OCALA EYE, P.A. has sponsored the creation of one or more 401k plans.
Additional information about OCALA EYE, P.A.
Submission information for form 5500 for 401k plan OCALA EYE, P.A. CAFETERIA PLAN
401k plan membership statisitcs for OCALA EYE, P.A. CAFETERIA PLAN
| Measure | Date | Value |
|---|
| 2022: OCALA EYE, P.A. CAFETERIA PLAN 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-02-01 | 185 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-02-01 | 187 |
| Number of retired or separated participants receiving benefits | 2022-02-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2022-02-01 | 0 |
| Total of all active and inactive participants | 2022-02-01 | 187 |
| 2021: OCALA EYE, P.A. CAFETERIA PLAN 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-02-01 | 184 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-02-01 | 184 |
| Number of retired or separated participants receiving benefits | 2021-02-01 | 1 |
| Number of other retired or separated participants entitled to future benefits | 2021-02-01 | 0 |
| Total of all active and inactive participants | 2021-02-01 | 185 |
| 2020: OCALA EYE, P.A. CAFETERIA PLAN 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-02-01 | 185 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-02-01 | 182 |
| Number of retired or separated participants receiving benefits | 2020-02-01 | 2 |
| Number of other retired or separated participants entitled to future benefits | 2020-02-01 | 0 |
| Total of all active and inactive participants | 2020-02-01 | 184 |
| 2019: OCALA EYE, P.A. CAFETERIA PLAN 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-02-01 | 173 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-02-01 | 183 |
| Number of retired or separated participants receiving benefits | 2019-02-01 | 2 |
| Number of other retired or separated participants entitled to future benefits | 2019-02-01 | 0 |
| Total of all active and inactive participants | 2019-02-01 | 185 |
| 2018: OCALA EYE, P.A. CAFETERIA PLAN 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-02-01 | 168 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-02-01 | 173 |
| Number of retired or separated participants receiving benefits | 2018-02-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2018-02-01 | 0 |
| Total of all active and inactive participants | 2018-02-01 | 173 |
| 2017: OCALA EYE, P.A. CAFETERIA PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-02-01 | 139 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-02-01 | 168 |
| Number of retired or separated participants receiving benefits | 2017-02-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2017-02-01 | 0 |
| Total of all active and inactive participants | 2017-02-01 | 168 |
| 2016: OCALA EYE, P.A. CAFETERIA PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-02-01 | 144 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-02-01 | 139 |
| Number of retired or separated participants receiving benefits | 2016-02-01 | 1 |
| Number of other retired or separated participants entitled to future benefits | 2016-02-01 | 0 |
| Total of all active and inactive participants | 2016-02-01 | 140 |
| 2015: OCALA EYE, P.A. CAFETERIA PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-02-01 | 143 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-02-01 | 144 |
| Number of retired or separated participants receiving benefits | 2015-02-01 | 2 |
| Number of other retired or separated participants entitled to future benefits | 2015-02-01 | 0 |
| Total of all active and inactive participants | 2015-02-01 | 146 |
| 2014: OCALA EYE, P.A. CAFETERIA PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-02-01 | 136 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-02-01 | 140 |
| Number of retired or separated participants receiving benefits | 2014-02-01 | 3 |
| Total of all active and inactive participants | 2014-02-01 | 143 |
| 2013: OCALA EYE, P.A. CAFETERIA PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-02-01 | 134 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-02-01 | 133 |
| Number of retired or separated participants receiving benefits | 2013-02-01 | 3 |
| Total of all active and inactive participants | 2013-02-01 | 136 |
| 2012: OCALA EYE, P.A. CAFETERIA PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-02-01 | 135 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-02-01 | 131 |
| Number of retired or separated participants receiving benefits | 2012-02-01 | 3 |
| Total of all active and inactive participants | 2012-02-01 | 134 |
| 2011: OCALA EYE, P.A. CAFETERIA PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-02-01 | 128 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-02-01 | 132 |
| Number of retired or separated participants receiving benefits | 2011-02-01 | 3 |
| Total of all active and inactive participants | 2011-02-01 | 135 |
