FOODONICS INTERNATIONAL, INC. has sponsored the creation of one or more 401k plans.
Additional information about FOODONICS INTERNATIONAL, INC.
Submission information for form 5500 for 401k plan FOODONICS INTERNATIONAL, INC.
401k plan membership statisitcs for FOODONICS INTERNATIONAL, INC.
| Measure | Date | Value |
|---|
| 2016: FOODONICS INTERNATIONAL, INC. 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-04-01 | 205 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-04-01 | 0 |
| 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 | 0 |
| 2015: FOODONICS INTERNATIONAL, INC. 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-04-01 | 190 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-04-01 | 205 |
| Number of retired or separated participants receiving benefits | 2015-04-01 | 1 |
| 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 | 206 |
| 2014: FOODONICS INTERNATIONAL, INC. 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-04-01 | 176 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-04-01 | 190 |
| Number of retired or separated participants receiving benefits | 2014-04-01 | 4 |
| 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 | 194 |
| 2013: FOODONICS INTERNATIONAL, INC. 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-04-01 | 152 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-04-01 | 176 |
| Number of retired or separated participants receiving benefits | 2013-04-01 | 2 |
| Total of all active and inactive participants | 2013-04-01 | 178 |
| 2012: FOODONICS INTERNATIONAL, INC. 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-04-01 | 160 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-04-01 | 152 |
| Total of all active and inactive participants | 2012-04-01 | 152 |
| 2011: FOODONICS INTERNATIONAL, INC. 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-04-01 | 227 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-04-01 | 160 |
| Total of all active and inactive participants | 2011-04-01 | 160 |
| 2009: FOODONICS INTERNATIONAL, INC. 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-04-01 | 141 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-04-01 | 158 |
| Total of all active and inactive participants | 2009-04-01 | 158 |
| 2006: FOODONICS INTERNATIONAL, INC. 2006 401k membership |
|---|
| Total participants, beginning-of-year | 2006-04-01 | 114 |
| Total number of active participants reported on line 7a of the Form 5500 | 2006-04-01 | 128 |
| Total of all active and inactive participants | 2006-04-01 | 128 |
| Total participants | 2006-04-01 | 128 |
| 2005: FOODONICS INTERNATIONAL, INC. 2005 401k membership |
|---|
| Total participants, beginning-of-year | 2005-04-01 | 99 |
| Total number of active participants reported on line 7a of the Form 5500 | 2005-04-01 | 114 |
| Total of all active and inactive participants | 2005-04-01 | 114 |
| Total participants | 2005-04-01 | 114 |
| 2016: FOODONICS INTERNATIONAL, INC. 2016 form 5500 responses |
|---|
| 2016-04-01 | Type of plan entity | Single employer plan |
| 2016-04-01 | This submission is the final filing | Yes |
| 2016-04-01 | Plan funding arrangement – Insurance | Yes |
| 2016-04-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2016-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: FOODONICS INTERNATIONAL, INC. 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 funding arrangement – General assets of the sponsor | Yes |
| 2015-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: FOODONICS INTERNATIONAL, INC. 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 funding arrangement – General assets of the sponsor | Yes |
| 2014-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: FOODONICS INTERNATIONAL, INC. 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 funding arrangement – General assets of the sponsor | Yes |
| 2013-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: FOODONICS INTERNATIONAL, INC. 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 funding arrangement – General assets of the sponsor | Yes |
| 2012-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: FOODONICS INTERNATIONAL, INC. 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 funding arrangement – General assets of the sponsor | Yes |
| 2011-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: FOODONICS INTERNATIONAL, INC. 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 funding arrangement – General assets of the sponsor | Yes |
| 2009-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2006: FOODONICS INTERNATIONAL, INC. 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 funding arrangement – General assets of the sponsor | Yes |
| 2006-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2005: FOODONICS INTERNATIONAL, INC. 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 funding arrangement – General assets of the sponsor | Yes |
| 2005-04-01 | Plan benefit arrangement – Insurance | Yes |
| AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) |
| Policy contract number | 91292 |
| Policy instance | 1 |
| Insurance contract or identification number | 91292 | | Number of Individuals Covered | 28 | | Insurance policy start date | 2015-06-01 | | Insurance policy end date | 2016-05-31 | | Total amount of commissions paid to insurance broker | USD $1,826 | | Welfare Benefit Premiums Paid to Carrier | USD $18,387 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | | Commission paid to Insurance Broker | USD $1,826 | | Insurance broker organization code? | 3 | | Insurance broker name | ACRISURE LLC DBA ALLTRUST INSURANCE |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010191373 |
