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MARKETING ALLIANCE GROUP WELFARE BENEFIT PLAN - HEALTH & VISION 401k Plan overview

Plan NameMARKETING ALLIANCE GROUP WELFARE BENEFIT PLAN - HEALTH & VISION
Plan identification number 501

MARKETING ALLIANCE GROUP WELFARE BENEFIT PLAN - HEALTH & VISION Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover

401k Sponsoring company profile

MARKETING ALLIANCE GROUP, INC. has sponsored the creation of one or more 401k plans.

Company Name:MARKETING ALLIANCE GROUP, INC.
Employer identification number (EIN):582369193
NAIC Classification:314000
NAIC Description: Textile Product Mills

Additional information about MARKETING ALLIANCE GROUP, INC.

Jurisdiction of Incorporation: Florida Department of State Division of Corporations
Incorporation Date: 2002-03-06
Company Identification Number: P02000024954
Legal Registered Office Address: 9801 SW 2ND STREET

PLANTATION

33324

More information about MARKETING ALLIANCE GROUP, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MARKETING ALLIANCE GROUP WELFARE BENEFIT PLAN - HEALTH & VISION

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-05-01
5012021-05-01
5012021-05-01
5012020-05-01
5012019-05-01
5012018-05-01
5012017-05-01BRYAN HAIR BRYAN HAIR2018-11-30
5012016-05-01BRYAN HAIR BRYAN HAIR2017-10-12
5012016-05-01 BRYAN HAIR2017-08-30
5012015-05-01BRYAN HAIR BRYAN HAIR2016-11-30
5012014-05-01BRYAN HAIR BRYAN HAIR2016-08-24
5012013-05-01BRYAN HAIR BRYAN HAIR2016-08-24
5012012-05-01BRYAN HAIR BRYAN HAIR2016-08-24
5012011-05-01BRYAN HAIR BRYAN HAIR2016-09-02
5012009-02-01BRYAN HAIR

Plan Statistics for MARKETING ALLIANCE GROUP WELFARE BENEFIT PLAN - HEALTH & VISION

401k plan membership statisitcs for MARKETING ALLIANCE GROUP WELFARE BENEFIT PLAN - HEALTH & VISION