| 2010: OCALA EYE, P.A. CAFETERIA PLAN 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-01-01 | 126 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-01-01 | 125 |
| Number of retired or separated participants receiving benefits | 2010-01-01 | 3 |
| Total of all active and inactive participants | 2010-01-01 | 128 |
| Total participants | 2010-01-01 | 128 |
| 2009: OCALA EYE, P.A. CAFETERIA PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-01-01 | 123 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 124 |
| Number of retired or separated participants receiving benefits | 2009-01-01 | 2 |
| Total of all active and inactive participants | 2009-01-01 | 126 |
| 2022: OCALA EYE, P.A. CAFETERIA PLAN 2022 form 5500 responses |
|---|
| 2022-02-01 | Type of plan entity | Single employer plan |
| 2022-02-01 | Plan funding arrangement – Insurance | Yes |
| 2022-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2022-02-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2021: OCALA EYE, P.A. CAFETERIA PLAN 2021 form 5500 responses |
|---|
| 2021-02-01 | Type of plan entity | Single employer plan |
| 2021-02-01 | Plan funding arrangement – Insurance | Yes |
| 2021-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2021-02-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2020: OCALA EYE, P.A. CAFETERIA PLAN 2020 form 5500 responses |
|---|
| 2020-02-01 | Type of plan entity | Single employer plan |
| 2020-02-01 | Plan funding arrangement – Insurance | Yes |
| 2020-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2020-02-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2019: OCALA EYE, P.A. CAFETERIA PLAN 2019 form 5500 responses |
|---|
| 2019-02-01 | Type of plan entity | Single employer plan |
| 2019-02-01 | Plan funding arrangement – Insurance | Yes |
| 2019-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2019-02-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2018: OCALA EYE, P.A. CAFETERIA PLAN 2018 form 5500 responses |
|---|
| 2018-02-01 | Type of plan entity | Single employer plan |
| 2018-02-01 | Plan funding arrangement – Insurance | Yes |
| 2018-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2018-02-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2017: OCALA EYE, P.A. CAFETERIA PLAN 2017 form 5500 responses |
|---|
| 2017-02-01 | Type of plan entity | Single employer plan |
| 2017-02-01 | Plan funding arrangement – Insurance | Yes |
| 2017-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2017-02-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2016: OCALA EYE, P.A. CAFETERIA PLAN 2016 form 5500 responses |
|---|
| 2016-02-01 | Type of plan entity | Single employer plan |
| 2016-02-01 | Plan funding arrangement – Insurance | Yes |
| 2016-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2016-02-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2015: OCALA EYE, P.A. CAFETERIA PLAN 2015 form 5500 responses |
|---|
| 2015-02-01 | Type of plan entity | Single employer plan |
| 2015-02-01 | Plan funding arrangement – Insurance | Yes |
| 2015-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2015-02-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2014: OCALA EYE, P.A. CAFETERIA PLAN 2014 form 5500 responses |
|---|
| 2014-02-01 | Type of plan entity | Single employer plan |
| 2014-02-01 | Plan funding arrangement – Insurance | Yes |
| 2014-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2014-02-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2013: OCALA EYE, P.A. CAFETERIA PLAN 2013 form 5500 responses |
|---|
| 2013-02-01 | Type of plan entity | Single employer plan |
| 2013-02-01 | Plan funding arrangement – Insurance | Yes |
| 2013-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2013-02-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2012: OCALA EYE, P.A. CAFETERIA PLAN 2012 form 5500 responses |
|---|
| 2012-02-01 | Type of plan entity | Single employer plan |
| 2012-02-01 | Plan funding arrangement – Insurance | Yes |
| 2012-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2012-02-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2011: OCALA EYE, P.A. CAFETERIA PLAN 2011 form 5500 responses |
|---|
| 2011-02-01 | Type of plan entity | Single employer plan |
| 2011-02-01 | Plan funding arrangement – Insurance | Yes |
| 2011-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2011-02-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2010: OCALA EYE, P.A. CAFETERIA PLAN 2010 form 5500 responses |
|---|
| 2010-01-01 | Type of plan entity | Single employer plan |
| 2010-01-01 | Submission has been amended | No |
| 2010-01-01 | This submission is the final filing | No |
| 2010-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2010-01-01 | Plan is a collectively bargained plan | No |
| 2010-01-01 | Plan funding arrangement – Insurance | Yes |
