HODGES MANAGEMENT COMPANY has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan HODGES MANAGEMENT CO. INC. CAFETERIA PLAN
401k plan membership statisitcs for HODGES MANAGEMENT CO. INC. CAFETERIA PLAN
| Measure | Date | Value |
|---|
| 2021: HODGES MANAGEMENT CO. INC. CAFETERIA PLAN 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-10-01 | 117 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-10-01 | 133 |
| Number of retired or separated participants receiving benefits | 2021-10-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2021-10-01 | 0 |
| Total of all active and inactive participants | 2021-10-01 | 133 |
| Total participants, beginning-of-year | 2021-04-01 | 130 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-04-01 | 117 |
| Number of retired or separated participants receiving benefits | 2021-04-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2021-04-01 | 0 |
| Total of all active and inactive participants | 2021-04-01 | 117 |
| 2020: HODGES MANAGEMENT CO. INC. CAFETERIA PLAN 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-04-01 | 130 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-04-01 | 130 |
| Number of retired or separated participants receiving benefits | 2020-04-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2020-04-01 | 0 |
| Total of all active and inactive participants | 2020-04-01 | 130 |
| 2019: HODGES MANAGEMENT CO. INC. CAFETERIA PLAN 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-04-01 | 96 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-04-01 | 130 |
| Number of retired or separated participants receiving benefits | 2019-04-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2019-04-01 | 0 |
| Total of all active and inactive participants | 2019-04-01 | 130 |
| 2018: HODGES MANAGEMENT CO. INC. CAFETERIA PLAN 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-04-01 | 99 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-04-01 | 96 |
| Number of retired or separated participants receiving benefits | 2018-04-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2018-04-01 | 0 |
| Total of all active and inactive participants | 2018-04-01 | 96 |
| 2017: HODGES MANAGEMENT CO. INC. CAFETERIA PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-04-01 | 140 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-04-01 | 99 |
| Number of retired or separated participants receiving benefits | 2017-04-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2017-04-01 | 0 |
| Total of all active and inactive participants | 2017-04-01 | 99 |
| 2016: HODGES MANAGEMENT CO. INC. CAFETERIA PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-04-01 | 183 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-04-01 | 140 |
| Number of retired or separated participants receiving benefits | 2016-04-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2016-04-01 | 0 |
| Total of all active and inactive participants | 2016-04-01 | 140 |
| 2015: HODGES MANAGEMENT CO. INC. CAFETERIA PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-04-01 | 205 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-04-01 | 183 |
| Number of retired or separated participants receiving benefits | 2015-04-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2015-04-01 | 0 |
| Total of all active and inactive participants | 2015-04-01 | 183 |
| 2014: HODGES MANAGEMENT CO. INC. CAFETERIA PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-04-01 | 164 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-04-01 | 205 |
| Number of retired or separated participants receiving benefits | 2014-04-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2014-04-01 | 0 |
| Total of all active and inactive participants | 2014-04-01 | 205 |
| 2013: HODGES MANAGEMENT CO. INC. CAFETERIA PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-04-01 | 223 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-04-01 | 164 |
| Total of all active and inactive participants | 2013-04-01 | 164 |
| 2012: HODGES MANAGEMENT CO. INC. CAFETERIA PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-04-01 | 229 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-04-01 | 223 |
| Total of all active and inactive participants | 2012-04-01 | 223 |
| 2011: HODGES MANAGEMENT CO. INC. CAFETERIA PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-04-01 | 138 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-04-01 | 229 |
| Total of all active and inactive participants | 2011-04-01 | 229 |
| 2010: HODGES MANAGEMENT CO. INC. CAFETERIA PLAN 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-04-01 | 108 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-04-01 | 138 |
| Total of all active and inactive participants | 2010-04-01 | 138 |
