97217 ) |
Policy contract number | GA7221 |
Policy instance | 2 |
Insurance contract or identification number | GA7221 | Number of Individuals Covered | 177 | Insurance policy start date | 2013-05-01 | Insurance policy end date | 2014-04-30 | 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 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $18,118 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC/ (G0385) (National Association of Insurance Commissioners NAIC id number: 54801 ) |
Policy contract number | GA7221 |
Policy instance | 1 |
Insurance contract or identification number | GA7221 | Number of Individuals Covered | 278 | Insurance policy start date | 2013-05-01 | Insurance policy end date | 2014-04-30 | 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 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $86,852 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 ) |
Policy contract number | GA7221 |
Policy instance | 3 |
Insurance contract or identification number | GA7221 | Number of Individuals Covered | 256 | Insurance policy start date | 2013-05-01 | Insurance policy end date | 2014-04-30 | Total amount of commissions paid to insurance broker | USD $59,145 | Total amount of fees paid to insurance company | USD $0 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Welfare Benefit Premiums Paid to Carrier | USD $1,370,676 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $59,145 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Insurance broker name | TIFFANY S DAVIS |
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BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 ) |
Policy contract number | 1044956000 |
Policy instance | 1 |
Insurance contract or identification number | 1044956000 | Number of Individuals Covered | 38 | Insurance policy start date | 2012-05-01 | Insurance policy end date | 2013-04-30 | 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 | Welfare Benefit Premiums Paid to Carrier | USD $160,244 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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GREATER GEORGIA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97217 ) |
Policy contract number | 1044956000 |
Policy instance | 3 |
Insurance contract or identification number | 1044956000 | Number of Individuals Covered | 166 | Insurance policy start date | 2012-05-01 | Insurance policy end date | 2013-04-30 | 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 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $16,240 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC/ (G0385) (National Association of Insurance Commissioners NAIC id number: 54801 ) |
Policy contract number | 1044956000 |
Policy instance | 2 |
Insurance contract or identification number | 1044956000 | Number of Individuals Covered | 265 | Insurance policy start date | 2012-05-01 | Insurance policy end date | 2013-04-30 | Total amount of commissions paid to insurance broker | USD $58,540 | 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 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,093,071 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $58,540 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Insurance broker name | TIFFANY S DAVIS |
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GREATER GEORGIA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97217 ) |
Policy contract number | 1044956000 |
Policy instance | 2 |
Insurance contract or identification number | 1044956000 | Number of Individuals Covered | 166 | Insurance policy start date | 2011-05-01 | Insurance policy end date | 2012-04-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $16,494 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC/ (G0385) (National Association of Insurance Commissioners NAIC id number: 54801 ) |
Policy contract number | 1044956000 |
Policy instance | 1 |
Insurance contract or identification number | 1044956000 | Number of Individuals Covered | 275 | Insurance policy start date | 2011-05-01 | Insurance policy end date | 2012-04-30 | Total amount of commissions paid to insurance broker | USD $59,016 | Total amount of fees paid to insurance company | USD $1,170 | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $994,054 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $59,016 | Amount paid for insurance broker fees | 1170 | Additional information about fees paid to insurance broker | OTHER FEES | Insurance broker organization code? | 3 | Insurance broker name | TIFFANY DAVIS |
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BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 ) |
Policy contract number | 1044956000 |
Policy instance | 3 |
Insurance contract or identification number | 1044956000 | Number of Individuals Covered | 30 | Insurance policy start date | 2011-05-01 | Insurance policy end date | 2012-04-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Welfare Benefit Premiums Paid to Carrier | USD $156,159 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 ) |
Policy contract number | 1044956000 |
Policy instance | 3 |
Insurance contract or identification number | 1044956000 | Number of Individuals Covered | 61 | Insurance policy start date | 2010-05-01 | Insurance policy end date | 2011-04-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Welfare Benefit Premiums Paid to Carrier | USD $307,761 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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GREATER GEORGIA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97217 ) |
Policy contract number | 1044956000 |
Policy instance | 2 |
Insurance contract or identification number | 1044956000 | Number of Individuals Covered | 121 | Insurance policy start date | 2010-05-01 | Insurance policy end date | 2011-04-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $12,618 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC/ (G0385) (National Association of Insurance Commissioners NAIC id number: 54801 ) |
Policy contract number | 1044956000 |
Policy instance | 1 |
Insurance contract or identification number | 1044956000 | Number of Individuals Covered | 213 | Insurance policy start date | 2010-05-01 | Insurance policy end date | 2011-04-30 | Total amount of commissions paid to insurance broker | USD $45,814 | Total amount of fees paid to insurance company | USD $311 | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $593,346 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $45,814 | Amount paid for insurance broker fees | 311 | Additional information about fees paid to insurance broker | OTHER FEES | Insurance broker organization code? | 3 | Insurance broker name | TIFFANY DAVIS |
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BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC/ (G0385) (National Association of Insurance Commissioners NAIC id number: 54801 ) |
Policy contract number | 1044956000 |
Policy instance | 1 |
Insurance contract or identification number | 1044956000 | Number of Individuals Covered | 194 | Insurance policy start date | 2009-05-01 | Insurance policy end date | 2010-04-30 | Total amount of commissions paid to insurance broker | USD $45,941 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $945,717 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $45,941 | Amount paid for insurance broker fees | 0 | Insurance broker organization code? | 3 | Insurance broker name | TIFFANY DAVIS |
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GREATER GEORGIA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97217 ) |
Policy contract number | 1044956000 |
Policy instance | 2 |
Insurance contract or identification number | 1044956000 | Number of Individuals Covered | 102 | Insurance policy start date | 2009-05-01 | Insurance policy end date | 2010-04-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $13,685 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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