| 2010-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2010-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2009: OCALA EYE, P.A. CAFETERIA PLAN 2009 form 5500 responses |
|---|
| 2009-01-01 | Type of plan entity | Single employer plan |
| 2009-01-01 | This submission is the final filing | No |
| 2009-01-01 | Plan funding arrangement – Insurance | Yes |
| 2009-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2009-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 95089 ) |
| Policy contract number | 51807 (HMO) |
| Policy instance | 6 |
| Insurance contract or identification number | 51807 (HMO) | | Number of Individuals Covered | 154 | | Insurance policy start date | 2022-02-01 | | Insurance policy end date | 2023-01-31 | | Total amount of commissions paid to insurance broker | USD $2,796 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,796 | | Additional information about fees paid to insurance broker | COMMISSIONS TO BROKER/AGENT | | Insurance broker organization code? | 3 |
|
| FLORIDA COMBINED LIFE INSURANCE COMPANY, INC. (National Association of Insurance Commissioners NAIC id number: 76031 ) |
| Policy contract number | X5605-X970D9 |
| Policy instance | 5 |
| Insurance contract or identification number | X5605-X970D9 | | Number of Individuals Covered | 162 | | Insurance policy start date | 2022-02-01 | | Insurance policy end date | 2023-01-31 | | Total amount of commissions paid to insurance broker | USD $9,972 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $107,802 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $9,972 | | Additional information about fees paid to insurance broker | SERVICE AGENT | | Insurance broker organization code? | 3 |
|
| BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 ) |
| Policy contract number | 51807 (BO) |
| Policy instance | 4 |
| Insurance contract or identification number | 51807 (BO) | | Number of Individuals Covered | 8 | | Insurance policy start date | 2022-02-01 | | Insurance policy end date | 2023-01-31 | | Total amount of commissions paid to insurance broker | USD $242 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $242 | | Additional information about fees paid to insurance broker | COMMISSIONS TO BROKER/AGENT | | Insurance broker organization code? | 3 |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | STD213040 |
| Policy instance | 3 |
| Insurance contract or identification number | STD213040 | | Number of Individuals Covered | 175 | | Insurance policy start date | 2022-02-01 | | Insurance policy end date | 2023-01-31 | | Total amount of commissions paid to insurance broker | USD $3,380 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $67,590 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,380 | | Additional information about fees paid to insurance broker | SERVICE AGENT | | Insurance broker organization code? | 3 |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | LTD213040 |
| Policy instance | 2 |
| Insurance contract or identification number | LTD213040 | | Number of Individuals Covered | 175 | | Insurance policy start date | 2022-02-01 | | Insurance policy end date | 2023-01-31 | | Total amount of commissions paid to insurance broker | USD $13,960 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $126,909 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $13,960 | | Additional information about fees paid to insurance broker | SERVICE AGENT | | Insurance broker organization code? | 3 |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | LIF213040 |
| Policy instance | 1 |
| Insurance contract or identification number | LIF213040 | | Number of Individuals Covered | 197 | | Insurance policy start date | 2022-02-01 | | Insurance policy end date | 2023-01-31 | | Total amount of commissions paid to insurance broker | USD $4,198 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $41,979 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,198 | | Additional information about fees paid to insurance broker | SERVICE AGENT | | Insurance broker organization code? | 3 |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | LIF213040 |
| Policy instance | 1 |
| Insurance contract or identification number | LIF213040 | | Number of Individuals Covered | 184 | | Insurance policy start date | 2021-02-01 | | Insurance policy end date | 2022-01-31 | | Total amount of commissions paid to insurance broker | USD $3,403 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $34,029 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,403 | | Additional information about fees paid to insurance broker | SERVICE AGENT | | Insurance broker organization code? | 3 |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | LTD213040 |
| Policy instance | 2 |