| Policy instance | 6 |
| Insurance contract or identification number | 000010191373 | | Number of Individuals Covered | 218 | | Insurance policy start date | 2015-06-01 | | Insurance policy end date | 2016-05-31 | | Total amount of commissions paid to insurance broker | USD $3,842 | | Total amount of fees paid to insurance company | USD $701 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $25,616 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,230 | | Amount paid for insurance broker fees | 701 | | Additional information about fees paid to insurance broker | LTD | | Insurance broker organization code? | 3 | | Insurance broker name | ACRISURE LLC |
|
| AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) |
| Policy contract number | 76157 |
| Policy instance | 5 |
| Insurance contract or identification number | 76157 | | Number of Individuals Covered | 10 | | Insurance policy start date | 2015-06-01 | | Insurance policy end date | 2016-05-31 | | Total amount of commissions paid to insurance broker | USD $592 | | Health Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $6,427 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $300 | | Additional information about fees paid to insurance broker | HEALTH LIFE | | Insurance broker organization code? | 3 | | Insurance broker name | RENEE H DORMINEY INS SERVICES INC |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 837565 |
| Policy instance | 4 |
| Insurance contract or identification number | 837565 | | Number of Individuals Covered | 297 | | Insurance policy start date | 2015-06-01 | | Insurance policy end date | 2016-05-31 | | Total amount of commissions paid to insurance broker | USD $10,289 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $978,947 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $7,774 | | Additional information about fees paid to insurance broker | HEALTH DENTAL | | Insurance broker organization code? | 3 | | Insurance broker name | ALLTRUST INSRUANCE INC |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010191372 |
| Policy instance | 3 |
| Insurance contract or identification number | 000010191372 | | Number of Individuals Covered | 218 | | Insurance policy start date | 2015-06-01 | | Insurance policy end date | 2016-05-31 | | Total amount of commissions paid to insurance broker | USD $4,610 | | Total amount of fees paid to insurance company | USD $865 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $30,734 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,874 | | Amount paid for insurance broker fees | 865 | | Additional information about fees paid to insurance broker | AD&D LIFE | | Insurance broker organization code? | 3 | | Insurance broker name | ACRISURE LLC |
|
| HUMANA INSURANCE COMPANY OF NE (National Association of Insurance Commissioners NAIC id number: 12634 ) |
| Policy contract number | VS2614 |
| Policy instance | 2 |
| Insurance contract or identification number | VS2614 | | Number of Individuals Covered | 163 | | Insurance policy start date | 2015-06-01 | | Insurance policy end date | 2016-05-31 | | Total amount of commissions paid to insurance broker | USD $2,059 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $22,707 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,059 | | Additional information about fees paid to insurance broker | VISION | | Insurance broker organization code? | 3 | | Insurance broker name | CHEPENIK BARNETT INC |
|
| HUMANA INSURANCE COMPANY OF NE (National Association of Insurance Commissioners NAIC id number: 12634 ) |
| Policy contract number | VS2614 |
| Policy instance | 2 |
| Insurance contract or identification number | VS2614 | | Number of Individuals Covered | 164 | | Insurance policy start date | 2014-06-01 | | Insurance policy end date | 2015-05-31 | | Total amount of commissions paid to insurance broker | USD $1,789 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $19,318 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,789 | | Insurance broker organization code? | 3 | | Insurance broker name | CHEPENIK BARNETT INC |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010191372 |
| Policy instance | 3 |
| Insurance contract or identification number | 000010191372 | | Number of Individuals Covered | 212 | | Insurance policy start date | 2014-06-01 | | Insurance policy end date | 2015-05-31 | | Total amount of commissions paid to insurance broker | USD $4,391 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $29,273 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,465 | | Insurance broker organization code? | 3 | | Insurance broker name | CHEPENIK FINANCIAL SERVICES INC. |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 837565 |
| Policy instance | 4 |
| Insurance contract or identification number | 837565 | | Number of Individuals Covered | 282 | | Insurance policy start date | 2014-06-01 | | Insurance policy end date | 2015-05-31 | | Total amount of commissions paid to insurance broker | USD $9,265 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $800,868 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $9,265 | | Insurance broker organization code? | 3 | | Insurance broker name | CHEPENIK MANAGEMENT INC |
|
| AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) |
| Policy contract number | 76157 |
| Policy instance | 5 |
