MOCK BEROTH INC. has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan MOCK-BEROTH, INC. FLEXIBLE PREMIUM PLAN
401k plan membership statisitcs for MOCK-BEROTH, INC. FLEXIBLE PREMIUM PLAN
Measure | Date | Value |
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2021: MOCK-BEROTH, INC. FLEXIBLE PREMIUM PLAN 2021 401k membership |
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Total participants, beginning-of-year | 2021-12-01 | 106 |
Total number of active participants reported on line 7a of the Form 5500 | 2021-12-01 | 99 |
Number of retired or separated participants receiving benefits | 2021-12-01 | 1 |
Number of other retired or separated participants entitled to future benefits | 2021-12-01 | 0 |
Total of all active and inactive participants | 2021-12-01 | 100 |
2020: MOCK-BEROTH, INC. FLEXIBLE PREMIUM PLAN 2020 401k membership |
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Total participants, beginning-of-year | 2020-12-01 | 136 |
Total number of active participants reported on line 7a of the Form 5500 | 2020-12-01 | 106 |
Number of retired or separated participants receiving benefits | 2020-12-01 | 1 |
Number of other retired or separated participants entitled to future benefits | 2020-12-01 | 0 |
Total of all active and inactive participants | 2020-12-01 | 107 |
2019: MOCK-BEROTH, INC. FLEXIBLE PREMIUM PLAN 2019 401k membership |
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Total participants, beginning-of-year | 2019-12-01 | 125 |
Total number of active participants reported on line 7a of the Form 5500 | 2019-12-01 | 136 |
Number of retired or separated participants receiving benefits | 2019-12-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2019-12-01 | 0 |
Total of all active and inactive participants | 2019-12-01 | 136 |
2018: MOCK-BEROTH, INC. FLEXIBLE PREMIUM PLAN 2018 401k membership |
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Total participants, beginning-of-year | 2018-12-01 | 117 |
Total number of active participants reported on line 7a of the Form 5500 | 2018-12-01 | 125 |
Number of retired or separated participants receiving benefits | 2018-12-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2018-12-01 | 0 |
Total of all active and inactive participants | 2018-12-01 | 125 |
2017: MOCK-BEROTH, INC. FLEXIBLE PREMIUM PLAN 2017 401k membership |
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Total participants, beginning-of-year | 2017-12-01 | 0 |
Total number of active participants reported on line 7a of the Form 5500 | 2017-12-01 | 0 |
Number of retired or separated participants receiving benefits | 2017-12-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2017-12-01 | 0 |
Total of all active and inactive participants | 2017-12-01 | 0 |
2016: MOCK-BEROTH, INC. FLEXIBLE PREMIUM PLAN 2016 401k membership |
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Total participants, beginning-of-year | 2016-12-01 | 117 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-12-01 | 119 |
Number of retired or separated participants receiving benefits | 2016-12-01 | 1 |
Number of other retired or separated participants entitled to future benefits | 2016-12-01 | 0 |
Total of all active and inactive participants | 2016-12-01 | 120 |
2015: MOCK-BEROTH, INC. FLEXIBLE PREMIUM PLAN 2015 401k membership |
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Total participants, beginning-of-year | 2015-12-01 | 114 |
Total number of active participants reported on line 7a of the Form 5500 | 2015-12-01 | 117 |
Number of retired or separated participants receiving benefits | 2015-12-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2015-12-01 | 0 |
Total of all active and inactive participants | 2015-12-01 | 117 |
2014: MOCK-BEROTH, INC. FLEXIBLE PREMIUM PLAN 2014 401k membership |
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Total participants, beginning-of-year | 2014-12-01 | 113 |
Total number of active participants reported on line 7a of the Form 5500 | 2014-12-01 | 114 |
Number of retired or separated participants receiving benefits | 2014-12-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2014-12-01 | 0 |
Total of all active and inactive participants | 2014-12-01 | 114 |
2013: MOCK-BEROTH, INC. FLEXIBLE PREMIUM PLAN 2013 401k membership |
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Total participants, beginning-of-year | 2013-12-01 | 121 |
Total number of active participants reported on line 7a of the Form 5500 | 2013-12-01 | 113 |
Number of retired or separated participants receiving benefits | 2013-12-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2013-12-01 | 0 |
Total of all active and inactive participants | 2013-12-01 | 113 |
2012: MOCK-BEROTH, INC. FLEXIBLE PREMIUM PLAN 2012 401k membership |
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Total participants, beginning-of-year | 2012-12-01 | 123 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-12-01 | 121 |
Number of retired or separated participants receiving benefits | 2012-12-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2012-12-01 | 0 |
Total of all active and inactive participants | 2012-12-01 | 121 |
2011: MOCK-BEROTH, INC. FLEXIBLE PREMIUM PLAN 2011 401k membership |