| 2009: HODGES MANAGEMENT CO. INC. CAFETERIA PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-04-01 | 117 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-04-01 | 108 |
| Total of all active and inactive participants | 2009-04-01 | 108 |
| 2007: HODGES MANAGEMENT CO. INC. CAFETERIA PLAN 2007 401k membership |
|---|
| Total participants, beginning-of-year | 2007-04-01 | 157 |
| Total number of active participants reported on line 7a of the Form 5500 | 2007-04-01 | 165 |
| Total of all active and inactive participants | 2007-04-01 | 165 |
| Total participants | 2007-04-01 | 165 |
| 2006: HODGES MANAGEMENT CO. INC. CAFETERIA PLAN 2006 401k membership |
|---|
| Total participants, beginning-of-year | 2006-04-01 | 157 |
| Total number of active participants reported on line 7a of the Form 5500 | 2006-04-01 | 157 |
| Total of all active and inactive participants | 2006-04-01 | 157 |
| Total participants | 2006-04-01 | 157 |
| 2005: HODGES MANAGEMENT CO. INC. CAFETERIA PLAN 2005 401k membership |
|---|
| Total participants, beginning-of-year | 2005-04-01 | 0 |
| Total number of active participants reported on line 7a of the Form 5500 | 2005-04-01 | 157 |
| Total of all active and inactive participants | 2005-04-01 | 157 |
| Total participants | 2005-04-01 | 157 |
| 2021: HODGES MANAGEMENT CO. INC. CAFETERIA PLAN 2021 form 5500 responses |
|---|
| 2021-10-01 | Type of plan entity | Single employer plan |
| 2021-10-01 | Plan funding arrangement – Insurance | Yes |
| 2021-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2021-04-01 | Type of plan entity | Single employer plan |
| 2021-04-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2021-04-01 | Plan funding arrangement – Insurance | Yes |
| 2021-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2020: HODGES MANAGEMENT CO. INC. CAFETERIA PLAN 2020 form 5500 responses |
|---|
| 2020-04-01 | Type of plan entity | Single employer plan |
| 2020-04-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2020-04-01 | Plan funding arrangement – Insurance | Yes |
| 2020-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2019: HODGES MANAGEMENT CO. INC. CAFETERIA PLAN 2019 form 5500 responses |
|---|
| 2019-04-01 | Type of plan entity | Single employer plan |
| 2019-04-01 | Plan funding arrangement – Insurance | Yes |
| 2019-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: HODGES MANAGEMENT CO. INC. CAFETERIA PLAN 2018 form 5500 responses |
|---|
| 2018-04-01 | Type of plan entity | Single employer plan |
| 2018-04-01 | Plan funding arrangement – Insurance | Yes |
| 2018-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: HODGES MANAGEMENT CO. INC. CAFETERIA PLAN 2017 form 5500 responses |
|---|
| 2017-04-01 | Type of plan entity | Single employer plan |
| 2017-04-01 | Plan funding arrangement – Insurance | Yes |
| 2017-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: HODGES MANAGEMENT CO. INC. CAFETERIA PLAN 2016 form 5500 responses |
|---|
| 2016-04-01 | Type of plan entity | Single employer plan |
| 2016-04-01 | Plan funding arrangement – Insurance | Yes |
| 2016-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: HODGES MANAGEMENT CO. INC. CAFETERIA PLAN 2015 form 5500 responses |
|---|
| 2015-04-01 | Type of plan entity | Single employer plan |
| 2015-04-01 | Plan funding arrangement – Insurance | Yes |
| 2015-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: HODGES MANAGEMENT CO. INC. CAFETERIA PLAN 2014 form 5500 responses |
|---|
| 2014-04-01 | Type of plan entity | Single employer plan |
| 2014-04-01 | Plan funding arrangement – Insurance | Yes |
| 2014-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: HODGES MANAGEMENT CO. INC. CAFETERIA PLAN 2013 form 5500 responses |
|---|
| 2013-04-01 | Type of plan entity | Single employer plan |
| 2013-04-01 | Plan funding arrangement – Insurance | Yes |
| 2013-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: HODGES MANAGEMENT CO. INC. CAFETERIA PLAN 2012 form 5500 responses |
|---|
| 2012-04-01 | Type of plan entity | Single employer plan |
| 2012-04-01 | Plan funding arrangement – Insurance | Yes |
| 2012-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: HODGES MANAGEMENT CO. INC. CAFETERIA PLAN 2011 form 5500 responses |
|---|
| 2011-04-01 | Type of plan entity | Single employer plan |
| 2011-04-01 | Plan funding arrangement – Insurance | Yes |
| 2011-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2010: HODGES MANAGEMENT CO. INC. CAFETERIA PLAN 2010 form 5500 responses |
|---|
| 2010-04-01 | Type of plan entity | Single employer plan |
| 2010-04-01 | Plan funding arrangement – Insurance | Yes |
| 2010-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: HODGES MANAGEMENT CO. INC. CAFETERIA PLAN 2009 form 5500 responses |
|---|
| 2009-04-01 | Type of plan entity | Single employer plan |
