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THE LAS OLAS COMPANY AND SUBSIDIARIES PREMIUM CONVERSION PLAN 401k Plan overview

Plan NameTHE LAS OLAS COMPANY AND SUBSIDIARIES PREMIUM CONVERSION PLAN
Plan identification number 501

THE LAS OLAS COMPANY AND SUBSIDIARIES PREMIUM CONVERSION PLAN 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

401k Sponsoring company profile

LAS OLAS COMPANY INC. has sponsored the creation of one or more 401k plans.

Company Name:LAS OLAS COMPANY INC.
Employer identification number (EIN):590198485
NAIC Classification:721110
NAIC Description:Hotels (except Casino Hotels) and Motels

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THE LAS OLAS COMPANY AND SUBSIDIARIES PREMIUM CONVERSION PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-03-01DIANE D'AGELO2023-11-16 MIKE WEYMOUTH2023-11-16
5012021-05-01DIANE D'ANGELO2022-12-23 MIKE WEYMOUTH2022-12-23
5012020-05-01DIANE D'ANGELO2021-11-19 MIKE WEYMOUTH2021-11-19
5012019-05-01DIANE D'ANGELO2020-11-30 MIKE WEYMOUTH2020-11-30
5012018-05-01DIANE D'ANGELO2019-11-21 DIANE D'ANGELO2019-11-21
5012018-05-01 DIANE D'ANGELO2019-11-21
5012018-05-01 DIANE D'ANGELO2019-11-21
5012018-05-01 DIANE D'ANGELO2019-11-21
5012018-05-01 DIANE D'ANGELO2019-11-21
5012017-05-01
5012016-05-01
5012015-05-01
5012014-05-01
5012013-05-01
5012011-05-01DIANE D'ANGELO
5012010-05-01DIANE D'ANGELO
5012009-05-01DIANE D'ANGELO
5012009-04-01DIANE D'ANGELO

Plan Statistics for THE LAS OLAS COMPANY AND SUBSIDIARIES PREMIUM CONVERSION PLAN

401k plan membership statisitcs for THE LAS OLAS COMPANY AND SUBSIDIARIES PREMIUM CONVERSION PLAN

Measure Date Value
2022: THE LAS OLAS COMPANY AND SUBSIDIARIES PREMIUM CONVERSION PLAN 2022 401k membership
Total participants, beginning-of-year2022-03-01138
Total number of active participants reported on line 7a of the Form 55002022-03-01138
Total of all active and inactive participants2022-03-01138
Total participants2022-03-01138
2021: THE LAS OLAS COMPANY AND SUBSIDIARIES PREMIUM CONVERSION PLAN 2021 401k membership
Total participants, beginning-of-year2021-05-01138
Total of all active and inactive participants2021-05-010
Total participants2021-05-010
2020: THE LAS OLAS COMPANY AND SUBSIDIARIES PREMIUM CONVERSION PLAN 2020 401k membership
Total participants, beginning-of-year2020-05-01109
Total of all active and inactive participants2020-05-010
Total participants2020-05-010
2019: THE LAS OLAS COMPANY AND SUBSIDIARIES PREMIUM CONVERSION PLAN 2019 401k membership
Total participants, beginning-of-year2019-05-01173
Total of all active and inactive participants2019-05-010
Total participants2019-05-010
2018: THE LAS OLAS COMPANY AND SUBSIDIARIES PREMIUM CONVERSION PLAN 2018 401k membership
Total participants, beginning-of-year2018-05-01126
Total of all active and inactive participants2018-05-010
Total participants2018-05-010
2017: THE LAS OLAS COMPANY AND SUBSIDIARIES PREMIUM CONVERSION PLAN 2017 401k membership
Total participants, beginning-of-year2017-05-01195
Total of all active and inactive participants2017-05-010
Total participants2017-05-010
2016: THE LAS OLAS COMPANY AND SUBSIDIARIES PREMIUM CONVERSION PLAN 2016 401k membership
Total participants, beginning-of-year2016-05-01213
Total of all active and inactive participants2016-05-010
Total participants2016-05-010
2015: THE LAS OLAS COMPANY AND SUBSIDIARIES PREMIUM CONVERSION PLAN 2015 401k membership
Total participants, beginning-of-year2015-05-01241
Total of all active and inactive participants2015-05-010
Total participants2015-05-010
2014: THE LAS OLAS COMPANY AND SUBSIDIARIES PREMIUM CONVERSION PLAN 2014 401k membership
Total participants, beginning-of-year2014-05-01241
Total of all active and inactive participants2014-05-010
Total participants2014-05-010
2013: THE LAS OLAS COMPANY AND SUBSIDIARIES PREMIUM CONVERSION PLAN 2013 401k membership
Total participants, beginning-of-year2013-05-01241
Total of all active and inactive participants2013-05-010
Total participants2013-05-010
2011: THE LAS OLAS COMPANY AND SUBSIDIARIES PREMIUM CONVERSION PLAN 2011 401k membership
Total participants, beginning-of-year2011-05-01415
Total of all active and inactive participants2011-05-010
Total participants2011-05-010
2010: THE LAS OLAS COMPANY AND SUBSIDIARIES PREMIUM CONVERSION PLAN 2010 401k membership
Total participants, beginning-of-year2010-05-01415
Total of all active and inactive participants2010-05-010
Total participants2010-05-010
2009: THE LAS OLAS COMPANY AND SUBSIDIARIES PREMIUM CONVERSION PLAN 2009 401k membership
Total participants, beginning-of-year2009-05-01415
Total of all active and inactive participants2009-05-010
Total participants2009-05-010
Total participants, beginning-of-year2009-04-01415
Total of all active and inactive participants2009-04-010
Total participants2009-04-010

Form 5500 Responses for THE LAS OLAS COMPANY AND SUBSIDIARIES PREMIUM CONVERSION PLAN