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Total participants, beginning-of-year | 2011-12-01 | 155 |
Total number of active participants reported on line 7a of the Form 5500 | 2011-12-01 | 123 |
Number of retired or separated participants receiving benefits | 2011-12-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2011-12-01 | 0 |
Total of all active and inactive participants | 2011-12-01 | 123 |
2009: MOCK-BEROTH, INC. FLEXIBLE PREMIUM PLAN 2009 401k membership |
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Total participants, beginning-of-year | 2009-12-01 | 160 |
Total number of active participants reported on line 7a of the Form 5500 | 2009-12-01 | 156 |
Number of retired or separated participants receiving benefits | 2009-12-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2009-12-01 | 0 |
Total of all active and inactive participants | 2009-12-01 | 156 |
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 0922523 |
Policy instance | 7 |
Insurance contract or identification number | 0922523 | Insurance policy start date | 2021-12-01 | Insurance policy end date | 2022-11-30 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Additional information about fees paid to insurance broker | SERVICE FEE AGREEMENT |
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PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
Policy contract number | 1049435 |
Policy instance | 1 |
Insurance contract or identification number | 1049435 | Number of Individuals Covered | 175 | Insurance policy start date | 2021-12-01 | Insurance policy end date | 2022-11-30 | Total amount of commissions paid to insurance broker | USD $17,689 | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $93,895 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $13,404 | Insurance broker organization code? | 3 |
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NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 ) |
Policy contract number | 38047 |
Policy instance | 2 |
Insurance contract or identification number | 38047 | Insurance policy start date | 2021-12-01 | Insurance policy end date | 2022-11-30 | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Insurance broker organization code? | 3 |
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BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 ) |
Policy contract number | 082692 |
Policy instance | 3 |
Insurance contract or identification number | 082692 | Number of Individuals Covered | 215 | Insurance policy start date | 2021-12-01 | Insurance policy end date | 2022-11-30 | Total amount of commissions paid to insurance broker | USD $13,428 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $715,203 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $13,428 | Insurance broker organization code? | 3 |
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AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) |
Policy contract number | 35487 |
Policy instance | 4 |
Insurance contract or identification number | 35487 | Number of Individuals Covered | 10 | Insurance policy start date | 2021-12-01 | Insurance policy end date | 2022-11-30 | Total amount of commissions paid to insurance broker | USD $1,879 | Other welfare benefits provided | GAP | Welfare Benefit Premiums Paid to Carrier | USD $12,526 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,548 | Insurance broker organization code? | 3 |
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RESERVE NATIONAL INSURANCE COMPANY DBA KEMPER BENEFITS (National Association of Insurance Commissioners NAIC id number: 68462 ) |
Policy contract number | KB20A20 |
Policy instance | 5 |
Insurance contract or identification number | KB20A20 | Number of Individuals Covered | 95 | Insurance policy start date | 2021-12-01 | Insurance policy end date | 2022-11-30 | Total amount of commissions paid to insurance broker | USD $3,918 | Other welfare benefits provided | HOSPITAL INDEMNITY | Welfare Benefit Premiums Paid to Carrier | USD $21,029 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,577 | Additional information about fees paid to insurance broker | COMMISSION | Insurance broker organization code? | 3 |
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NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 ) |
Policy contract number | 038047 |
Policy instance | 6 |
Insurance contract or identification number | 038047 | Insurance policy start date | 2021-12-01 | Insurance policy end date | 2022-11-30 | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
Policy contract number | 1049435 |
Policy instance | 1 |
Insurance contract or identification number | 1049435 | Number of Individuals Covered | 172 | Insurance policy start date | 2020-12-01 | Insurance policy end date | 2021-11-30 | Total amount of commissions paid to insurance broker | USD $15,355 | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $102,468 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $15,355 | Insurance broker organization code? | 3 |
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NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 ) |
Policy contract number | 38047 |
Policy instance | 2 |