| 2009-04-01 | Plan funding arrangement – Insurance | Yes |
| 2009-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2007: HODGES MANAGEMENT CO. INC. CAFETERIA PLAN 2007 form 5500 responses |
|---|
| 2007-04-01 | Type of plan entity | Single employer plan |
| 2007-04-01 | Submission has been amended | No |
| 2007-04-01 | This submission is the final filing | No |
| 2007-04-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2007-04-01 | Plan is a collectively bargained plan | No |
| 2007-04-01 | Plan funding arrangement – Insurance | Yes |
| 2007-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2006: HODGES MANAGEMENT CO. INC. CAFETERIA PLAN 2006 form 5500 responses |
|---|
| 2006-04-01 | Type of plan entity | Single employer plan |
| 2006-04-01 | Submission has been amended | No |
| 2006-04-01 | This submission is the final filing | No |
| 2006-04-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2006-04-01 | Plan is a collectively bargained plan | No |
| 2006-04-01 | Plan funding arrangement – Insurance | Yes |
| 2006-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2005: HODGES MANAGEMENT CO. INC. CAFETERIA PLAN 2005 form 5500 responses |
|---|
| 2005-04-01 | Type of plan entity | Single employer plan |
| 2005-04-01 | First time form 5500 has been submitted | Yes |
| 2005-04-01 | Submission has been amended | No |
| 2005-04-01 | This submission is the final filing | No |
| 2005-04-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2005-04-01 | Plan is a collectively bargained plan | No |
| 2005-04-01 | Plan funding arrangement – Insurance | Yes |
| 2005-04-01 | Plan benefit arrangement – Insurance | Yes |
| BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 ) |
| Policy contract number | GB0177 |
| Policy instance | 2 |
| Insurance contract or identification number | GB0177 | | Number of Individuals Covered | 133 | | Insurance policy start date | 2021-10-01 | | Insurance policy end date | 2022-09-30 | | Total amount of commissions paid to insurance broker | USD $39,607 | | Total amount of fees paid to insurance company | USD $2,160 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $586,617 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $39,607 | | Amount paid for insurance broker fees | 2160 | | Additional information about fees paid to insurance broker | AGENT OR BROKER OF RECORD OTHER COMPENSATION | | Insurance broker organization code? | 3 |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000AWG5 |
| Policy instance | 1 |
| Insurance contract or identification number | G000AWG5 | | Number of Individuals Covered | 88 | | Insurance policy start date | 2021-10-01 | | Insurance policy end date | 2022-09-30 | | Total amount of commissions paid to insurance broker | USD $20,341 | | Total amount of fees paid to insurance company | USD $11,831 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | CRITICAL ILLNESS, ACCIDENT | | Welfare Benefit Premiums Paid to Carrier | USD $101,708 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $20,341 | | Amount paid for insurance broker fees | 6745 | | Additional information about fees paid to insurance broker | AGENT OR BROKER OF RECORD OTHER COMPENSATION | | Insurance broker organization code? | 3 |
|
| BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 ) |
| Policy contract number | GB0177 |
| Policy instance | 2 |
| Insurance contract or identification number | GB0177 | | Number of Individuals Covered | 117 | | Insurance policy end date | 2021-09-30 | | Total amount of commissions paid to insurance broker | USD $43,032 | | Total amount of fees paid to insurance company | USD $258 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $672,481 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $43,032 | | Amount paid for insurance broker fees | 258 | | Insurance broker organization code? | 3 |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000AWG5 |
| Policy instance | 1 |
| Insurance contract or identification number | G000AWG5 | | Number of Individuals Covered | 88 | | Insurance policy start date | 2021-04-01 | | Insurance policy end date | 2021-09-30 | | Total amount of commissions paid to insurance broker | USD $24,589 | | Total amount of fees paid to insurance company | USD $10,219 | | 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 | | Other welfare benefits provided | CRITICAL ILLNESS, ACCIDENT | | Welfare Benefit Premiums Paid to Carrier | USD $158,932 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $24,589 | | Amount paid for insurance broker fees | 6610 | | Additional information about fees paid to insurance broker | AGENT OR BROKER OF RECORD OTHER COMPENSATION | | Insurance broker organization code? | 3 |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00398127 |