2022: THE LAS OLAS COMPANY AND SUBSIDIARIES PREMIUM CONVERSION PLAN 2022 form 5500 responses
2022-03-01Type of plan entitySingle employer plan
2022-03-01Submission has been amendedNo
2022-03-01This submission is the final filingNo
2022-03-01This return/report is a short plan year return/report (less than 12 months)No
2022-03-01Plan is a collectively bargained planNo
2022-03-01Plan funding arrangement – InsuranceYes
2022-03-01Plan benefit arrangement – InsuranceYes
2021: THE LAS OLAS COMPANY AND SUBSIDIARIES PREMIUM CONVERSION PLAN 2021 form 5500 responses
2021-05-01Type of plan entitySingle employer plan
2021-05-01Plan funding arrangement – InsuranceYes
2021-05-01Plan benefit arrangement – InsuranceYes
2020: THE LAS OLAS COMPANY AND SUBSIDIARIES PREMIUM CONVERSION PLAN 2020 form 5500 responses
2020-05-01Type of plan entitySingle employer plan
2020-05-01Plan funding arrangement – InsuranceYes
2020-05-01Plan benefit arrangement – InsuranceYes
2019: THE LAS OLAS COMPANY AND SUBSIDIARIES PREMIUM CONVERSION PLAN 2019 form 5500 responses
2019-05-01Type of plan entitySingle employer plan
2019-05-01Plan funding arrangement – InsuranceYes
2019-05-01Plan benefit arrangement – InsuranceYes
2018: THE LAS OLAS COMPANY AND SUBSIDIARIES PREMIUM CONVERSION PLAN 2018 form 5500 responses
2018-05-01Type of plan entitySingle employer plan
2018-05-01Plan funding arrangement – InsuranceYes
2018-05-01Plan benefit arrangement – InsuranceYes
2017: THE LAS OLAS COMPANY AND SUBSIDIARIES PREMIUM CONVERSION PLAN 2017 form 5500 responses
2017-05-01Type of plan entitySingle employer plan
2017-05-01Plan funding arrangement – InsuranceYes
2017-05-01Plan benefit arrangement – InsuranceYes
2016: THE LAS OLAS COMPANY AND SUBSIDIARIES PREMIUM CONVERSION PLAN 2016 form 5500 responses
2016-05-01Type of plan entitySingle employer plan
2016-05-01Plan funding arrangement – InsuranceYes
2016-05-01Plan benefit arrangement – InsuranceYes
2015: THE LAS OLAS COMPANY AND SUBSIDIARIES PREMIUM CONVERSION PLAN 2015 form 5500 responses
2015-05-01Type of plan entitySingle employer plan
2015-05-01Plan funding arrangement – InsuranceYes
2015-05-01Plan benefit arrangement – InsuranceYes
2014: THE LAS OLAS COMPANY AND SUBSIDIARIES PREMIUM CONVERSION PLAN 2014 form 5500 responses
2014-05-01Type of plan entitySingle employer plan
2014-05-01Plan funding arrangement – InsuranceYes
2014-05-01Plan benefit arrangement – InsuranceYes
2013: THE LAS OLAS COMPANY AND SUBSIDIARIES PREMIUM CONVERSION PLAN 2013 form 5500 responses
2013-05-01Type of plan entitySingle employer plan
2013-05-01Plan funding arrangement – InsuranceYes
2013-05-01Plan benefit arrangement – InsuranceYes
2011: THE LAS OLAS COMPANY AND SUBSIDIARIES PREMIUM CONVERSION PLAN 2011 form 5500 responses
2011-05-01Type of plan entitySingle employer plan
2011-05-01Plan funding arrangement – InsuranceYes
2011-05-01Plan benefit arrangement – InsuranceYes
2010: THE LAS OLAS COMPANY AND SUBSIDIARIES PREMIUM CONVERSION PLAN 2010 form 5500 responses
2010-05-01Type of plan entitySingle employer plan
2010-05-01Plan funding arrangement – InsuranceYes
2010-05-01Plan benefit arrangement – InsuranceYes
2009: THE LAS OLAS COMPANY AND SUBSIDIARIES PREMIUM CONVERSION PLAN 2009 form 5500 responses
2009-05-01Type of plan entitySingle employer plan
2009-05-01Plan funding arrangement – InsuranceYes
2009-05-01Plan benefit arrangement – InsuranceYes
2009-04-01Type of plan entitySingle employer plan
2009-04-01This return/report is a short plan year return/report (less than 12 months)Yes
2009-04-01Plan funding arrangement – InsuranceYes
2009-04-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number417071
Policy instance 7
Insurance contract or identification number417071
Number of Individuals Covered131
Insurance policy start date2022-05-01
Insurance policy end date2023-04-30
Total amount of commissions paid to insurance brokerUSD $5,936
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 providedVOL LIFE
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 $43,901
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $472
Additional information about fees paid to insurance brokerADMIN SERVICES
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number417071
Policy instance 6
Insurance contract or identification number417071
Number of Individuals Covered9
Insurance policy start date2022-05-01
Insurance policy end date2023-04-30
Total amount of commissions paid to insurance brokerUSD $1,242
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 BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
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 $10,405
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $113
Additional information about fees paid to insurance brokerADMIN SERVICES
Insurance broker organization code?3
HUMANA MEDICAL PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95270 )