Measure Date Value
2022: MARKETING ALLIANCE GROUP WELFARE BENEFIT PLAN - HEALTH & VISION 2022 401k membership
Total participants, beginning-of-year2022-05-011,033
Total number of active participants reported on line 7a of the Form 55002022-05-011,041
Number of retired or separated participants receiving benefits2022-05-010
Number of other retired or separated participants entitled to future benefits2022-05-014
Total of all active and inactive participants2022-05-011,045
2021: MARKETING ALLIANCE GROUP WELFARE BENEFIT PLAN - HEALTH & VISION 2021 401k membership
Total participants, beginning-of-year2021-05-01818
Total number of active participants reported on line 7a of the Form 55002021-05-01811
Number of retired or separated participants receiving benefits2021-05-010
Number of other retired or separated participants entitled to future benefits2021-05-010
Total of all active and inactive participants2021-05-01811
2020: MARKETING ALLIANCE GROUP WELFARE BENEFIT PLAN - HEALTH & VISION 2020 401k membership
Total participants, beginning-of-year2020-05-01971
Total number of active participants reported on line 7a of the Form 55002020-05-01818
Number of retired or separated participants receiving benefits2020-05-010
Number of other retired or separated participants entitled to future benefits2020-05-010
Total of all active and inactive participants2020-05-01818
2019: MARKETING ALLIANCE GROUP WELFARE BENEFIT PLAN - HEALTH & VISION 2019 401k membership
Total participants, beginning-of-year2019-05-01602
Total number of active participants reported on line 7a of the Form 55002019-05-01971
Number of retired or separated participants receiving benefits2019-05-010
Number of other retired or separated participants entitled to future benefits2019-05-010
Total of all active and inactive participants2019-05-01971
2018: MARKETING ALLIANCE GROUP WELFARE BENEFIT PLAN - HEALTH & VISION 2018 401k membership
Total participants, beginning-of-year2018-05-01585
Total number of active participants reported on line 7a of the Form 55002018-05-01602
Number of retired or separated participants receiving benefits2018-05-010
Number of other retired or separated participants entitled to future benefits2018-05-010
Total of all active and inactive participants2018-05-01602
2017: MARKETING ALLIANCE GROUP WELFARE BENEFIT PLAN - HEALTH & VISION 2017 401k membership
Total participants, beginning-of-year2017-05-01557
Total number of active participants reported on line 7a of the Form 55002017-05-01585
Number of retired or separated participants receiving benefits2017-05-010
Number of other retired or separated participants entitled to future benefits2017-05-010
Total of all active and inactive participants2017-05-01585
2016: MARKETING ALLIANCE GROUP WELFARE BENEFIT PLAN - HEALTH & VISION 2016 401k membership
Total participants, beginning-of-year2016-05-01569
Total number of active participants reported on line 7a of the Form 55002016-05-01557
Number of retired or separated participants receiving benefits2016-05-010
Number of other retired or separated participants entitled to future benefits2016-05-010
Total of all active and inactive participants2016-05-01557
2015: MARKETING ALLIANCE GROUP WELFARE BENEFIT PLAN - HEALTH & VISION 2015 401k membership
Total participants, beginning-of-year2015-05-010
Total number of active participants reported on line 7a of the Form 55002015-05-010
Number of retired or separated participants receiving benefits2015-05-010
Number of other retired or separated participants entitled to future benefits2015-05-010
Total of all active and inactive participants2015-05-010
2014: MARKETING ALLIANCE GROUP WELFARE BENEFIT PLAN - HEALTH & VISION 2014 401k membership
Total participants, beginning-of-year2014-05-010
Total number of active participants reported on line 7a of the Form 55002014-05-010
Number of retired or separated participants receiving benefits2014-05-010
Number of other retired or separated participants entitled to future benefits2014-05-010
Total of all active and inactive participants2014-05-010
2013: MARKETING ALLIANCE GROUP WELFARE BENEFIT PLAN - HEALTH & VISION 2013 401k membership
Total participants, beginning-of-year2013-05-01690
Total number of active participants reported on line 7a of the Form 55002013-05-01550
Total of all active and inactive participants2013-05-01550
2012: MARKETING ALLIANCE GROUP WELFARE BENEFIT PLAN - HEALTH & VISION 2012 401k membership
Total participants, beginning-of-year2012-05-01690
Total of all active and inactive participants2012-05-010
2011: MARKETING ALLIANCE GROUP WELFARE BENEFIT PLAN - HEALTH & VISION 2011 401k membership
Total participants, beginning-of-year2011-05-010
Total number of active participants reported on line 7a of the Form 55002011-05-01690
Number of retired or separated participants receiving benefits2011-05-010
Number of other retired or separated participants entitled to future benefits2011-05-010
Total of all active and inactive participants2011-05-01690
2009: MARKETING ALLIANCE GROUP WELFARE BENEFIT PLAN - HEALTH & VISION 2009 401k membership
Total participants, beginning-of-year2009-02-01295
Total number of active participants reported on line 7a of the Form 55002009-02-01281
Number of retired or separated participants receiving benefits2009-02-011
Number of other retired or separated participants entitled to future benefits2009-02-010
Total of all active and inactive participants2009-02-01282
Total participants2009-02-01282