| Policy instance | 1 |
| Insurance contract or identification number | 00398127 | | Number of Individuals Covered | 83 | | Insurance policy end date | 2020-09-30 | | Total amount of commissions paid to insurance broker | USD $3,483 | | Total amount of fees paid to insurance company | USD $2,612 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $43,541 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,483 | | Amount paid for insurance broker fees | 2612 | | Insurance broker organization code? | 3 |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000AWG5 |
| Policy instance | 2 |
| Insurance contract or identification number | G000AWG5 | | Number of Individuals Covered | 84 | | Insurance policy start date | 2020-04-01 | | Insurance policy end date | 2020-09-30 | | Total amount of commissions paid to insurance broker | USD $7,601 | | Total amount of fees paid to insurance company | USD $4,180 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | CRITICAL ILLNESS, ACCIDENT | | Welfare Benefit Premiums Paid to Carrier | USD $38,004 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $7,601 | | Amount paid for insurance broker fees | 4180 | | Insurance broker organization code? | 3 |
|
| BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 ) |
| Policy contract number | GB0177 |
| Policy instance | 3 |
| Insurance contract or identification number | GB0177 | | Number of Individuals Covered | 130 | | Insurance policy end date | 2020-09-30 | | Total amount of commissions paid to insurance broker | USD $19,520 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $318,621 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $19,520 | | Insurance broker organization code? | 3 |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00398127 |
| Policy instance | 1 |
| Insurance contract or identification number | 00398127 | | Number of Individuals Covered | 83 | | Insurance policy start date | 2019-04-01 | | Insurance policy end date | 2020-03-31 | | Total amount of commissions paid to insurance broker | USD $3,483 | | Total amount of fees paid to insurance company | USD $2,612 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $43,541 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,483 | | Amount paid for insurance broker fees | 2612 | | Insurance broker organization code? | 3 |
|
| HUMANA EMPLOYERS HEALTH PLAN OF GEORGIA, INC. (National Association of Insurance Commissioners NAIC id number: 95519 ) |
| Policy contract number | 862114 |
| Policy instance | 2 |
| Insurance contract or identification number | 862114 | | Number of Individuals Covered | 85 | | Insurance policy end date | 2019-09-30 | | Total amount of commissions paid to insurance broker | USD $15,046 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $250,103 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $15,046 | | Insurance broker organization code? | 3 |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000AWG5 |
| Policy instance | 3 |
| Insurance contract or identification number | G000AWG5 | | Number of Individuals Covered | 84 | | Insurance policy end date | 2020-03-31 | | Total amount of commissions paid to insurance broker | USD $13,771 | | Total amount of fees paid to insurance company | USD $7,574 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | CRITICAL ILLNESS, ACCIDENT | | Welfare Benefit Premiums Paid to Carrier | USD $60,854 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $13,771 | | Amount paid for insurance broker fees | 7574 | | Insurance broker organization code? | 3 |
|
| BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 ) |
| Policy contract number | GB0177 |
| Policy instance | 4 |
| Insurance contract or identification number | GB0177 | | Number of Individuals Covered | 130 | | Insurance policy end date | 2020-03-31 | | Total amount of commissions paid to insurance broker | USD $19,520 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $637,242 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $19,520 | | Insurance broker organization code? | 3 |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000AWG5 |
| Policy instance | 3 |
| Insurance contract or identification number | G000AWG5 | | Number of Individuals Covered | 84 | | Insurance policy end date | 2019-03-31 | | Total amount of commissions paid to insurance broker | USD $15,538 | | Total amount of fees paid to insurance company | USD $8,216 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | CRITICAL ILLNESS, ACCIDENT | | Welfare Benefit Premiums Paid to Carrier | USD $77,691 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $15,538 | | Amount paid for insurance broker fees | 8216 | | Insurance broker organization code? | 3 |
|
| HUMANA EMPLOYERS HEALTH PLAN OF GEORGIA, INC. (National Association of Insurance Commissioners NAIC id number: 95519 ) |