Policy contract number538359
Policy instance 4
Insurance contract or identification number538359
Number of Individuals Covered105
Insurance policy start date2022-05-01
Insurance policy end date2023-04-30
Total amount of commissions paid to insurance brokerUSD $46,485
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 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
Welfare Benefit Premiums Paid to CarrierUSD $865,451
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $46,485
Additional information about fees paid to insurance brokerCONSULTING SERVICES
Insurance broker organization code?3
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number538359
Policy instance 3
Insurance contract or identification number538359
Number of Individuals Covered87
Insurance policy start date2022-05-01
Insurance policy end date2023-04-30
Total amount of commissions paid to insurance brokerUSD $1,442
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 $6,150
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $668
Additional information about fees paid to insurance brokerCONSULTING SERVICES
Insurance broker organization code?3
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number538359
Policy instance 2
Insurance contract or identification number538359
Number of Individuals Covered67
Insurance policy start date2022-05-01
Insurance policy end date2023-04-30
Total amount of commissions paid to insurance brokerUSD $1,442
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 BenefitYes
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
Welfare Benefit Premiums Paid to CarrierUSD $26,781
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,442
Additional information about fees paid to insurance brokerCONSULTING SERVICES
Insurance broker organization code?3
COMPBENEFITS COMPANY (National Association of Insurance Commissioners NAIC id number: 52015 )
Policy contract number538359
Policy instance 1
Insurance contract or identification number538359
Number of Individuals Covered53
Insurance policy start date2022-05-01
Insurance policy end date2023-04-30
Total amount of commissions paid to insurance brokerUSD $537
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 BenefitYes
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
Welfare Benefit Premiums Paid to CarrierUSD $9,927
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $537
Additional information about fees paid to insurance brokerCONSULTING SERVICES
Insurance broker organization code?3
COMPBENEFITS COMPANY (National Association of Insurance Commissioners NAIC id number: 52015 )
Policy contract number538359
Policy instance 1
Insurance contract or identification number538359
Number of Individuals Covered51
Insurance policy start date2021-05-01
Insurance policy end date2022-04-30
Total amount of commissions paid to insurance brokerUSD $436
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $9,646
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $436
Additional information about fees paid to insurance brokerBENEFITS CONSULTATION
Insurance broker organization code?3
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number538359
Policy instance 2
Insurance contract or identification number538359
Number of Individuals Covered54
Insurance policy start date2021-05-01
Insurance policy end date2022-04-30
Total amount of commissions paid to insurance brokerUSD $1,143
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $25,071
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,143
Additional information about fees paid to insurance brokerBENEFITS CONSULTATION
Insurance broker organization code?3
HUMANA MEDICAL PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95270 )
Policy contract number538359
Policy instance 3
Insurance contract or identification number538359
Number of Individuals Covered97
Insurance policy start date2021-05-01
Insurance policy end date2022-04-30
Total amount of commissions paid to insurance brokerUSD $37,085
Health Insurance Welfare BenefitYes
Other welfare benefits providedPOS
Welfare Benefit Premiums Paid to CarrierUSD $818,945
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $37,085
Additional information about fees paid to insurance brokerBENEFITS CONSULTATION
Insurance broker organization code?3
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number538359
Policy instance 4
Insurance contract or identification number538359
Number of Individuals Covered79
Insurance policy start date2021-05-01
Insurance policy end date2022-04-30
Total amount of commissions paid to insurance brokerUSD $547
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,016
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $547
Additional information about fees paid to insurance brokerBENEFITS CONSULTATION
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number717070
Policy instance 6