| Insurance contract or identification number | 76157 | | Number of Individuals Covered | 11 | | Insurance policy start date | 2014-06-01 | | Insurance policy end date | 2015-05-31 | | Total amount of commissions paid to insurance broker | USD $645 | | Health Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $6,963 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $31 | | Insurance broker organization code? | 3 | | Insurance broker name | RENEE H DORMINEY INS SERVICES INC |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010191373 |
| Policy instance | 6 |
| Insurance contract or identification number | 000010191373 | | Number of Individuals Covered | 217 | | Insurance policy start date | 2014-06-01 | | Insurance policy end date | 2015-05-31 | | Total amount of commissions paid to insurance broker | USD $3,563 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $23,752 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,189 | | Insurance broker organization code? | 3 | | Insurance broker name | CHEPENIK FINANCIAL SERVICES INC. |
|
| AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) |
| Policy contract number | 91292 |
| Policy instance | 1 |
| Insurance contract or identification number | 91292 | | Number of Individuals Covered | 22 | | Insurance policy start date | 2014-06-01 | | Insurance policy end date | 2015-05-31 | | Total amount of commissions paid to insurance broker | USD $1,120 | | Welfare Benefit Premiums Paid to Carrier | USD $11,202 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | | Commission paid to Insurance Broker | USD $1,120 | | Insurance broker organization code? | 3 | | Insurance broker name | CHEPENIK MANAGEMENT INC. |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 837565 |
| Policy instance | 4 |
| Insurance contract or identification number | 837565 | | Number of Individuals Covered | 269 | | Insurance policy start date | 2013-06-01 | | Insurance policy end date | 2014-05-31 | | Total amount of commissions paid to insurance broker | USD $13,880 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $705,110 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,025 | | Insurance broker organization code? | 3 | | Insurance broker name | CHEPENIK MANAGEMENT INC |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00367928 |
| Policy instance | 3 |
| Insurance contract or identification number | 00367928 | | Number of Individuals Covered | 91 | | Insurance policy start date | 2013-06-01 | | Insurance policy end date | 2014-05-31 | | Total amount of commissions paid to insurance broker | USD $4,007 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | OTHER-SHORT TERM DISABILITY | | Welfare Benefit Premiums Paid to Carrier | USD $30,464 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,608 | | Insurance broker organization code? | 3 | | Insurance broker name | HARRISON-DAVIS INC |
|
| HUMANA INSURANCE COMPANY OF NE (National Association of Insurance Commissioners NAIC id number: 12634 ) |
| Policy contract number | VS2614 |
| Policy instance | 2 |
| Insurance contract or identification number | VS2614 | | Number of Individuals Covered | 149 | | Insurance policy start date | 2013-06-01 | | Insurance policy end date | 2014-05-31 | | Total amount of commissions paid to insurance broker | USD $1,813 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $17,935 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $439 | | Insurance broker organization code? | 3 | | Insurance broker name | CHEPENIK BARNETT INC |
|
| AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) |
| Policy contract number | 91292 |
| Policy instance | 1 |
| Insurance contract or identification number | 91292 | | Number of Individuals Covered | 14 | | Insurance policy start date | 2013-06-01 | | Insurance policy end date | 2014-05-31 | | Total amount of commissions paid to insurance broker | USD $868 | | Welfare Benefit Premiums Paid to Carrier | USD $11,390 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | | Commission paid to Insurance Broker | USD $868 | | Insurance broker organization code? | 3 | | Insurance broker name | CHEPENIK MANAGEMENT INC. |
|
| AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) |
| Policy contract number | 76157 |
| Policy instance | 5 |
| Insurance contract or identification number | 76157 | | Number of Individuals Covered | 28 | | Insurance policy start date | 2013-06-01 | | Insurance policy end date | 2014-05-31 | | Total amount of commissions paid to insurance broker | USD $1,775 | | Health Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $15,466 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $701 | | Insurance broker organization code? | 3 | | Insurance broker name | KAREN R O'LESSKER |
|
| AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) |
| Policy contract number | 76157 |
| Policy instance | 7 |
| Insurance contract or identification number | 76157 | | Number of Individuals Covered | 46 | | Insurance policy start date | 2012-06-01 | | Insurance policy end date | 2013-05-31 | | Total amount of commissions paid to insurance broker | USD $6,326 | | Health Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $23,521 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,890 | | Insurance broker organization code? | 3 | | Insurance broker name | RENEE TAYLOR |
|
| BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 ) |
| Policy contract number | G0386 |
| Policy instance | 1 |
| Insurance contract or identification number | G0386 | | Insurance policy start date | 2012-06-01 | | Insurance policy end date | 2013-05-31 | | Total amount of commissions paid to insurance broker | USD $2,307 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $-382 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,307 | | Insurance broker organization code? | 3 | | Insurance broker name | THE NIA GROUP LLC |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 837565 |