| Insurance contract or identification number | LTD213040 | | Number of Individuals Covered | 170 | | Insurance policy start date | 2021-02-01 | | Insurance policy end date | 2022-01-31 | | Total amount of commissions paid to insurance broker | USD $12,044 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $109,493 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $12,044 | | Additional information about fees paid to insurance broker | SERVICE AGENT | | Insurance broker organization code? | 3 |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | STD213040 |
| Policy instance | 3 |
| Insurance contract or identification number | STD213040 | | Number of Individuals Covered | 169 | | Insurance policy start date | 2021-02-01 | | Insurance policy end date | 2022-01-31 | | Total amount of commissions paid to insurance broker | USD $2,827 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $56,551 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,827 | | Additional information about fees paid to insurance broker | SERVICE AGENT | | Insurance broker organization code? | 3 |
|
| BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 ) |
| Policy contract number | 51807 (BO) |
| Policy instance | 4 |
| Insurance contract or identification number | 51807 (BO) | | Number of Individuals Covered | 10 | | Insurance policy start date | 2021-02-01 | | Insurance policy end date | 2022-01-31 | | Total amount of commissions paid to insurance broker | USD $4,229 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,229 | | Additional information about fees paid to insurance broker | COMMISSIONS TO BROKER/AGENT | | Insurance broker organization code? | 3 |
|
| FLORIDA COMBINED LIFE INSURANCE COMPANY, INC. (National Association of Insurance Commissioners NAIC id number: 76031 ) |
| Policy contract number | X5605-X970D9 |
| Policy instance | 5 |
| Insurance contract or identification number | X5605-X970D9 | | Number of Individuals Covered | 160 | | Insurance policy start date | 2021-02-01 | | Insurance policy end date | 2022-01-31 | | Total amount of commissions paid to insurance broker | USD $9,259 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $101,347 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $9,259 | | Additional information about fees paid to insurance broker | SERVICE AGENT | | Insurance broker organization code? | 3 |
|
| BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 95089 ) |
| Policy contract number | 51807 (HMO) |
| Policy instance | 6 |
| Insurance contract or identification number | 51807 (HMO) | | Number of Individuals Covered | 147 | | Insurance policy start date | 2021-02-01 | | Insurance policy end date | 2022-01-31 | | Total amount of commissions paid to insurance broker | USD $40,419 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $40,419 | | Additional information about fees paid to insurance broker | COMMISSIONS TO BROKER/AGENT | | Insurance broker organization code? | 3 |
|
| BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 95089 ) |
| Policy contract number | 51807 (HMO) |
| Policy instance | 6 |
| Insurance contract or identification number | 51807 (HMO) | | Number of Individuals Covered | 141 | | Insurance policy start date | 2020-02-01 | | Insurance policy end date | 2021-01-31 | | Total amount of commissions paid to insurance broker | USD $36,913 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $24,454 | | Additional information about fees paid to insurance broker | COMMISSIONS TO BROKER/AGENT | | Insurance broker organization code? | 3 |
|
| FLORIDA COMBINED LIFE INSURANCE COMPANY, INC. (National Association of Insurance Commissioners NAIC id number: 76031 ) |
| Policy contract number | X5605-X970D9 |
| Policy instance | 5 |
| Insurance contract or identification number | X5605-X970D9 | | Number of Individuals Covered | 154 | | Insurance policy start date | 2020-02-01 | | Insurance policy end date | 2021-01-31 | | Total amount of commissions paid to insurance broker | USD $6,308 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $86,351 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,308 | | Additional information about fees paid to insurance broker | SERVICE AGENT | | Insurance broker organization code? | 3 |
|
| BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 ) |
| Policy contract number | 51807 (BO) |
| Policy instance | 4 |
| Insurance contract or identification number | 51807 (BO) | | Number of Individuals Covered | 11 | | Insurance policy start date | 2020-02-01 | | Insurance policy end date | 2021-01-31 | | Total amount of commissions paid to insurance broker | USD $4,425 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,896 | | Additional information about fees paid to insurance broker | COMMISSIONS TO BROKER/AGENT | | Insurance broker organization code? | 3 |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | STD213040 |