Insurance contract or identification number717070
Number of Individuals Covered138
Insurance policy start date2021-05-01
Insurance policy end date2022-04-30
Total amount of commissions paid to insurance brokerUSD $4,653
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $42,278
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,653
Additional information about fees paid to insurance brokerBENEFITS CONSULTATION
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number417071
Policy instance 5
Insurance contract or identification number417071
Number of Individuals Covered11
Insurance policy start date2021-05-01
Insurance policy end date2022-04-30
Total amount of commissions paid to insurance brokerUSD $1,017
Life Insurance Welfare BenefitYes
Other welfare benefits providedADD
Welfare Benefit Premiums Paid to CarrierUSD $11,049
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,017
Additional information about fees paid to insurance brokerBENEFITS CONSULTATION
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number417071
Policy instance 1
Insurance contract or identification number417071
Number of Individuals Covered11
Insurance policy start date2020-05-01
Insurance policy end date2021-04-30
Total amount of commissions paid to insurance brokerUSD $1,175
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $11,036
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $71
Additional information about fees paid to insurance brokerBROKER SERVICES
Insurance broker organization code?3
HUMANA MEDICAL PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95270 )
Policy contract number538359
Policy instance 5
Insurance contract or identification number538359
Number of Individuals Covered90
Insurance policy start date2020-05-01
Insurance policy end date2021-04-30
Total amount of commissions paid to insurance brokerUSD $35,469
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $722,013
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $35,469
Additional information about fees paid to insurance brokerBENEFITS CONSULTATION
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number417070
Policy instance 2
Insurance contract or identification number417070
Number of Individuals Covered109
Insurance policy start date2020-05-01
Insurance policy end date2021-04-30
Total amount of commissions paid to insurance brokerUSD $4,772
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $37,407
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $282
Additional information about fees paid to insurance brokerBROKER SERVICES
Insurance broker organization code?3
COMPBENEFITS COMPANY (National Association of Insurance Commissioners NAIC id number: 52015 )
Policy contract number538359
Policy instance 3
Insurance contract or identification number538359
Number of Individuals Covered49
Insurance policy start date2020-05-01
Insurance policy end date2021-04-30
Total amount of commissions paid to insurance brokerUSD $562
Other welfare benefits providedDENTAL HMO
Welfare Benefit Premiums Paid to CarrierUSD $11,393
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $562
Additional information about fees paid to insurance brokerBENEFITS CONSULTATION
Insurance broker organization code?3
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number538359
Policy instance 4
Insurance contract or identification number538359
Number of Individuals Covered58
Insurance policy start date2020-05-01
Insurance policy end date2021-04-30
Total amount of commissions paid to insurance brokerUSD $1,749
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,683
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,749
Additional information about fees paid to insurance brokerBENEFITS CONSULTATION
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberR0643809
Policy instance 6
Insurance contract or identification numberR0643809
Number of Individuals Covered18
Insurance policy start date2019-05-01
Insurance policy end date2020-04-30
Total amount of commissions paid to insurance brokerUSD $521
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,061
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $521
Additional information about fees paid to insurance brokerBENEFITS CONSULTATION
Insurance broker organization code?3
HUMANA MEDICAL PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95270 )
Policy contract number538359
Policy instance 3
Insurance contract or identification number538359
Number of Individuals Covered146
Insurance policy start date2019-05-01
Insurance policy end date2020-04-30
Total amount of commissions paid to insurance brokerUSD $48,687
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $925,639
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $48,687
Additional information about fees paid to insurance brokerBENEFITS CONSULTATION
Insurance broker organization code?3
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number538359