Financial Data on MARKETING ALLIANCE GROUP WELFARE BENEFIT PLAN - HEALTH & VISION

Measure Date Value
2022 : MARKETING ALLIANCE GROUP WELFARE BENEFIT PLAN - HEALTH & VISION 2022 401k financial data
Total income from all sources2022-04-30$0
Expenses. Total of all expenses incurred2022-04-30$0
Total plan assets at end of year2022-04-30$0
Total plan assets at beginning of year2022-04-30$0
Net income (gross income less expenses)2022-04-30$0
Net plan assets at end of year (total assets less liabilities)2022-04-30$0
Net plan assets at beginning of year (total assets less liabilities)2022-04-30$0
2021 : MARKETING ALLIANCE GROUP WELFARE BENEFIT PLAN - HEALTH & VISION 2021 401k financial data
Total income from all sources2021-04-30$0
Total plan assets at end of year2021-04-30$0
Total plan assets at beginning of year2021-04-30$0
Net plan assets at end of year (total assets less liabilities)2021-04-30$0
Net plan assets at beginning of year (total assets less liabilities)2021-04-30$0
2020 : MARKETING ALLIANCE GROUP WELFARE BENEFIT PLAN - HEALTH & VISION 2020 401k financial data
Total income from all sources2020-04-30$0
Total plan assets at end of year2020-04-30$0
Total plan assets at beginning of year2020-04-30$0
Net plan assets at end of year (total assets less liabilities)2020-04-30$0
Net plan assets at beginning of year (total assets less liabilities)2020-04-30$0
2018 : MARKETING ALLIANCE GROUP WELFARE BENEFIT PLAN - HEALTH & VISION 2018 401k financial data
Total income from all sources2018-04-30$0
Total plan assets at end of year2018-04-30$0
Total plan assets at beginning of year2018-04-30$0
Net plan assets at end of year (total assets less liabilities)2018-04-30$0
Net plan assets at beginning of year (total assets less liabilities)2018-04-30$0
2017 : MARKETING ALLIANCE GROUP WELFARE BENEFIT PLAN - HEALTH & VISION 2017 401k financial data
Total income from all sources2017-04-30$0
Total plan assets at end of year2017-04-30$0
Total plan assets at beginning of year2017-04-30$0
Net plan assets at end of year (total assets less liabilities)2017-04-30$0
Net plan assets at beginning of year (total assets less liabilities)2017-04-30$0
2016 : MARKETING ALLIANCE GROUP WELFARE BENEFIT PLAN - HEALTH & VISION 2016 401k financial data
Total income from all sources2016-04-30$0
Total plan assets at end of year2016-04-30$0
Total plan assets at beginning of year2016-04-30$0
Net plan assets at end of year (total assets less liabilities)2016-04-30$0
Net plan assets at beginning of year (total assets less liabilities)2016-04-30$0
2015 : MARKETING ALLIANCE GROUP WELFARE BENEFIT PLAN - HEALTH & VISION 2015 401k financial data
Total income from all sources2015-04-30$0
Total plan assets at end of year2015-04-30$0
Total plan assets at beginning of year2015-04-30$0
Net plan assets at end of year (total assets less liabilities)2015-04-30$0
Net plan assets at beginning of year (total assets less liabilities)2015-04-30$0
2014 : MARKETING ALLIANCE GROUP WELFARE BENEFIT PLAN - HEALTH & VISION 2014 401k financial data
Total income from all sources2014-04-30$0
Total plan assets at end of year2014-04-30$0
Total plan assets at beginning of year2014-04-30$0
Net plan assets at end of year (total assets less liabilities)2014-04-30$0
Net plan assets at beginning of year (total assets less liabilities)2014-04-30$0
2013 : MARKETING ALLIANCE GROUP WELFARE BENEFIT PLAN - HEALTH & VISION 2013 401k financial data
Total income from all sources2013-04-30$0
Total plan assets at end of year2013-04-30$0
Total plan assets at beginning of year2013-04-30$0
Net plan assets at end of year (total assets less liabilities)2013-04-30$0
Net plan assets at beginning of year (total assets less liabilities)2013-04-30$0
2012 : MARKETING ALLIANCE GROUP WELFARE BENEFIT PLAN - HEALTH & VISION 2012 401k financial data
Total income from all sources2012-04-30$0
Total plan assets at end of year2012-04-30$0
Total plan assets at beginning of year2012-04-30$0
Net plan assets at end of year (total assets less liabilities)2012-04-30$0
Net plan assets at beginning of year (total assets less liabilities)2012-04-30$0

Form 5500 Responses for MARKETING ALLIANCE GROUP WELFARE BENEFIT PLAN - HEALTH & VISION

