BENTON-GEORGIA, INC. has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan BENTON-GEORGIA, INC. WELFARE BENEFITS PLAN
401k plan membership statisitcs for BENTON-GEORGIA, INC. WELFARE BENEFITS PLAN
Measure | Date | Value |
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2013: BENTON-GEORGIA, INC. WELFARE BENEFITS PLAN 2013 401k membership |
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Total participants, beginning-of-year | 2013-11-01 | 310 |
Total number of active participants reported on line 7a of the Form 5500 | 2013-11-01 | 321 |
Number of retired or separated participants receiving benefits | 2013-11-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2013-11-01 | 0 |
Total of all active and inactive participants | 2013-11-01 | 321 |
2012: BENTON-GEORGIA, INC. WELFARE BENEFITS PLAN 2012 401k membership |
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Total participants, beginning-of-year | 2012-11-01 | 358 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-11-01 | 310 |
Number of retired or separated participants receiving benefits | 2012-11-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2012-11-01 | 0 |
Total of all active and inactive participants | 2012-11-01 | 310 |
2011: BENTON-GEORGIA, INC. WELFARE BENEFITS PLAN 2011 401k membership |
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Total participants, beginning-of-year | 2011-11-01 | 358 |
Total number of active participants reported on line 7a of the Form 5500 | 2011-11-01 | 358 |
Number of retired or separated participants receiving benefits | 2011-11-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2011-11-01 | 0 |
Total of all active and inactive participants | 2011-11-01 | 358 |
2010: BENTON-GEORGIA, INC. WELFARE BENEFITS PLAN 2010 401k membership |
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Total participants, beginning-of-year | 2010-11-01 | 250 |
Total number of active participants reported on line 7a of the Form 5500 | 2010-11-01 | 250 |
Number of retired or separated participants receiving benefits | 2010-11-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2010-11-01 | 0 |
Total of all active and inactive participants | 2010-11-01 | 250 |
2009: BENTON-GEORGIA, INC. WELFARE BENEFITS PLAN 2009 401k membership |
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Total participants, beginning-of-year | 2009-11-01 | 217 |
Total number of active participants reported on line 7a of the Form 5500 | 2009-11-01 | 217 |
Number of retired or separated participants receiving benefits | 2009-11-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2009-11-01 | 0 |
Total of all active and inactive participants | 2009-11-01 | 217 |
2008: BENTON-GEORGIA, INC. WELFARE BENEFITS PLAN 2008 401k membership |
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Total participants, beginning-of-year | 2008-11-01 | 460 |
Total number of active participants reported on line 7a of the Form 5500 | 2008-11-01 | 460 |
Number of retired or separated participants receiving benefits | 2008-11-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2008-11-01 | 0 |
Total of all active and inactive participants | 2008-11-01 | 460 |
2007: BENTON-GEORGIA, INC. WELFARE BENEFITS PLAN 2007 401k membership |
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Total participants, beginning-of-year | 2007-11-01 | 436 |
Total number of active participants reported on line 7a of the Form 5500 | 2007-11-01 | 436 |
Number of retired or separated participants receiving benefits | 2007-11-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2007-11-01 | 0 |
Total of all active and inactive participants | 2007-11-01 | 436 |
2006: BENTON-GEORGIA, INC. WELFARE BENEFITS PLAN 2006 401k membership |
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Total participants, beginning-of-year | 2006-11-01 | 485 |
Total number of active participants reported on line 7a of the Form 5500 | 2006-11-01 | 485 |
Number of retired or separated participants receiving benefits | 2006-11-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2006-11-01 | 0 |
Total of all active and inactive participants | 2006-11-01 | 485 |
2005: BENTON-GEORGIA, INC. WELFARE BENEFITS PLAN 2005 401k membership |
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Total participants, beginning-of-year | 2005-11-01 | 273 |
Total number of active participants reported on line 7a of the Form 5500 | 2005-11-01 | 273 |
Number of retired or separated participants receiving benefits | 2005-11-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2005-11-01 | 0 |
Total of all active and inactive participants | 2005-11-01 | 273 |