Policy instance 2
Insurance contract or identification number538359
Number of Individuals Covered67
Insurance policy start date2019-05-01
Insurance policy end date2020-04-30
Total amount of commissions paid to insurance brokerUSD $1,773
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $33,094
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,773
Additional information about fees paid to insurance brokerBENEFITS CONSULTATION
Insurance broker organization code?3
COMPBENEFITS COMPANY (National Association of Insurance Commissioners NAIC id number: 52015 )
Policy contract number538359
Policy instance 1
Insurance contract or identification number538359
Number of Individuals Covered96
Insurance policy start date2019-05-01
Insurance policy end date2020-04-30
Total amount of commissions paid to insurance brokerUSD $1,066
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $20,443
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,066
Additional information about fees paid to insurance brokerBENEFITS CONSULTATION
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number417071
Policy instance 7
Insurance contract or identification number417071
Number of Individuals Covered23
Insurance policy start date2019-05-01
Insurance policy end date2020-04-30
Total amount of commissions paid to insurance brokerUSD $1,088
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $10,882
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,088
Additional information about fees paid to insurance brokerBENEFITS CONSULTATION
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number417070
Policy instance 8
Insurance contract or identification number417070
Number of Individuals Covered173
Insurance policy start date2019-05-01
Insurance policy end date2020-04-30
Total amount of commissions paid to insurance brokerUSD $6,566
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedSTD
Welfare Benefit Premiums Paid to CarrierUSD $60,468
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,566
Additional information about fees paid to insurance brokerBENEFITS CONSULTATION
Insurance broker organization code?3
HUMANA MEDICAL PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95270 )
Policy contract number538359
Policy instance 4
Insurance contract or identification number538359
Number of Individuals Covered3
Insurance policy start date2019-05-01
Insurance policy end date2020-04-30
Total amount of commissions paid to insurance brokerUSD $1,485
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $29,116
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,485
Insurance broker organization code?3
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number538359
Policy instance 5
Insurance contract or identification number538359
Number of Individuals Covered99
Insurance policy start date2019-05-01
Insurance policy end date2020-04-30
Total amount of commissions paid to insurance brokerUSD $915
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $8,611
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $915
Additional information about fees paid to insurance brokerBENEFITS CONSULTATION
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number417071
Policy instance 1
Insurance contract or identification number417071
Number of Individuals Covered20
Insurance policy start date2018-05-01
Insurance policy end date2019-04-30
Total amount of commissions paid to insurance brokerUSD $722
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,223
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $722
Additional information about fees paid to insurance brokerBENEFITS CONSULTATION
Insurance broker organization code?3
COMPBENEFITS COMPANY (National Association of Insurance Commissioners NAIC id number: 52015 )
Policy contract number538359
Policy instance 3
Insurance contract or identification number538359
Number of Individuals Covered51
Insurance policy start date2018-05-01
Insurance policy end date2019-04-30
Total amount of commissions paid to insurance brokerUSD $36,054
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $11,743
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $36,054
Additional information about fees paid to insurance brokerBENEFITS CONSULTATION
Insurance broker organization code?3
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number538359
Policy instance 4
Insurance contract or identification number538359
Number of Individuals Covered80
Insurance policy start date2018-05-01
Insurance policy end date2019-04-30
Total amount of commissions paid to insurance brokerUSD $1,782
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $32,857
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,782
Additional information about fees paid to insurance brokerBENEFITS CONSULTATION
Insurance broker organization code?3
HUMANA MEDICAL PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95270 )