2022: MARKETING ALLIANCE GROUP WELFARE BENEFIT PLAN - HEALTH & VISION 2022 form 5500 responses
2022-05-01Type of plan entitySingle employer plan
2022-05-01Submission has been amendedYes
2022-05-01This submission is the final filingNo
2022-05-01This return/report is a short plan year return/report (less than 12 months)No
2022-05-01Plan is a collectively bargained planNo
2022-05-01Plan funding arrangement – InsuranceYes
2022-05-01Plan funding arrangement – General assets of the sponsorYes
2022-05-01Plan benefit arrangement – InsuranceYes
2022-05-01Plan benefit arrangement – General assets of the sponsorYes
2021: MARKETING ALLIANCE GROUP WELFARE BENEFIT PLAN - HEALTH & VISION 2021 form 5500 responses
2021-05-01Type of plan entityMulti-employer plan
2021-05-01Submission has been amendedYes
2021-05-01This submission is the final filingNo
2021-05-01This return/report is a short plan year return/report (less than 12 months)No
2021-05-01Plan is a collectively bargained planYes
2021-05-01Plan funding arrangement – InsuranceYes
2021-05-01Plan funding arrangement – General assets of the sponsorYes
2021-05-01Plan benefit arrangement – InsuranceYes
2021-05-01Plan benefit arrangement – General assets of the sponsorYes
2020: MARKETING ALLIANCE GROUP WELFARE BENEFIT PLAN - HEALTH & VISION 2020 form 5500 responses
2020-05-01Type of plan entityMulti-employer plan
2020-05-01Plan is a collectively bargained planYes
2020-05-01Plan funding arrangement – General assets of the sponsorYes
2020-05-01Plan benefit arrangement – InsuranceYes
2019: MARKETING ALLIANCE GROUP WELFARE BENEFIT PLAN - HEALTH & VISION 2019 form 5500 responses
2019-05-01Type of plan entityMulti-employer plan
2019-05-01Plan funding arrangement – General assets of the sponsorYes
2019-05-01Plan benefit arrangement – InsuranceYes
2018: MARKETING ALLIANCE GROUP WELFARE BENEFIT PLAN - HEALTH & VISION 2018 form 5500 responses
2018-05-01Type of plan entityMulti-employer plan
2018-05-01Plan funding arrangement – General assets of the sponsorYes
2018-05-01Plan benefit arrangement – InsuranceYes
2017: MARKETING ALLIANCE GROUP WELFARE BENEFIT PLAN - HEALTH & VISION 2017 form 5500 responses
2017-05-01Type of plan entityMulti-employer plan
2017-05-01Plan funding arrangement – General assets of the sponsorYes
2017-05-01Plan benefit arrangement – InsuranceYes
2016: MARKETING ALLIANCE GROUP WELFARE BENEFIT PLAN - HEALTH & VISION 2016 form 5500 responses
2016-05-01Type of plan entityMulti-employer plan
2016-05-01Submission has been amendedYes
2016-05-01Plan funding arrangement – General assets of the sponsorYes
2016-05-01Plan benefit arrangement – InsuranceYes
2015: MARKETING ALLIANCE GROUP WELFARE BENEFIT PLAN - HEALTH & VISION 2015 form 5500 responses
2015-05-01Type of plan entityMulti-employer plan
2015-05-01Plan funding arrangement – General assets of the sponsorYes
2015-05-01Plan benefit arrangement – InsuranceYes
2014: MARKETING ALLIANCE GROUP WELFARE BENEFIT PLAN - HEALTH & VISION 2014 form 5500 responses
2014-05-01Type of plan entityMulti-employer plan
2014-05-01Plan funding arrangement – General assets of the sponsorYes
2014-05-01Plan benefit arrangement – InsuranceYes
2013: MARKETING ALLIANCE GROUP WELFARE BENEFIT PLAN - HEALTH & VISION 2013 form 5500 responses
2013-05-01Type of plan entityMulti-employer plan
2013-05-01Plan funding arrangement – General assets of the sponsorYes
2013-05-01Plan benefit arrangement – InsuranceYes
2012: MARKETING ALLIANCE GROUP WELFARE BENEFIT PLAN - HEALTH & VISION 2012 form 5500 responses
2012-05-01Type of plan entityMulti-employer plan
2012-05-01Plan funding arrangement – General assets of the sponsorYes
2012-05-01Plan benefit arrangement – InsuranceYes
2011: MARKETING ALLIANCE GROUP WELFARE BENEFIT PLAN - HEALTH & VISION 2011 form 5500 responses
2011-05-01Type of plan entityMulti-employer plan
2011-05-01First time form 5500 has been submittedYes
2011-05-01Plan funding arrangement – General assets of the sponsorYes
2011-05-01Plan benefit arrangement – InsuranceYes
2009: MARKETING ALLIANCE GROUP WELFARE BENEFIT PLAN - HEALTH & VISION 2009 form 5500 responses
2009-02-01Type of plan entitySingle employer plan
2009-02-01Submission has been amendedNo
2009-02-01This submission is the final filingNo
2009-02-01This return/report is a short plan year return/report (less than 12 months)No
2009-02-01Plan is a collectively bargained planNo
2009-02-01Plan funding arrangement – InsuranceYes
2009-02-01Plan funding arrangement – General assets of the sponsorYes
2009-02-01Plan benefit arrangement – InsuranceYes
2009-02-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3343578
Policy instance 4
Insurance contract or identification number3343578
Number of Individuals Covered782
Insurance policy start date2022-05-01
Insurance policy end date2023-04-30
Total amount of commissions paid to insurance brokerUSD $230,541
Total amount of fees paid to insurance companyUSD $7,920
Are there contracts with allocated funds for individual policies?0
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM, ACCIDENT, CRITICAL ILLNESS
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 CarrierUSD $1,139,727
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $230,541
Amount paid for insurance broker fees7920
Additional information about fees paid to insurance brokerSERVICE/GEN.AGENT FEES
Insurance broker organization code?3
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number74870
Policy instance 3
Insurance contract or identification number74870
Number of Individuals Covered15
Insurance policy start date2022-05-01
Insurance policy end date2023-04-30
Total amount of commissions paid to insurance brokerUSD $768
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedCANCER
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 CarrierUSD $5,243