Insurance contract or identification number | 38047 | Number of Individuals Covered | 95 | Insurance policy start date | 2020-12-01 | Insurance policy end date | 2021-11-30 | Vision Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Insurance broker organization code? | 3 |
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BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 ) |
Policy contract number | 082692 |
Policy instance | 3 |
Insurance contract or identification number | 082692 | Number of Individuals Covered | 125 | Insurance policy start date | 2020-12-01 | Insurance policy end date | 2021-11-30 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Insurance broker organization code? | 3 |
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AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) |
Policy contract number | 35487 |
Policy instance | 4 |
Insurance contract or identification number | 35487 | Number of Individuals Covered | 15 | Insurance policy start date | 2020-12-01 | Insurance policy end date | 2021-11-30 | Total amount of commissions paid to insurance broker | USD $2,092 | Other welfare benefits provided | GAP | Welfare Benefit Premiums Paid to Carrier | USD $13,950 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,802 | Insurance broker organization code? | 3 |
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RESERVE NATIONAL INSURANCE COMPANY DBA KEMPER BENEFITS (National Association of Insurance Commissioners NAIC id number: 68462 ) |
Policy contract number | KB20A20 |
Policy instance | 5 |
Insurance contract or identification number | KB20A20 | Number of Individuals Covered | 108 | Insurance policy start date | 2020-12-01 | Insurance policy end date | 2021-11-30 | Total amount of commissions paid to insurance broker | USD $17,924 | Other welfare benefits provided | HOSPITAL INDEMNITY | Welfare Benefit Premiums Paid to Carrier | USD $25,983 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $16,826 | Additional information about fees paid to insurance broker | COMMISSION | Insurance broker organization code? | 3 |
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NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 ) |
Policy contract number | 038047 |
Policy instance | 6 |
Insurance contract or identification number | 038047 | Number of Individuals Covered | 76 | Insurance policy start date | 2020-12-01 | Insurance policy end date | 2021-11-30 | Total amount of commissions paid to insurance broker | USD $950 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $9,504 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $950 |
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 0922523 |
Policy instance | 7 |
Insurance contract or identification number | 0922523 | Number of Individuals Covered | 100 | Insurance policy start date | 2020-12-01 | Insurance policy end date | 2021-11-30 | Total amount of commissions paid to insurance broker | USD $2,500 | Total amount of fees paid to insurance company | USD $15,778 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $700,524 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 15778 | Additional information about fees paid to insurance broker | SERVICE FEE AGREEMENT | Commission paid to Insurance Broker | USD $2,500 |
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PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
Policy contract number | 1049435 |
Policy instance | 1 |
Insurance contract or identification number | 1049435 | Number of Individuals Covered | 227 | Insurance policy start date | 2019-12-01 | Insurance policy end date | 2020-11-30 | Total amount of commissions paid to insurance broker | USD $17,665 | Dental Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $115,148 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $17,665 | Insurance broker organization code? | 3 |
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NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 ) |
Policy contract number | 38047 |
Policy instance | 2 |
Insurance contract or identification number | 38047 | Number of Individuals Covered | 95 | Insurance policy start date | 2019-12-01 | Insurance policy end date | 2020-11-30 | Total amount of commissions paid to insurance broker | USD $989 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $9,889 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $989 | Insurance broker organization code? | 3 |
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BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 ) |
Policy contract number | 082692 |
Policy instance | 3 |
Insurance contract or identification number | 082692 | Number of Individuals Covered | 125 | Insurance policy start date | 2019-12-01 | Insurance policy end date | 2020-11-30 | Total amount of commissions paid to insurance broker | USD $17,223 | Total amount of fees paid to insurance company | USD $323 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $367,378 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $17,223 | Amount paid for insurance broker fees | 323 | Insurance broker organization code? | 3 |
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AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) |
Policy contract number | 35487 |