| Policy instance | 3 |
| Insurance contract or identification number | STD213040 | | Number of Individuals Covered | 166 | | Insurance policy start date | 2020-02-01 | | Insurance policy end date | 2021-01-31 | | Total amount of commissions paid to insurance broker | USD $2,937 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $58,736 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,937 | | Additional information about fees paid to insurance broker | SERVICE AGENT | | Insurance broker organization code? | 3 |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | LTD213040 |
| Policy instance | 2 |
| Insurance contract or identification number | LTD213040 | | Number of Individuals Covered | 166 | | Insurance policy start date | 2020-02-01 | | Insurance policy end date | 2021-01-31 | | Total amount of commissions paid to insurance broker | USD $12,452 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $113,203 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $12,452 | | Additional information about fees paid to insurance broker | SERVICE AGENT | | Insurance broker organization code? | 3 |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | LIF213040 |
| Policy instance | 1 |
| Insurance contract or identification number | LIF213040 | | Number of Individuals Covered | 182 | | Insurance policy start date | 2020-02-01 | | Insurance policy end date | 2021-01-31 | | Total amount of commissions paid to insurance broker | USD $3,562 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $35,616 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,562 | | Additional information about fees paid to insurance broker | SERVICE AGENT | | Insurance broker organization code? | 3 |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | LIF213040 |
| Policy instance | 1 |
| Insurance contract or identification number | LIF213040 | | Number of Individuals Covered | 183 | | Insurance policy start date | 2019-02-01 | | Insurance policy end date | 2020-01-31 | | Total amount of commissions paid to insurance broker | USD $3,182 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $31,815 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,182 | | Additional information about fees paid to insurance broker | SERVICE AGENT | | Insurance broker organization code? | 3 |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | LTD213040 |
| Policy instance | 2 |
| Insurance contract or identification number | LTD213040 | | Number of Individuals Covered | 170 | | Insurance policy start date | 2019-02-01 | | Insurance policy end date | 2020-01-31 | | Total amount of commissions paid to insurance broker | USD $12,548 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $115,965 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $12,548 | | Additional information about fees paid to insurance broker | SERVICE AGENT | | Insurance broker organization code? | 3 |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | STD213040 |
| Policy instance | 3 |
| Insurance contract or identification number | STD213040 | | Number of Individuals Covered | 170 | | Insurance policy start date | 2019-02-01 | | Insurance policy end date | 2020-01-31 | | Total amount of commissions paid to insurance broker | USD $2,775 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $55,504 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,775 | | Additional information about fees paid to insurance broker | SERVICE AGENT | | Insurance broker organization code? | 3 |
|
| BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 ) |
| Policy contract number | 51807 (BOP) |
| Policy instance | 4 |
| Insurance contract or identification number | 51807 (BOP) | | Number of Individuals Covered | 10 | | Insurance policy start date | 2019-02-01 | | Insurance policy end date | 2020-01-31 | | Total amount of commissions paid to insurance broker | USD $4,229 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,229 | | Additional information about fees paid to insurance broker | COMMISSIONS TO BROKER/AGENT | | Insurance broker organization code? | 3 |
|
| FLORIDA COMBINED LIFE INSURANCE COMPANY, INC. (National Association of Insurance Commissioners NAIC id number: 76031 ) |
| Policy contract number | X5605-X970D9 |
| Policy instance | 5 |
| Insurance contract or identification number | X5605-X970D9 | | Number of Individuals Covered | 153 | | Insurance policy start date | 2019-02-01 | | Insurance policy end date | 2020-01-31 | | Total amount of commissions paid to insurance broker | USD $7,270 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $88,879 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $7,270 | | Additional information about fees paid to insurance broker | SERVICE AGENT | | Insurance broker organization code? | 3 |
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| BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 95089 ) |