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $768
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00351493
Policy instance 2
Insurance contract or identification number00351493
Number of Individuals Covered538
Insurance policy start date2022-05-01
Insurance policy end date2023-04-30
Total amount of commissions paid to insurance brokerUSD $53,958
Total amount of fees paid to insurance companyUSD $8,354
Are there contracts with allocated funds for individual policies?0
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, CANCER
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 CarrierUSD $317,675
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $44,428
Insurance broker organization code?3
Amount paid for insurance broker fees8354
Additional information about fees paid to insurance brokerFEES PAID
BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 )
Policy contract numberGA8652
Policy instance 1
Insurance contract or identification numberGA8652
Number of Individuals Covered1458
Insurance policy start date2022-05-01
Insurance policy end date2023-04-30
Total amount of commissions paid to insurance brokerUSD $6,601
Total amount of fees paid to insurance companyUSD $404
Are there contracts with allocated funds for individual policies?0
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $55,017
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $6,601
Amount paid for insurance broker fees404
Additional information about fees paid to insurance brokerFEES PAID
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 )
Policy contract numberGA8652
Policy instance 1
Insurance contract or identification numberGA8652
Number of Individuals Covered852
Insurance policy start date2021-05-01
Insurance policy end date2022-04-30
Total amount of commissions paid to insurance brokerUSD $6,368
Total amount of fees paid to insurance companyUSD $470
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $53,052
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,368
Amount paid for insurance broker fees470
Insurance broker organization code?3
Are there contracts with allocated funds for individual policies?0
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Additional information about fees paid to insurance brokerFEES PAID
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00351493
Policy instance 2
Insurance contract or identification number00351493
Number of Individuals Covered512
Insurance policy start date2021-05-01
Insurance policy end date2022-04-30
Total amount of commissions paid to insurance brokerUSD $46,751
Total amount of fees paid to insurance companyUSD $11,581
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedOTHER - CANCER
Welfare Benefit Premiums Paid to CarrierUSD $275,688
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $38,480
Insurance broker organization code?3
Amount paid for insurance broker fees11581
Are there contracts with allocated funds for individual policies?0
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Additional information about fees paid to insurance brokerFEES PAID
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number74870
Policy instance 3
Insurance contract or identification number74870
Number of Individuals Covered15
Insurance policy start date2021-05-01
Insurance policy end date2022-04-30
Total amount of commissions paid to insurance brokerUSD $847
Other welfare benefits providedCANCER
Welfare Benefit Premiums Paid to CarrierUSD $5,788
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $847
Insurance broker organization code?3
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3343578
Policy instance 4
Insurance contract or identification number3343578
Number of Individuals Covered811
Insurance policy start date2021-05-01
Insurance policy end date2022-04-30
Total amount of commissions paid to insurance brokerUSD $409,160
Total amount of fees paid to insurance companyUSD $37,177
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,007,484
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $409,160
Amount paid for insurance broker fees37177
Insurance broker organization code?3
Are there contracts with allocated funds for individual policies?0
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM, ACCIDENT, CRITICAL ILLNESS
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Additional information about fees paid to insurance brokerFEES PAID
BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 )
Policy contract numberGA8652
Policy instance 1
Insurance contract or identification numberGA8652
Number of Individuals Covered818
Insurance policy start date2020-05-01
Insurance policy end date2021-04-30
Total amount of commissions paid to insurance brokerUSD $25,074
Total amount of fees paid to insurance companyUSD $9,989
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $54,017
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $25,074
Amount paid for insurance broker fees9989
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00351493
Policy instance 2
Insurance contract or identification number00351493
Number of Individuals Covered519
Insurance policy start date2020-05-01
Insurance policy end date2021-04-30
Total amount of commissions paid to insurance brokerUSD $69,146
Total amount of fees paid to insurance companyUSD $7,202
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedOTHER - CANCER
Welfare Benefit Premiums Paid to CarrierUSD $384,970
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $55,307
Insurance broker organization code?3
Amount paid for insurance broker fees7202
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number74870
Policy instance 3
Insurance contract or identification number74870
Number of Individuals Covered18
Insurance policy start date2020-05-01