| Policy instance | 6 |
| Insurance contract or identification number | 837565 | | Number of Individuals Covered | 244 | | Insurance policy start date | 2012-06-01 | | Insurance policy end date | 2013-05-31 | | Total amount of commissions paid to insurance broker | USD $11,502 | | Total amount of fees paid to insurance company | USD $4,896 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $595,577 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $10,571 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 3590 | | Additional information about fees paid to insurance broker | PM CROSS-SALE | | Insurance broker name | MARSH & MCCLENNAN AGENCY LLC |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 9S309/SG634 |
| Policy instance | 5 |
| Insurance contract or identification number | 9S309/SG634 | | Number of Individuals Covered | 82 | | Insurance policy start date | 2012-06-01 | | Insurance policy end date | 2013-05-31 | | Total amount of commissions paid to insurance broker | USD $4,083 | | Dental Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | OTHER-SHORT TERM DISABILITY | | Welfare Benefit Premiums Paid to Carrier | USD $31,410 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,402 | | Additional information about fees paid to insurance broker | CONTRACT ID SG634 | | Insurance broker organization code? | 3 | | Insurance broker name | BB&T INXURANCE SERVICES INC |
|
| HUMANA INSURANCE COMPANY OF NE (National Association of Insurance Commissioners NAIC id number: 12634 ) |
| Policy contract number | VS2614 |
| Policy instance | 4 |
| Insurance contract or identification number | VS2614 | | Number of Individuals Covered | 127 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $1,652 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $15,357 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,652 | | Insurance broker organization code? | 3 | | Insurance broker name | MARSH & MCLENNAN AGENCY LLC |
|
| BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC/ (G0385) (National Association of Insurance Commissioners NAIC id number: 54801 ) |
| Policy contract number | G0385 |
| Policy instance | 2 |
| Insurance contract or identification number | G0385 | | Insurance policy start date | 2012-06-01 | | Insurance policy end date | 2013-05-31 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 | | Insurance broker name | THE NIA GROUP LLC |
|
| BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 ) |
| Policy contract number | G0386 |
| Policy instance | 1 |
| Insurance contract or identification number | G0386 | | Number of Individuals Covered | 5 | | Insurance policy start date | 2011-06-01 | | Insurance policy end date | 2012-05-31 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $24,553 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC/ (G0385) (National Association of Insurance Commissioners NAIC id number: 54801 ) |
| Policy contract number | G0385 |
| Policy instance | 2 |
| Insurance contract or identification number | G0385 | | Insurance policy start date | 2011-06-01 | | Insurance policy end date | 2012-05-31 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $-14 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC/ (G0385) (National Association of Insurance Commissioners NAIC id number: 54801 ) |
| Policy contract number | G0385 |
| Policy instance | 3 |
| Insurance contract or identification number | G0385 | | Number of Individuals Covered | 122 | | Insurance policy start date | 2011-06-01 | | Insurance policy end date | 2012-05-31 | | Total amount of commissions paid to insurance broker | USD $28,017 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $529,102 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| GREATER GEORGIA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97217 ) |
| Policy contract number | GA2252 |
| Policy instance | 4 |
| Insurance contract or identification number | GA2252 | | Insurance policy start date | 2011-06-01 | | Insurance policy end date | 2012-05-31 | | Total amount of commissions paid to insurance broker | USD $274 | | Life Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| GREATER GEORGIA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97217 ) |
| Policy contract number | GA2252 |
| Policy instance | 5 |
| Insurance contract or identification number | GA2252 | | Insurance policy start date | 2011-06-01 | | Insurance policy end date | 2012-05-31 | | Long Term Disability Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HUMANA INSURANCE COMPANY OF NE (National Association of Insurance Commissioners NAIC id number: 12634 ) |
| Policy contract number | VS2614 |
| Policy instance | 6 |
| Insurance contract or identification number | VS2614 | | Number of Individuals Covered | 126 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $1,246 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $13,561 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | SG14-634Y1583 |
| Policy instance | 7 |
| Insurance contract or identification number | SG14-634Y1583 | | Number of Individuals Covered | 172 | | Insurance policy start date | 2011-06-01 | | Insurance policy end date | 2012-05-31 | | Total amount of commissions paid to insurance broker | USD $13,696 | | Total amount of fees paid to insurance company | USD $4,192 | | Dental Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ADD SHORT TERM LIFE OPT LIFE | | Welfare Benefit Premiums Paid to Carrier | USD $144,624 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| COMPBENEFITS COMPANY (National Association of Insurance Commissioners NAIC id number: 52015 ) |