Policy instance | 4 |
Insurance contract or identification number | 35487 | Number of Individuals Covered | 31 | Insurance policy start date | 2019-12-01 | Insurance policy end date | 2020-11-30 | Total amount of commissions paid to insurance broker | USD $2,810 | Other welfare benefits provided | GAP | Welfare Benefit Premiums Paid to Carrier | USD $22,557 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,682 | Insurance broker organization code? | 3 |
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AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) |
Policy contract number | 95125 |
Policy instance | 7 |
Insurance contract or identification number | 95125 | Number of Individuals Covered | 22 | Insurance policy start date | 2018-12-01 | Insurance policy end date | 2019-11-30 | Total amount of commissions paid to insurance broker | USD $3,660 | Other welfare benefits provided | GAP INSURANCE | Welfare Benefit Premiums Paid to Carrier | USD $24,397 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,660 | Insurance broker organization code? | 3 |
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NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 ) |
Policy contract number | 38047 |
Policy instance | 6 |
Insurance contract or identification number | 38047 | Number of Individuals Covered | 84 | Insurance policy start date | 2018-12-01 | Insurance policy end date | 2019-11-30 | Total amount of commissions paid to insurance broker | USD $1,143 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $11,431 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,143 | Insurance broker organization code? | 3 |
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BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 ) |
Policy contract number | 082692 |
Policy instance | 5 |
Insurance contract or identification number | 082692 | Number of Individuals Covered | 184 | Insurance policy start date | 2018-12-01 | Insurance policy end date | 2019-11-30 | Total amount of commissions paid to insurance broker | USD $26,632 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $321,010 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $26,632 | Insurance broker organization code? | 3 |
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AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) |
Policy contract number | 35487 |
Policy instance | 4 |
Insurance contract or identification number | 35487 | Number of Individuals Covered | 4 | Insurance policy start date | 2018-12-01 | Insurance policy end date | 2019-11-30 | Total amount of commissions paid to insurance broker | USD $742 | Other welfare benefits provided | CRITICAL ILLNESS | Welfare Benefit Premiums Paid to Carrier | USD $1,065 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $559 | Insurance broker organization code? | 3 |
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AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) |
Policy contract number | 35487 |
Policy instance | 3 |
Insurance contract or identification number | 35487 | Number of Individuals Covered | 4 | Insurance policy start date | 2018-12-01 | Insurance policy end date | 2019-11-30 | Total amount of commissions paid to insurance broker | USD $613 | Other welfare benefits provided | CANCER | Welfare Benefit Premiums Paid to Carrier | USD $1,223 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $480 | Insurance broker organization code? | 3 |
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AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) |
Policy contract number | 35487 |
Policy instance | 2 |
Insurance contract or identification number | 35487 | Number of Individuals Covered | 6 | Insurance policy start date | 2018-12-01 | Insurance policy end date | 2019-11-30 | Total amount of commissions paid to insurance broker | USD $988 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,193 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $751 | Insurance broker organization code? | 3 |
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PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
Policy contract number | 1049435 |
Policy instance | 1 |
Insurance contract or identification number | 1049435 | Number of Individuals Covered | 227 | Insurance policy start date | 2018-12-01 | Insurance policy end date | 2019-11-30 | Total amount of commissions paid to insurance broker | USD $16,794 | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $111,138 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $16,794 | Insurance broker organization code? | 3 |
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PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
Policy contract number | 1049435 |
Policy instance | 1 |
Insurance contract or identification number | 1049435 | Number of Individuals Covered | 234 | Insurance policy start date | 2017-12-01 | Insurance policy end date | 2018-11-30 | Dental Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Insurance broker organization code? | 3 | Total amount of commissions paid to insurance broker | USD $11,634 | Total amount of fees paid to insurance company | USD $4,415 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $111,193 | Insurance broker name | DIGITAL INSURANCE INC. |