Insurance policy end date2021-04-30
Total amount of commissions paid to insurance brokerUSD $1,162
Other welfare benefits providedCANCER
Welfare Benefit Premiums Paid to CarrierUSD $7,992
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,162
Insurance broker organization code?3
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3343578
Policy instance 4
Insurance contract or identification number3343578
Number of Individuals Covered802
Insurance policy start date2020-05-01
Insurance policy end date2021-04-30
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $970,507
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
GREATER GEORGIA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97217 )
Policy contract numberGA2915
Policy instance 2
Insurance contract or identification numberGA2915
Number of Individuals Covered579
Insurance policy start date2019-05-01
Insurance policy end date2020-04-30
Total amount of commissions paid to insurance brokerUSD $42,098
Total amount of fees paid to insurance companyUSD $11,438
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $324,490
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $42,098
Amount paid for insurance broker fees11438
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00351493
Policy instance 3
Insurance contract or identification number00351493
Number of Individuals Covered41
Insurance policy start date2019-05-01
Insurance policy end date2020-04-30
Total amount of commissions paid to insurance brokerUSD $5,093
Total amount of fees paid to insurance companyUSD $1,784
Other welfare benefits providedOTHER - CANCER
Welfare Benefit Premiums Paid to CarrierUSD $31,377
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,362
Amount paid for insurance broker fees1784
Insurance broker organization code?3
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract number74870
Policy instance 4
Insurance contract or identification number74870
Number of Individuals Covered23
Insurance policy start date2019-05-01
Insurance policy end date2020-04-30
Total amount of commissions paid to insurance brokerUSD $1,760
Other welfare benefits providedCANCER
Welfare Benefit Premiums Paid to CarrierUSD $11,932
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,760
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 )
Policy contract numberGA8652
Policy instance 1
Insurance contract or identification numberGA8652
Number of Individuals Covered602
Insurance policy start date2019-05-01
Insurance policy end date2020-04-30
Total amount of commissions paid to insurance brokerUSD $285,151
Total amount of fees paid to insurance companyUSD $297
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,693,044
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $285,151
Amount paid for insurance broker fees297
Insurance broker organization code?3
GREATER GEORGIA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97217 )
Policy contract numberGA2915
Policy instance 2
Insurance contract or identification numberGA2915
Number of Individuals Covered579
Insurance policy start date2018-05-01
Insurance policy end date2019-04-30
Total amount of commissions paid to insurance brokerUSD $50,876
Total amount of fees paid to insurance companyUSD $3,184
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $358,257
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $26,721
Amount paid for insurance broker fees3184
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00351493
Policy instance 3
Insurance contract or identification number00351493
Number of Individuals Covered41
Insurance policy start date2018-05-01
Insurance policy end date2019-04-30
Total amount of commissions paid to insurance brokerUSD $6,373
Total amount of fees paid to insurance companyUSD $2,497
Other welfare benefits providedOTHER - CANCER
Welfare Benefit Premiums Paid to CarrierUSD $33,700
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,442
Amount paid for insurance broker fees2497
Insurance broker organization code?3
CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 )
Policy contract number0000022806
Policy instance 4
Insurance contract or identification number0000022806
Number of Individuals Covered544
Insurance policy start date2018-05-01
Insurance policy end date2019-04-30
Total amount of commissions paid to insurance brokerUSD $26,608
Other welfare benefits providedOTHER (AFLAC/VOLUNTARY BENEFITS)
Welfare Benefit Premiums Paid to CarrierUSD $115,195
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,088
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 )
Policy contract numberGA8652
Policy instance 1
Insurance contract or identification numberGA8652
Number of Individuals Covered602
Insurance policy start date2018-05-01
Insurance policy end date2019-04-30
Total amount of commissions paid to insurance brokerUSD $258,955
Total amount of fees paid to insurance companyUSD $349
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,889,772
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $173,456
Amount paid for insurance broker fees349
Additional information about fees paid to insurance brokerACCOUNT SERVICE
Insurance broker organization code?3
CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 )
Policy contract number0000022806
Policy instance 4
Insurance contract or identification number0000022806
Number of Individuals Covered502
Insurance policy start date2017-05-01
Insurance policy end date2018-04-30
Total amount of commissions paid to insurance brokerUSD $44,763
Other welfare benefits providedOTHER (AFLAC/VOLUNTARY BENEFITS)
Welfare Benefit Premiums Paid to CarrierUSD $144,009
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17,246
Insurance broker organization code?3
Insurance broker nameANDY GLENN