| Policy contract number | VS2614 |
| Policy instance | 6 |
| Insurance contract or identification number | VS2614 | | Number of Individuals Covered | 117 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $1,212 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $12,019 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| GREATER GEORGIA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97217 ) |
| Policy contract number | GA2252 |
| Policy instance | 5 |
| Insurance contract or identification number | GA2252 | | Number of Individuals Covered | 168 | | Insurance policy start date | 2010-06-01 | | Insurance policy end date | 2011-05-31 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $25,527 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| GREATER GEORGIA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97217 ) |
| Policy contract number | GA2252 |
| Policy instance | 4 |
| Insurance contract or identification number | GA2252 | | Number of Individuals Covered | 169 | | Insurance policy start date | 2010-06-01 | | Insurance policy end date | 2011-05-31 | | Total amount of commissions paid to insurance broker | USD $4,522 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $35,870 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC/ (G0385) (National Association of Insurance Commissioners NAIC id number: 54801 ) |
| Policy contract number | G0385 |
| Policy instance | 2 |
| Insurance contract or identification number | G0385 | | Number of Individuals Covered | 227 | | Insurance policy start date | 2010-06-01 | | Insurance policy end date | 2011-05-31 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $58,709 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 ) |
| Policy contract number | G0386 |
| Policy instance | 1 |
| Insurance contract or identification number | G0386 | | Number of Individuals Covered | 26 | | Insurance policy start date | 2010-06-01 | | Insurance policy end date | 2011-05-31 | | Total amount of commissions paid to insurance broker | USD $30,030 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $64,909 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC/ (G0385) (National Association of Insurance Commissioners NAIC id number: 54801 ) |
| Policy contract number | G0385 |
| Policy instance | 3 |
| Insurance contract or identification number | G0385 | | Number of Individuals Covered | 152 | | Insurance policy start date | 2010-06-01 | | Insurance policy end date | 2011-05-31 | | Total amount of commissions paid to insurance broker | USD $87 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $487,112 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | SG14/SG634 |
| Policy instance | 1 |
| Insurance contract or identification number | SG14/SG634 | | Number of Individuals Covered | 141 | | Insurance policy start date | 2008-04-01 | | Insurance policy end date | 2009-03-31 | | Total amount of commissions paid to insurance broker | USD $11,783 | | Total amount of fees paid to insurance company | USD $3,832 | | Dental Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $120,927 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 0710004 |
| Policy instance | 2 |
| Insurance contract or identification number | 0710004 | | Number of Individuals Covered | 88 | | Insurance policy start date | 2007-06-01 | | Insurance policy end date | 2008-05-31 | | Total amount of commissions paid to insurance broker | USD $17,146 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $342,919 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | SG14/SG634 |
| Policy instance | 1 |
| Insurance contract or identification number | SG14/SG634 | | Number of Individuals Covered | 122 | | Insurance policy start date | 2007-04-01 | | Insurance policy end date | 2008-03-31 | | Total amount of commissions paid to insurance broker | USD $8,606 | | Total amount of fees paid to insurance company | USD $5,205 | | Dental Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $87,004 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 0710004 |
| Policy instance | 2 |
| Insurance contract or identification number | 0710004 | | Number of Individuals Covered | 116 | | Insurance policy start date | 2006-08-01 | | Insurance policy end date | 2007-05-31 | | Total amount of commissions paid to insurance broker | USD $13,278 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $294,885 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | SG14/SG634 |
| Policy instance | 1 |
| Insurance contract or identification number | SG14/SG634 | | Number of Individuals Covered | 128 | | Insurance policy start date | 2006-04-01 | | Insurance policy end date | 2007-03-31 | | Total amount of commissions paid to insurance broker | USD $8,687 | | Total amount of fees paid to insurance company | USD $3,243 | | Dental Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $89,347 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | SG14/SG634 |
| Policy instance | 1 |
| Insurance contract or identification number | SG14/SG634 | | Number of Individuals Covered | 114 | | Insurance policy start date | 2005-04-01 | | Insurance policy end date | 2006-03-31 | | Total amount of commissions paid to insurance broker | USD $7,637 | | Total amount of fees paid to insurance company | USD $3,888 | | Dental Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $76,191 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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