| Policy contract number | 862114 |
| Policy instance | 2 |
| Insurance contract or identification number | 862114 | | Number of Individuals Covered | 85 | | Insurance policy end date | 2019-04-30 | | Total amount of commissions paid to insurance broker | USD $29,560 | | Total amount of fees paid to insurance company | USD $1,238 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $593,811 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $19,816 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 1238 |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00398127 |
| Policy instance | 1 |
| Insurance contract or identification number | 00398127 | | Number of Individuals Covered | 83 | | Insurance policy start date | 2018-04-01 | | Insurance policy end date | 2019-03-31 | | Total amount of commissions paid to insurance broker | USD $3,219 | | Total amount of fees paid to insurance company | USD $2,185 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $38,373 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,219 | | Amount paid for insurance broker fees | 2185 | | Insurance broker organization code? | 3 |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000AWG5 |
| Policy instance | 3 |
| Insurance contract or identification number | G000AWG5 | | Number of Individuals Covered | 88 | | Insurance policy start date | 2017-04-01 | | Insurance policy end date | 2018-03-31 | | Total amount of commissions paid to insurance broker | USD $13,513 | | Total amount of fees paid to insurance company | USD $1,255 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | CRITICAL ILLNESS, ACCIDENT | | Welfare Benefit Premiums Paid to Carrier | USD $67,570 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $12,472 | | Amount paid for insurance broker fees | 1255 | | Insurance broker organization code? | 3 | | Insurance broker name | GARY G OETGEN INC |
|
| BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 ) |
| Policy contract number | GA8631 |
| Policy instance | 2 |
| Insurance contract or identification number | GA8631 | | Number of Individuals Covered | 99 | | Insurance policy start date | 2017-04-01 | | Insurance policy end date | 2018-03-31 | | Total amount of commissions paid to insurance broker | USD $30,752 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $641,583 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $28,576 | | Insurance broker organization code? | 3 | | Insurance broker name | GARY G. OETGEN INC. |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00398127 |
| Policy instance | 1 |
| Insurance contract or identification number | 00398127 | | Number of Individuals Covered | 82 | | Insurance policy start date | 2017-04-01 | | Insurance policy end date | 2018-03-31 | | Total amount of commissions paid to insurance broker | USD $2,902 | | Total amount of fees paid to insurance company | USD $1,906 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $35,989 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,902 | | Amount paid for insurance broker fees | 1906 | | Insurance broker organization code? | 3 | | Insurance broker name | DIGITAL INSURANCE, LLC |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00398127 |
| Policy instance | 1 |
| Insurance contract or identification number | 00398127 | | Number of Individuals Covered | 92 | | Insurance policy start date | 2015-04-01 | | Insurance policy end date | 2016-03-31 | | Total amount of commissions paid to insurance broker | USD $3,081 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $35,483 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,081 | | Insurance broker organization code? | 3 | | Insurance broker name | GARY G. OETGEN INC. |
|
| BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 ) |
| Policy contract number | GA8631 |
| Policy instance | 2 |
| Insurance contract or identification number | GA8631 | | Number of Individuals Covered | 90 | | Insurance policy start date | 2015-04-01 | | Insurance policy end date | 2016-03-31 | | Total amount of commissions paid to insurance broker | USD $26,688 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $536,865 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $26,688 | | Insurance broker organization code? | 3 | | Insurance broker name | GARY G. OETGEN INC. |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000AWG5 |
| Policy instance | 3 |