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00351493
Policy instance 3
Insurance contract or identification number00351493
Number of Individuals Covered44
Insurance policy start date2017-05-01
Insurance policy end date2018-04-30
Total amount of commissions paid to insurance brokerUSD $3,836
Total amount of fees paid to insurance companyUSD $189
Other welfare benefits providedOTHER - CANCER
Welfare Benefit Premiums Paid to CarrierUSD $22,534
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,707
Insurance broker organization code?3
Amount paid for insurance broker fees189
Insurance broker namePEACHTREE PLANNING OF GEORGIA
GREATER GEORGIA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97217 )
Policy contract numberGA2915
Policy instance 2
Insurance contract or identification numberGA2915
Number of Individuals Covered579
Insurance policy start date2017-05-01
Insurance policy end date2018-04-30
Total amount of commissions paid to insurance brokerUSD $32,032
Total amount of fees paid to insurance companyUSD $8,317
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $240,993
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $32,032
Amount paid for insurance broker fees8317
Additional information about fees paid to insurance brokerACCOUNT SERVICE
Insurance broker organization code?3
Insurance broker nameADCOCK FINANCIAL GROUP
BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 )
Policy contract numberGA8652
Policy instance 1
Insurance contract or identification numberGA8652
Number of Individuals Covered585
Insurance policy start date2017-05-01
Insurance policy end date2018-04-30
Total amount of commissions paid to insurance brokerUSD $253,007
Total amount of fees paid to insurance companyUSD $8,041
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,656,087
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $187,722
Amount paid for insurance broker fees8041
Additional information about fees paid to insurance brokerACCOUNT SERVICE 3
Insurance broker organization code?3
Insurance broker nameMARSH & MCLENNAN AGENCY, LLC
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00351493
Policy instance 2
Insurance contract or identification number00351493
Number of Individuals Covered569
Insurance policy start date2015-05-01
Insurance policy end date2016-04-30
Total amount of commissions paid to insurance brokerUSD $45,094
Total amount of fees paid to insurance companyUSD $9,409
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedOTHER (SPECIFY)
Welfare Benefit Premiums Paid to CarrierUSD $504,731
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $44,952
Amount paid for insurance broker fees9409
Insurance broker nameASHFORD ADVISORS INC.
BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 )
Policy contract numberGA8652
Policy instance 1
Insurance contract or identification numberGA8652
Number of Individuals Covered560
Insurance policy start date2015-05-01
Insurance policy end date2016-04-30
Total amount of commissions paid to insurance brokerUSD $196,653
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,623,243
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $196,653
Additional information about fees paid to insurance brokerACCOUNT SERVICE 3
Insurance broker nameDON W. ADCOCK
ALLIANT HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 11256 )
Policy contract numberA13440001
Policy instance 2
Insurance contract or identification numberA13440001
Number of Individuals Covered581
Insurance policy start date2014-05-01
Insurance policy end date2015-04-30
Total amount of commissions paid to insurance brokerUSD $86,740
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,927,565
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $86,740
Additional information about fees paid to insurance brokerACCOUNT SERVICE 3
Insurance broker nameDON W. ADCOCK
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number647931
Policy instance 1
Insurance contract or identification number647931
Number of Individuals Covered366
Insurance policy start date2014-05-01
Insurance policy end date2015-04-30
Total amount of commissions paid to insurance brokerUSD $4,855
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $48,552
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,855
Additional information about fees paid to insurance broker3
Insurance broker nameADCOCK FINANCIAL GROUP
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00351493
Policy instance 3
Insurance contract or identification number00351493
Number of Individuals Covered515
Insurance policy start date2014-05-01
Insurance policy end date2015-04-30
Total amount of commissions paid to insurance brokerUSD $32,558
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedOTHER (SPECIFY)
Welfare Benefit Premiums Paid to CarrierUSD $422,835
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $32,425
Insurance broker nameASHFORD ADVISORS INC.
GREATER GEORGIA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97217 )
Policy contract numberGA2660
Policy instance 5
Insurance contract or identification numberGA2660
Number of Individuals Covered95
Insurance policy start date2014-03-01
Insurance policy end date2015-02-28
Total amount of commissions paid to insurance brokerUSD $2,649
Welfare Benefit Premiums Paid to CarrierUSD $49,962
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,649
Insurance broker nameADCOCK FINANCIAL GROUP
ALLIANT HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 11256 )
Policy contract numberA13440002
Policy instance 4
Insurance contract or identification numberA13440002
Number of Individuals Covered332
Insurance policy start date2014-05-01
Insurance policy end date2015-04-30
Total amount of commissions paid to insurance brokerUSD $43,961
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $976,902