2004: BENTON-GEORGIA, INC. WELFARE BENEFITS PLAN 2004 401k membership |
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Total participants, beginning-of-year | 2004-11-01 | 189 |
Total number of active participants reported on line 7a of the Form 5500 | 2004-11-01 | 273 |
Number of retired or separated participants receiving benefits | 2004-11-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2004-11-01 | 0 |
Total of all active and inactive participants | 2004-11-01 | 273 |
2003: BENTON-GEORGIA, INC. WELFARE BENEFITS PLAN 2003 401k membership |
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Total participants, beginning-of-year | 2003-11-01 | 189 |
Total number of active participants reported on line 7a of the Form 5500 | 2003-11-01 | 189 |
Number of retired or separated participants receiving benefits | 2003-11-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2003-11-01 | 0 |
Total of all active and inactive participants | 2003-11-01 | 189 |
2013: BENTON-GEORGIA, INC. WELFARE BENEFITS PLAN 2013 form 5500 responses |
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2013-11-01 | Type of plan entity | Single employer plan |
2013-11-01 | Submission has been amended | No |
2013-11-01 | This submission is the final filing | No |
2013-11-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
2013-11-01 | Plan is a collectively bargained plan | No |
2013-11-01 | Plan funding arrangement – Insurance | Yes |
2013-11-01 | Plan benefit arrangement – Insurance | Yes |
2012: BENTON-GEORGIA, INC. WELFARE BENEFITS PLAN 2012 form 5500 responses |
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2012-11-01 | Type of plan entity | Single employer plan |
2012-11-01 | Submission has been amended | No |
2012-11-01 | This submission is the final filing | No |
2012-11-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2012-11-01 | Plan is a collectively bargained plan | No |
2012-11-01 | Plan funding arrangement – Insurance | Yes |
2012-11-01 | Plan benefit arrangement – Insurance | Yes |
2011: BENTON-GEORGIA, INC. WELFARE BENEFITS PLAN 2011 form 5500 responses |
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2011-11-01 | Type of plan entity | Single employer plan |
2011-11-01 | Submission has been amended | No |
2011-11-01 | This submission is the final filing | No |
2011-11-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2011-11-01 | Plan is a collectively bargained plan | No |
2011-11-01 | Plan funding arrangement – Insurance | Yes |
2011-11-01 | Plan benefit arrangement – Insurance | Yes |
2010: BENTON-GEORGIA, INC. WELFARE BENEFITS PLAN 2010 form 5500 responses |
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2010-11-01 | Type of plan entity | Single employer plan |
2010-11-01 | Submission has been amended | No |
2010-11-01 | This submission is the final filing | No |
2010-11-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2010-11-01 | Plan is a collectively bargained plan | No |
2010-11-01 | Plan funding arrangement – Insurance | Yes |
2010-11-01 | Plan benefit arrangement – Insurance | Yes |
2009: BENTON-GEORGIA, INC. WELFARE BENEFITS PLAN 2009 form 5500 responses |
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2009-11-01 | Type of plan entity | Single employer plan |
2009-11-01 | Submission has been amended | No |
2009-11-01 | This submission is the final filing | No |
2009-11-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2009-11-01 | Plan is a collectively bargained plan | No |
2009-11-01 | Plan funding arrangement – Insurance | Yes |
2009-11-01 | Plan benefit arrangement – Insurance | Yes |
2008: BENTON-GEORGIA, INC. WELFARE BENEFITS PLAN 2008 form 5500 responses |
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2008-11-01 | Type of plan entity | Single employer plan |
2008-11-01 | Submission has been amended | No |
2008-11-01 | This submission is the final filing | No |
2008-11-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2008-11-01 | Plan is a collectively bargained plan | No |
2008-11-01 | Plan funding arrangement – Insurance | Yes |
2008-11-01 | Plan benefit arrangement – Insurance | Yes |
2007: BENTON-GEORGIA, INC. WELFARE BENEFITS PLAN 2007 form 5500 responses |
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2007-11-01 | Type of plan entity | Single employer plan |
2007-11-01 | Submission has been amended | No |
2007-11-01 | This submission is the final filing | No |
2007-11-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2007-11-01 | Plan is a collectively bargained plan | No |
2007-11-01 | Plan funding arrangement – Insurance | Yes |
2007-11-01 | Plan benefit arrangement – Insurance | Yes |