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COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
Policy contract number | E4367918 |
Policy instance | 2 |
Insurance contract or identification number | E4367918 | Number of Individuals Covered | 51 | Insurance policy start date | 2017-12-01 | Insurance policy end date | 2018-11-30 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Insurance broker organization code? | 3 | Total amount of commissions paid to insurance broker | USD $9,163 | Total amount of fees paid to insurance company | USD $1,881 | Welfare Benefit Premiums Paid to Carrier | USD $40,499 | Insurance broker name | DIGITAL INSURANCE INC |
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 695041 |
Policy instance | 3 |
Insurance contract or identification number | 695041 | Number of Individuals Covered | 186 | Insurance policy start date | 2017-12-01 | Insurance policy end date | 2018-11-30 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Welfare Benefit Premiums Paid to Carrier | USD $836,984 |
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PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
Policy contract number | 1049435 |
Policy instance | 2 |
Insurance contract or identification number | 1049435 | Number of Individuals Covered | 235 | Insurance policy start date | 2014-12-01 | Insurance policy end date | 2015-11-30 | Total amount of commissions paid to insurance broker | USD $9,655 | Dental Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $9,655 | Insurance broker organization code? | 3 | Insurance broker name | DIGITAL INSURANCE INC. |
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AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 ) |
Policy contract number | 580663085 |
Policy instance | 1 |
Insurance contract or identification number | 580663085 | Number of Individuals Covered | 22 | Insurance policy start date | 2014-12-01 | Insurance policy end date | 2015-11-30 | Total amount of commissions paid to insurance broker | USD $2,595 | Total amount of fees paid to insurance company | USD $128 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $21,831 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $849 | Amount paid for insurance broker fees | 58 | Additional information about fees paid to insurance broker | FEES & AWARDS | Insurance broker organization code? | 3 | Insurance broker name | EXSEPTIONAL SERVICES, INC. |
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COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
Policy contract number | E4367918 |
Policy instance | 3 |
Insurance contract or identification number | E4367918 | Number of Individuals Covered | 60 | Insurance policy start date | 2014-12-01 | Insurance policy end date | 2015-11-30 | Total amount of commissions paid to insurance broker | USD $14,127 | Total amount of fees paid to insurance company | USD $4,440 | Welfare Benefit Premiums Paid to Carrier | USD $22,851 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 174 | Insurance broker name | DIGITAL INSURANCE INC |
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UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 ) |
Policy contract number | 5448476 |
Policy instance | 1 |
Insurance contract or identification number | 5448476 | Number of Individuals Covered | 140 | Insurance policy start date | 2013-12-01 | Insurance policy end date | 2014-11-30 | Total amount of commissions paid to insurance broker | USD $9,729 | Dental Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | VOL LIFE AND VOL DEP LIFE | Welfare Benefit Premiums Paid to Carrier | USD $86,925 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $8,150 | Insurance broker organization code? | 3 | Insurance broker name | DIGITAL INSURANCE, INC. |
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AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 ) |
Policy contract number | 580663085 |
Policy instance | 3 |
Insurance contract or identification number | 580663085 | Number of Individuals Covered | 81 | Insurance policy start date | 2013-12-01 | Insurance policy end date | 2014-11-30 | Total amount of commissions paid to insurance broker | USD $7,227 | Total amount of fees paid to insurance company | USD $119 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $50,768 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,726 | Amount paid for insurance broker fees | 62 | Additional information about fees paid to insurance broker | FEES & AWARDS | Insurance broker organization code? | 3 | Insurance broker name | EXSEPTIONAL SERVICES, INC. |
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SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | MBINC98 |
Policy instance | 2 |
Insurance contract or identification number | MBINC98 | Number of Individuals Covered | 149 | Insurance policy start date | 2013-12-01 | Insurance policy end date | 2014-11-30 | Total amount of commissions paid to insurance broker | USD $35,017 | Welfare Benefit Premiums Paid to Carrier | USD $233,445 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $23,345 | Insurance broker organization code? | 3 | Insurance broker name | CORPORATE BENEFIT CONCEPTS, INC |