Policy contract number538359
Policy instance 5
Insurance contract or identification number538359
Number of Individuals Covered128
Insurance policy start date2018-05-01
Insurance policy end date2019-04-30
Total amount of commissions paid to insurance brokerUSD $33,729
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $734,237
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $33,729
Additional information about fees paid to insurance brokerBENEFITS CONSULTATION
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number417070
Policy instance 2
Insurance contract or identification number417070
Number of Individuals Covered227
Insurance policy start date2018-05-01
Insurance policy end date2019-04-30
Total amount of commissions paid to insurance brokerUSD $6,081
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $53,487
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,081
Additional information about fees paid to insurance brokerBENEFITS CONSULTATION
Insurance broker organization code?3
COMPBENEFITS COMPANY (National Association of Insurance Commissioners NAIC id number: 52015 )
Policy contract number53859
Policy instance 1
Insurance contract or identification number53859
Number of Individuals Covered45
Insurance policy start date2017-05-01
Insurance policy end date2018-04-30
Total amount of commissions paid to insurance brokerUSD $505
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $10,098
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $505
Additional information about fees paid to insurance brokerBENEFITS CONSULTATION
Insurance broker organization code?3
Insurance broker nameEBS ADVISORS, I8NC
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number53859
Policy instance 2
Insurance contract or identification number53859
Number of Individuals Covered40
Insurance policy start date2017-05-01
Insurance policy end date2018-04-30
Total amount of commissions paid to insurance brokerUSD $866
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $17,798
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $866
Additional information about fees paid to insurance brokerBENEFITS CONSULTATION
Insurance broker organization code?3
Insurance broker nameEBS ADVISORS, INC
HUMANA MEDICAL PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95270 )
Policy contract number538359
Policy instance 3
Insurance contract or identification number538359
Number of Individuals Covered109
Insurance policy start date2017-05-01
Insurance policy end date2018-04-30
Total amount of commissions paid to insurance brokerUSD $30,967
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $620,314
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $30,967
Additional information about fees paid to insurance brokerBENEFITS CONSULTATION
Insurance broker organization code?3
Insurance broker nameEBS ADVISORS, INC
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number538359
Policy instance 5
Insurance contract or identification number538359
Number of Individuals Covered68
Insurance policy start date2017-05-01
Insurance policy end date2018-04-30
Total amount of commissions paid to insurance brokerUSD $544
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,456
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $544
Additional information about fees paid to insurance brokerBENEFITS CONSULTATION
Insurance broker organization code?3
Insurance broker nameEBS ADVISORS, INC
HUMANA MEDICAL PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95270 )
Policy contract number538359
Policy instance 4
Insurance contract or identification number538359
Number of Individuals Covered2
Insurance policy start date2017-05-01
Insurance policy end date2018-04-30
Total amount of commissions paid to insurance brokerUSD $1,108
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $22,161
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,108
Additional information about fees paid to insurance brokerBENEFITS CONSULTATI0N
Insurance broker organization code?3
Insurance broker nameEBS ADVISORS, INC
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number417071
Policy instance 6
Insurance contract or identification number417071
Number of Individuals Covered22
Insurance policy start date2017-05-01
Insurance policy end date2018-04-30
Total amount of commissions paid to insurance brokerUSD $784
Life Insurance Welfare BenefitYes
Other welfare benefits providedADD
Welfare Benefit Premiums Paid to CarrierUSD $7,848
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $784
Additional information about fees paid to insurance brokerBENEFITS CONSULTATION
Insurance broker organization code?3
Insurance broker nameEBS ADVISORS
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number417070
Policy instance 7
Insurance contract or identification number417070
Number of Individuals Covered195