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $43,961
Insurance broker organization code?3
Insurance broker nameADCOCK FINANCIAL GROUP
ALLIANT HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 11256 )
Policy contract numberA13440001
Policy instance 2
Insurance contract or identification numberA13440001
Number of Individuals Covered550
Insurance policy start date2013-05-01
Insurance policy end date2014-04-30
Total amount of commissions paid to insurance brokerUSD $111,571
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,479,346
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $111,571
Additional information about fees paid to insurance brokerACCOUNT SERVICE 3
Insurance broker nameDON W. ADCOCK
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number647931
Policy instance 1
Insurance contract or identification number647931
Number of Individuals Covered357
Insurance policy start date2013-05-01
Insurance policy end date2014-04-30
Total amount of commissions paid to insurance brokerUSD $4,727
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,727
Additional information about fees paid to insurance broker3
Insurance broker nameADCOCK FINANCIAL GROUP
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00351493
Policy instance 3
Insurance contract or identification number00351493
Number of Individuals Covered488
Insurance policy start date2013-05-01
Insurance policy end date2014-04-30
Total amount of commissions paid to insurance brokerUSD $34,719
Total amount of fees paid to insurance companyUSD $6,997
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedOTHER (SPECIFY)
Welfare Benefit Premiums Paid to CarrierUSD $418,235
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $34,587
Amount paid for insurance broker fees6997
Insurance broker nameASHFORD ADVISORS INC.
ALLIANT HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 11256 )
Policy contract numberA13440002
Policy instance 4
Insurance contract or identification numberA13440002
Number of Individuals Covered300
Insurance policy start date2013-05-01
Insurance policy end date2014-04-30
Total amount of commissions paid to insurance brokerUSD $49,348
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,096,619
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $49,348
Insurance broker organization code?3
Insurance broker nameADCOCK FINANCIAL GROUP
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00351493
Policy instance 3
Insurance contract or identification number00351493
Number of Individuals Covered487
Insurance policy start date2012-05-01
Insurance policy end date2013-04-30
Total amount of commissions paid to insurance brokerUSD $24,432
Total amount of fees paid to insurance companyUSD $8,373
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedOTHER (SPECIFY)
Welfare Benefit Premiums Paid to CarrierUSD $339,575
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $24,309
Amount paid for insurance broker fees8373
Insurance broker nameASHFORD ADVISORS INC.
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number647931
Policy instance 1
Insurance contract or identification number647931
Number of Individuals Covered311
Insurance policy start date2012-05-01
Insurance policy end date2013-04-30
Total amount of commissions paid to insurance brokerUSD $4,056
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,056
Additional information about fees paid to insurance broker3
Insurance broker nameADCOCK FINANCIAL GROUP
ALLIANT HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 11256 )
Policy contract numberA13440001
Policy instance 2
Insurance contract or identification numberA13440001
Number of Individuals Covered690
Insurance policy start date2012-05-01
Insurance policy end date2013-04-30
Total amount of commissions paid to insurance brokerUSD $101,183
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,248,505
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $101,183
Additional information about fees paid to insurance brokerACCOUNT SERVICE 3
Insurance broker nameDON W. ADCOCK
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00351493
Policy instance 3
Insurance contract or identification number00351493
Number of Individuals Covered471
Insurance policy start date2011-05-01
Insurance policy end date2012-04-30
Total amount of commissions paid to insurance brokerUSD $25,657
Total amount of fees paid to insurance companyUSD $11,849
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedOTHER (SPECIFY)
Welfare Benefit Premiums Paid to CarrierUSD $363,552
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $25,517
Amount paid for insurance broker fees11849
Insurance broker nameASHFORD ADVISORS INC.
ALLIANT HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 11256 )
Policy contract numberA13440001
Policy instance 2
Insurance contract or identification numberA13440001
Number of Individuals Covered690
Insurance policy start date2011-05-01
Insurance policy end date2012-04-30
Total amount of commissions paid to insurance brokerUSD $104,949
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,354,946
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $104,949
Additional information about fees paid to insurance brokerACCOUNT SERVICE 3
Insurance broker nameDON W. ADCOCK
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number647931
Policy instance 1
Insurance contract or identification number647931
Number of Individuals Covered320
Insurance policy start date2011-05-01
Insurance policy end date2012-04-30
Total amount of commissions paid to insurance brokerUSD $4,246
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,246
Additional information about fees paid to insurance broker3
Insurance broker nameADCOCK FINANCIAL GROUP

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