2006: BENTON-GEORGIA, INC. WELFARE BENEFITS PLAN 2006 form 5500 responses |
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2006-11-01 | Type of plan entity | Single employer plan |
2006-11-01 | Submission has been amended | No |
2006-11-01 | This submission is the final filing | No |
2006-11-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2006-11-01 | Plan is a collectively bargained plan | No |
2006-11-01 | Plan funding arrangement – Insurance | Yes |
2006-11-01 | Plan benefit arrangement – Insurance | Yes |
2005: BENTON-GEORGIA, INC. WELFARE BENEFITS PLAN 2005 form 5500 responses |
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2005-11-01 | Type of plan entity | Single employer plan |
2005-11-01 | Submission has been amended | No |
2005-11-01 | This submission is the final filing | No |
2005-11-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2005-11-01 | Plan is a collectively bargained plan | No |
2005-11-01 | Plan funding arrangement – Insurance | Yes |
2005-11-01 | Plan benefit arrangement – Insurance | Yes |
2004: BENTON-GEORGIA, INC. WELFARE BENEFITS PLAN 2004 form 5500 responses |
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2004-11-01 | Type of plan entity | Single employer plan |
2004-11-01 | Submission has been amended | No |
2004-11-01 | This submission is the final filing | No |
2004-11-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2004-11-01 | Plan is a collectively bargained plan | No |
2004-11-01 | Plan funding arrangement – Insurance | Yes |
2004-11-01 | Plan benefit arrangement – Insurance | Yes |
2003: BENTON-GEORGIA, INC. WELFARE BENEFITS PLAN 2003 form 5500 responses |
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2003-11-01 | Type of plan entity | Single employer plan |
2003-11-01 | First time form 5500 has been submitted | Yes |
2003-11-01 | Submission has been amended | No |
2003-11-01 | This submission is the final filing | No |
2003-11-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2003-11-01 | Plan is a collectively bargained plan | No |
2003-11-01 | Plan funding arrangement – Insurance | Yes |
2003-11-01 | Plan benefit arrangement – Insurance | Yes |
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | TM05995408 |
Policy instance | 2 |
Insurance contract or identification number | TM05995408 | Number of Individuals Covered | 1006 | Insurance policy start date | 2013-11-01 | Insurance policy end date | 2013-11-30 | Total amount of commissions paid to insurance broker | USD $253 | Total amount of fees paid to insurance company | USD $2,533 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $12,726 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $253 | Amount paid for insurance broker fees | 2533 | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | BB&T INSURANCE SERVICES INC |
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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 | 1043514000 |
Policy instance | 1 |
Insurance contract or identification number | 1043514000 | Number of Individuals Covered | 607 | Insurance policy start date | 2013-11-01 | Insurance policy end date | 2013-11-30 | Total amount of commissions paid to insurance broker | USD $7,295 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $64,920 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $7,295 | Insurance broker organization code? | 3 | Insurance broker name | BB&T INSURANCE SERVICE |
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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 | 1043514000 |
Policy instance | 1 |
Insurance contract or identification number | 1043514000 | Number of Individuals Covered | 568 | Insurance policy start date | 2012-11-01 | Insurance policy end date | 2013-10-31 | Total amount of commissions paid to insurance broker | USD $75,539 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $2,155,915 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $75,539 | Insurance broker organization code? | 3 | Insurance broker name | BB&T INSURANCE SERVICE |
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METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
Policy contract number | TM05995408 |
Policy instance | 2 |
Insurance contract or identification number | TM05995408 | Number of Individuals Covered | 984 | Insurance policy start date | 2012-11-01 | Insurance policy end date | 2013-10-31 | Total amount of commissions paid to insurance broker | USD $3,920 | Total amount of fees paid to insurance company | USD $7,459 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $142,738 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,920 | Amount paid for insurance broker fees | 7459 | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | BB&T INSURANCE SERVICES INC |