Insurance policy start date2017-05-01
Insurance policy end date2018-04-30
Total amount of commissions paid to insurance brokerUSD $4,825
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $40,753
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,825
Additional information about fees paid to insurance brokerBENEFITS CONSULTATION
Insurance broker nameEBS ADVISORS
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number417070
Policy instance 1
Insurance contract or identification number417070
Number of Individuals Covered215
Insurance policy start date2015-05-01
Insurance policy end date2016-04-30
Total amount of commissions paid to insurance brokerUSD $5,431
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $46,813
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,431
Additional information about fees paid to insurance brokerBENEFITS CONSULTATION
Insurance broker organization code?3
Insurance broker nameEBS ADVISORS, INC
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number417071
Policy instance 2
Insurance contract or identification number417071
Number of Individuals Covered19
Insurance policy start date2015-05-01
Insurance policy end date2016-04-30
Total amount of commissions paid to insurance brokerUSD $621
Other welfare benefits providedVOLUNTARY LIFE ADD
Welfare Benefit Premiums Paid to CarrierUSD $6,210
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $621
Additional information about fees paid to insurance brokerBENEFITS CONSULTATION
Insurance broker organization code?3
Insurance broker nameEBS ADVISORS, INC
COMPBENEFITS COMPANY (National Association of Insurance Commissioners NAIC id number: 52015 )
Policy contract number538359
Policy instance 3
Insurance contract or identification number538359
Number of Individuals Covered42
Insurance policy start date2015-05-01
Insurance policy end date2016-04-30
Total amount of commissions paid to insurance brokerUSD $443
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $8,866
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $443
Additional information about fees paid to insurance brokerBENEFITS CONSULTATION
Insurance broker organization code?3
Insurance broker nameEBS ADVISORS, INC
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number538359
Policy instance 4
Insurance contract or identification number538359
Number of Individuals Covered66
Insurance policy start date2015-05-01
Insurance policy end date2016-04-30
Total amount of commissions paid to insurance brokerUSD $1,508
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $25,025
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,508
Additional information about fees paid to insurance brokerBENEFITS CONSULTATION
Insurance broker organization code?3
Insurance broker nameEBS ADVISORS, INC
HUMANA MEDICAL PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95270 )
Policy contract number538359
Policy instance 5
Insurance contract or identification number538359
Number of Individuals Covered101
Insurance policy start date2015-05-01
Insurance policy end date2016-04-30
Total amount of commissions paid to insurance brokerUSD $25,453
Total amount of fees paid to insurance companyUSD $254
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $508,431
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $25,453
Amount paid for insurance broker fees254
Additional information about fees paid to insurance brokerBENEFITS CONSULTATION
Insurance broker organization code?3
Insurance broker nameEBS ADVISORS, INC
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number538359
Policy instance 1
Insurance contract or identification number538359
Number of Individuals Covered103
Insurance policy start date2014-05-01
Insurance policy end date2015-04-30
Total amount of commissions paid to insurance brokerUSD $32,897
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $595,813
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $32,897
Additional information about fees paid to insurance brokerBENEFITS CONSULTATION
Insurance broker organization code?3
Insurance broker nameEBS ADVISORS, INC
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number417070
Policy instance 2
Insurance contract or identification number417070
Number of Individuals Covered208
Insurance policy start date2014-05-01
Insurance policy end date2015-04-30
Total amount of commissions paid to insurance brokerUSD $5,654
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedADD
Welfare Benefit Premiums Paid to CarrierUSD $40,043
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,654
Additional information about fees paid to insurance brokerBENEFITS CONSULTATION
Insurance broker organization code?3
Insurance broker nameEBS ADVISORS, INC
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10158112
Policy instance 2
Insurance contract or identification number10158112
Number of Individuals Covered127
Insurance policy start date2013-05-01