| Policy contract number | 51807 (HMO) |
| Policy instance | 6 |
| Insurance contract or identification number | 51807 (HMO) | | Number of Individuals Covered | 144 | | Insurance policy start date | 2019-02-01 | | Insurance policy end date | 2020-01-31 | | Total amount of commissions paid to insurance broker | USD $36,113 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $36,113 | | Additional information about fees paid to insurance broker | COMMISSIONS TO BROKER/AGENT | | Insurance broker organization code? | 3 |
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| FLORIDA COMBINED LIFE (National Association of Insurance Commissioners NAIC id number: 76031 ) |
| Policy contract number | X5605-X970D9 |
| Policy instance | 6 |
| Insurance contract or identification number | X5605-X970D9 | | Number of Individuals Covered | 140 | | Insurance policy start date | 2017-02-01 | | Insurance policy end date | 2018-01-31 | | Total amount of commissions paid to insurance broker | USD $5,988 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $74,149 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,988 | | Additional information about fees paid to insurance broker | SERVICE AGENT | | Insurance broker organization code? | 3 | | Insurance broker name | BARTON,FENSTERMAKER,TONDELLO & ASSC |
|
| BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 ) |
| Policy contract number | 51807 |
| Policy instance | 5 |
| Insurance contract or identification number | 51807 | | Number of Individuals Covered | 144 | | Insurance policy start date | 2017-02-01 | | Insurance policy end date | 2018-01-31 | | Total amount of commissions paid to insurance broker | USD $31,870 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $31,870 | | Additional information about fees paid to insurance broker | COMMISSIONS TO BROKER/AGENT | | Insurance broker organization code? | 3 | | Insurance broker name | SCOTT FENSTERMAKER |
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| UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 ) |
| Policy contract number | 5475615 |
| Policy instance | 4 |
| Insurance contract or identification number | 5475615 | | Number of Individuals Covered | 133 | | Insurance policy start date | 2017-02-01 | | Insurance policy end date | 2017-02-28 | | Total amount of commissions paid to insurance broker | USD $479 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $5,372 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $479 | | Additional information about fees paid to insurance broker | SERVICE AGENT | | Insurance broker organization code? | 3 | | Insurance broker name | STRATEGIC BENEFITS GROUP LLC |
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| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | STD213040 |
| Policy instance | 3 |
| Insurance contract or identification number | STD213040 | | Number of Individuals Covered | 153 | | Insurance policy start date | 2017-02-01 | | Insurance policy end date | 2018-01-31 | | Total amount of commissions paid to insurance broker | USD $3,463 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $49,099 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,463 | | Additional information about fees paid to insurance broker | SERVICE AGENT | | Insurance broker organization code? | 3 | | Insurance broker name | DAVID ASHLEY |
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| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | LTD213040 |
| Policy instance | 2 |
| Insurance contract or identification number | LTD213040 | | Number of Individuals Covered | 153 | | Insurance policy start date | 2017-02-01 | | Insurance policy end date | 2018-01-31 | | Total amount of commissions paid to insurance broker | USD $10,091 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $100,905 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $10,091 | | Additional information about fees paid to insurance broker | SERVICE AGENT | | Insurance broker organization code? | 3 | | Insurance broker name | DAVID ASHLEY |
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| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | LIF213040 |
| Policy instance | 1 |
| Insurance contract or identification number | LIF213040 | | Number of Individuals Covered | 168 | | Insurance policy start date | 2017-02-01 | | Insurance policy end date | 2018-01-31 | | Total amount of commissions paid to insurance broker | USD $2,526 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $25,262 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,526 | | Additional information about fees paid to insurance broker | SERVICE AGENT | | Insurance broker organization code? | 3 | | Insurance broker name | DAVID ASHLEY |
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