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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 | 1043514000 |
Policy instance | 1 |
Insurance contract or identification number | 1043514000 | Number of Individuals Covered | 638 | Insurance policy start date | 2011-11-01 | Insurance policy end date | 2012-10-31 | Total amount of commissions paid to insurance broker | USD $81,908 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $2,093,533 | 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 | 1043514000 |
Policy instance | 1 |
Insurance contract or identification number | 1043514000 | Number of Individuals Covered | 432 | Insurance policy start date | 2010-11-01 | Insurance policy end date | 2011-10-31 | Total amount of commissions paid to insurance broker | USD $60,469 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $1,233,996 | 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 | 1043514000 |
Policy instance | 1 |
Insurance contract or identification number | 1043514000 | Number of Individuals Covered | 694 | Insurance policy start date | 2008-11-01 | Insurance policy end date | 2009-10-31 | Total amount of commissions paid to insurance broker | USD $41,460 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $41,460 | Insurance broker organization code? | 3 | Insurance broker name | BB&T INSURANCE SERVICE |
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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 | 1043514000 |
Policy instance | 1 |
Insurance contract or identification number | 1043514000 | Number of Individuals Covered | 660 | Insurance policy start date | 2007-11-01 | Insurance policy end date | 2008-10-31 | Total amount of commissions paid to insurance broker | USD $37,606 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | 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 $37,606 | Insurance broker organization code? | 3 | Insurance broker name | BB&T INSURANCE SERVICE |
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 376175/387744 |
Policy instance | 1 |
Insurance contract or identification number | 376175/387744 | Number of Individuals Covered | 485 | Insurance policy start date | 2006-11-01 | Insurance policy end date | 2007-10-31 | Total amount of commissions paid to insurance broker | USD $83,730 | Total amount of fees paid to insurance company | USD $12,920 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $1,872,873 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $83,730 | Amount paid for insurance broker fees | 12920 | Additional information about fees paid to insurance broker | ADDITIONAL BROKER COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | BB&T INSURANCE SERVICE |
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 376175/387744 |
Policy instance | 1 |
Insurance contract or identification number | 376175/387744 | Number of Individuals Covered | 273 | Insurance policy start date | 2005-11-01 | Insurance policy end date | 2006-10-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | 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? | Yes | Commission paid to Insurance Broker | USD $0 | Insurance broker organization code? | 3 | Insurance broker name | BB&T INSURANCE SERVICE |
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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 | 1024210000 |
Policy instance | 1 |
Insurance contract or identification number | 1024210000 | Number of Individuals Covered | 543 | Insurance policy start date | 2004-11-01 | Insurance policy end date | 2005-10-31 | Total amount of commissions paid to insurance broker | USD $432,791 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | 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 $432,791 | Insurance broker organization code? | 3 | Insurance broker name | BB&T INSURANCE SERVICE |
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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 | 1024210000 |
Policy instance | 1 |
Insurance contract or identification number | 1024210000 | Number of Individuals Covered | 389 | Insurance policy start date | 2003-11-01 | Insurance policy end date | 2004-10-31 | Total amount of commissions paid to insurance broker | USD $51,125 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | 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 $51,125 | Insurance broker organization code? | 3 | Insurance broker name | BB&T INSURANCE SERVICE |
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