Insurance policy end date2014-04-30
Total amount of commissions paid to insurance brokerUSD $1,951
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $19,518
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,951
Additional information about fees paid to insurance brokerBENEFITS CONSULTATION
Insurance broker organization code?3
Insurance broker nameEBS ADVISORS, INC
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number400158113
Policy instance 3
Insurance contract or identification number400158113
Number of Individuals Covered18
Insurance policy start date2013-05-01
Insurance policy end date2014-04-30
Total amount of commissions paid to insurance brokerUSD $550
Other welfare benefits providedVOLUNTARY LIFE
Welfare Benefit Premiums Paid to CarrierUSD $5,503
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $550
Additional information about fees paid to insurance brokerBENEFITS CONSULTATION
Insurance broker organization code?3
Insurance broker nameEBS ADVISORS, INC
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number400158114
Policy instance 4
Insurance contract or identification number400158114
Number of Individuals Covered23
Insurance policy start date2013-05-01
Insurance policy end date2014-04-30
Total amount of commissions paid to insurance brokerUSD $1,293
Other welfare benefits providedVOLUNTARY WI
Welfare Benefit Premiums Paid to CarrierUSD $12,938
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,293
Additional information about fees paid to insurance brokerBENEFITS CONSULTATION
Insurance broker organization code?3
Insurance broker nameEBS ADVISORS, INC
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10158111
Policy instance 1
Insurance contract or identification number10158111
Number of Individuals Covered147
Insurance policy start date2013-05-01
Insurance policy end date2014-04-30
Total amount of commissions paid to insurance brokerUSD $1,143
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $11,434
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,143
Additional information about fees paid to insurance brokerBENEFITS CONSULTATION
Insurance broker organization code?3
Insurance broker nameEBS ADVISORS, INC
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number538359
Policy instance 5
Insurance contract or identification number538359
Number of Individuals Covered105
Insurance policy start date2013-05-01
Insurance policy end date2014-04-30
Total amount of commissions paid to insurance brokerUSD $34,045
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $627,840
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $34,045
Additional information about fees paid to insurance brokerBENEFITS CONSULTATION
Insurance broker organization code?3
Insurance broker nameEBS ADVISORS, INC
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number865596G
Policy instance 2
Insurance contract or identification number865596G
Number of Individuals Covered141
Insurance policy start date2011-05-01
Insurance policy end date2012-04-30
Total amount of commissions paid to insurance brokerUSD $7,185
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $49,422
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number538359
Policy instance 1
Insurance contract or identification number538359
Number of Individuals Covered99
Insurance policy start date2011-05-01
Insurance policy end date2012-04-30
Total amount of commissions paid to insurance brokerUSD $40,741
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $600,481
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number865596G
Policy instance 3
Insurance contract or identification number865596G
Number of Individuals Covered165
Insurance policy start date2010-05-01
Insurance policy end date2011-04-30
Total amount of commissions paid to insurance brokerUSD $7,677
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $58,820
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number9720350
Policy instance 2
Insurance contract or identification number9720350
Number of Individuals Covered100
Insurance policy start date2010-05-01
Insurance policy end date2011-04-30
Total amount of commissions paid to insurance brokerUSD $729
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,300
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HUMANA MEDICAL PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95270 )
Policy contract number538359
Policy instance 1
Insurance contract or identification number538359
Number of Individuals Covered113
Insurance policy start date2010-05-01
Insurance policy end date2011-04-30
Total amount of commissions paid to insurance brokerUSD $32,722
Total amount of fees paid to insurance companyUSD $5,097
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $737,472
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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