| Insurance contract or identification number | G000AWG5 | | Number of Individuals Covered | 65 | | Insurance policy start date | 2015-04-01 | | Insurance policy end date | 2016-03-31 | | Total amount of commissions paid to insurance broker | USD $16,252 | | Total amount of fees paid to insurance company | USD $2,775 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | CRITICAL ILLNESS, ACCIDENT | | Welfare Benefit Premiums Paid to Carrier | USD $81,253 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $16,252 | | Amount paid for insurance broker fees | 2775 | | Insurance broker organization code? | 3 | | Insurance broker name | GARY G OETGEN INC |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00398127 |
| Policy instance | 2 |
| Insurance contract or identification number | 00398127 | | Number of Individuals Covered | 106 | | Insurance policy start date | 2014-04-01 | | Insurance policy end date | 2015-03-31 | | Total amount of commissions paid to insurance broker | USD $3,212 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $36,052 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,803 | | Insurance broker organization code? | 3 | | Insurance broker name | THE MATHIS-HILL-ROBERTSON AGENCY |
|
| AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) |
| Policy contract number | 19134 |
| Policy instance | 1 |
| Insurance contract or identification number | 19134 | | Number of Individuals Covered | 205 | | Insurance policy start date | 2014-04-01 | | Insurance policy end date | 2015-03-31 | | Total amount of commissions paid to insurance broker | USD $25,131 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $38,735 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,231 | | Insurance broker organization code? | 3 | | Insurance broker name | PAUL COLLINS |
|
| CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 ) |
| Policy contract number | 0000009641 |
| Policy instance | 2 |
| Insurance contract or identification number | 0000009641 | | Number of Individuals Covered | 81 | | Insurance policy start date | 2013-04-01 | | Insurance policy end date | 2014-03-31 | | Total amount of commissions paid to insurance broker | USD $3,209 | | Other welfare benefits provided | OTHER (SPECIFY) | | Welfare Benefit Premiums Paid to Carrier | USD $12,631 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,376 | | Insurance broker name | CR RAMSEY POTTS |
|
| AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 ) |
| Policy contract number | MJ430 |
| Policy instance | 1 |
| Insurance contract or identification number | MJ430 | | Number of Individuals Covered | 164 | | Insurance policy start date | 2013-04-01 | | Insurance policy end date | 2014-03-31 | | Total amount of commissions paid to insurance broker | USD $13,216 | | Total amount of fees paid to insurance company | USD $2 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | CANCER | | Welfare Benefit Premiums Paid to Carrier | USD $67,281 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,903 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 2 | | Insurance broker name | J. BECK INC |
|
| CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 ) |
| Policy contract number | 0000009641 |
| Policy instance | 2 |
| Insurance contract or identification number | 0000009641 | | Number of Individuals Covered | 81 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $4,865 | | Other welfare benefits provided | OTHER (SPECIFY) | | Welfare Benefit Premiums Paid to Carrier | USD $11,392 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,211 | | Insurance broker name | GEORGIA SOUTH |
|
| AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 ) |
| Policy contract number | MJ430 |
| Policy instance | 1 |
| Insurance contract or identification number | MJ430 | | Number of Individuals Covered | 223 | | Insurance policy start date | 2012-04-01 | | Insurance policy end date | 2013-03-31 | | Total amount of commissions paid to insurance broker | USD $18,066 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | CANCER | | Welfare Benefit Premiums Paid to Carrier | USD $78,073 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,428 | | Insurance broker name | CARLTON F. REID JR |
|
| AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 ) |
| Policy contract number | 58-0663085 |
| Policy instance | 1 |
| Insurance contract or identification number | 58-0663085 | | Number of Individuals Covered | 229 | | Insurance policy start date | 2011-04-01 | | Insurance policy end date | 2012-03-31 | | Total amount of commissions paid to insurance broker | USD $15,883 | | Total amount of fees paid to insurance company | USD $1,383 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | CANCER | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 ) |
| Policy contract number | 9641 |
| Policy instance | 2 |
| Insurance contract or identification number | 9641 | | Number of Individuals Covered | 58 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $5,528 | | Other welfare benefits provided | CRITICAL CARE | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