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UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 ) |
Policy contract number | 5448476 |
Policy instance | 1 |
Insurance contract or identification number | 5448476 | Number of Individuals Covered | 135 | Insurance policy start date | 2012-12-01 | Insurance policy end date | 2013-11-30 | Total amount of commissions paid to insurance broker | USD $10,093 | Dental Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | VOL LIFE AND VOL DEP LIFE | Welfare Benefit Premiums Paid to Carrier | USD $91,561 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $10,093 | Insurance broker organization code? | 3 | Insurance broker name | CORPORATE BENEFIT SERVICES |
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SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 023060 |
Policy instance | 2 |
Insurance contract or identification number | 023060 | Number of Individuals Covered | 154 | Insurance policy start date | 2012-12-01 | Insurance policy end date | 2013-11-30 | Total amount of commissions paid to insurance broker | USD $36,495 | Welfare Benefit Premiums Paid to Carrier | USD $243,295 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $24,330 | Insurance broker organization code? | 3 | Additional information about fees paid to insurance broker | 3 | Insurance broker name | CORPORATE BENEFIT CONCEPTS, INC |
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AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 ) |
Policy contract number | 580663085 |
Policy instance | 3 |
Insurance contract or identification number | 580663085 | Number of Individuals Covered | 85 | Insurance policy start date | 2012-12-01 | Insurance policy end date | 2013-11-30 | Total amount of commissions paid to insurance broker | USD $9,096 | Total amount of fees paid to insurance company | USD $217 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $64,568 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,970 | Amount paid for insurance broker fees | 99 | Additional information about fees paid to insurance broker | FEES & AWARDS | Insurance broker organization code? | 3 | Insurance broker name | GBS MARKETING |
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SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 023060 |
Policy instance | 2 |
Insurance contract or identification number | 023060 | Number of Individuals Covered | 158 | Insurance policy start date | 2011-12-01 | Insurance policy end date | 2012-11-30 | Total amount of commissions paid to insurance broker | USD $35,613 | Welfare Benefit Premiums Paid to Carrier | USD $237,421 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 ) |
Policy contract number | 5448476 |
Policy instance | 1 |
Insurance contract or identification number | 5448476 | Number of Individuals Covered | 158 | Insurance policy start date | 2011-12-01 | Insurance policy end date | 2012-11-30 | Total amount of commissions paid to insurance broker | USD $9,633 | Dental Insurance Welfare Benefit | Yes | Other welfare benefits provided | VOL LIFE AND VOL DEP LIFE | Welfare Benefit Premiums Paid to Carrier | USD $86,286 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 ) |
Policy contract number | 580663085 |
Policy instance | 3 |
Insurance contract or identification number | 580663085 | Number of Individuals Covered | 113 | Insurance policy start date | 2011-12-01 | Insurance policy end date | 2012-11-30 | Total amount of commissions paid to insurance broker | USD $11,445 | Total amount of fees paid to insurance company | USD $278 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $68,740 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 ) |
Policy contract number | 5448476 |
Policy instance | 1 |
Insurance contract or identification number | 5448476 | Number of Individuals Covered | 153 | Insurance policy start date | 2010-12-01 | Insurance policy end date | 2011-11-30 | Total amount of commissions paid to insurance broker | USD $8,040 | Total amount of fees paid to insurance company | USD $438 | Dental Insurance Welfare Benefit | Yes | Other welfare benefits provided | VOL LIFE AND VOL DEP LIFE | Welfare Benefit Premiums Paid to Carrier | USD $72,384 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 ) |
Policy contract number | 580663085 |
Policy instance | 3 |
Insurance contract or identification number | 580663085 | Number of Individuals Covered | 112 | Insurance policy start date | 2010-12-01 | Insurance policy end date | 2011-11-30 | Total amount of commissions paid to insurance broker | USD $10,609 | Total amount of fees paid to insurance company | USD $192 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $68,522 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 023060 |
Policy instance | 2 |
Insurance contract or identification number | 023060 | Number of Individuals Covered | 121 | Insurance policy start date | 2010-12-01 | Insurance policy end date | 2011-11-30 | Total amount of commissions paid to insurance broker | USD $32,377 | Welfare Benefit Premiums Paid to Carrier | USD $215,844 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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