401k Plan data: BAYCARE HEALTH SYSTEM INC. GROUP WELFARE BENEFITS PLAN plan

BAYCARE HEALTH SYSTEM INC. GROUP WELFARE BENEFITS PLAN 401k Plan overview

Plan Name	BAYCARE HEALTH SYSTEM INC. GROUP WELFARE BENEFITS PLAN
Plan identification number	520

BAYCARE HEALTH SYSTEM INC. GROUP WELFARE BENEFITS PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Temporary disability (accident and sickness) Prepaid legal Long-term disability cover Death benefits (include travel accident but not life insurance) Other welfare benefit cover

401k Sponsoring company profile

BAYCARE HEALTH SYSTEM INC. has sponsored the creation of one or more 401k plans.

Company Name: BAYCARE HEALTH SYSTEM INC.

Employer identification number (EIN): 592796965

NAIC Classification: 622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BAYCARE HEALTH SYSTEM INC. GROUP WELFARE BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
520 2022-01-01 KYLE BARR 2023-07-26
520 2021-01-01 KYLE BARR 2022-07-29
520 2020-01-01 KYLE BARR 2021-07-21
520 2019-01-01 KYLE BARR 2020-07-22
520 2018-01-01 KYLE BARR 2019-07-29
520 2017-01-01
520 2016-01-01
520 2015-01-01
520 2014-01-01
520 2013-01-01
520 2012-01-01 DANIEL WALKER
520 2011-01-01 DANIEL WALKER
520 2009-01-01 LANA BILCHAK
520 2009-01-01 LANA BILCHAK

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
520	2022-01-01	KYLE BARR	2023-07-26
520	2021-01-01	KYLE BARR	2022-07-29
520	2020-01-01	KYLE BARR	2021-07-21
520	2019-01-01	KYLE BARR	2020-07-22
520	2018-01-01	KYLE BARR	2019-07-29
520	2017-01-01
520	2016-01-01
520	2015-01-01
520	2014-01-01
520	2013-01-01
520	2012-01-01	DANIEL WALKER
520	2011-01-01	DANIEL WALKER
520	2009-01-01	LANA BILCHAK
520	2009-01-01	LANA BILCHAK

Plan Statistics for BAYCARE HEALTH SYSTEM INC. GROUP WELFARE BENEFITS PLAN

401k plan membership statisitcs for BAYCARE HEALTH SYSTEM INC. GROUP WELFARE BENEFITS PLAN

Measure Date Value
2022: BAYCARE HEALTH SYSTEM INC. GROUP WELFARE BENEFITS PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 24,468
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 25,119
Number of retired or separated participants receiving benefits 2022-01-01 115
Number of other retired or separated participants entitled to future benefits 2022-01-01 0
Total of all active and inactive participants 2022-01-01 25,234
2021: BAYCARE HEALTH SYSTEM INC. GROUP WELFARE BENEFITS PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 24,406
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 23,609
Number of retired or separated participants receiving benefits 2021-01-01 283
Number of other retired or separated participants entitled to future benefits 2021-01-01 0
Total of all active and inactive participants 2021-01-01 23,892
2020: BAYCARE HEALTH SYSTEM INC. GROUP WELFARE BENEFITS PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 25,387
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 24,846
Number of retired or separated participants receiving benefits 2020-01-01 136
Number of other retired or separated participants entitled to future benefits 2020-01-01 0
Total of all active and inactive participants 2020-01-01 24,982
2019: BAYCARE HEALTH SYSTEM INC. GROUP WELFARE BENEFITS PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 24,559
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 25,016
Number of retired or separated participants receiving benefits 2019-01-01 89
Number of other retired or separated participants entitled to future benefits 2019-01-01 0
Total of all active and inactive participants 2019-01-01 25,105
2018: BAYCARE HEALTH SYSTEM INC. GROUP WELFARE BENEFITS PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 23,742
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 24,461
Number of retired or separated participants receiving benefits 2018-01-01 97
Number of other retired or separated participants entitled to future benefits 2018-01-01 0
Total of all active and inactive participants 2018-01-01 24,558
2017: BAYCARE HEALTH SYSTEM INC. GROUP WELFARE BENEFITS PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 23,190
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 24,067
Number of retired or separated participants receiving benefits 2017-01-01 99
Number of other retired or separated participants entitled to future benefits 2017-01-01 0
Total of all active and inactive participants 2017-01-01 24,166
2016: BAYCARE HEALTH SYSTEM INC. GROUP WELFARE BENEFITS PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 21,921
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 22,826
Number of retired or separated participants receiving benefits 2016-01-01 166
Number of other retired or separated participants entitled to future benefits 2016-01-01 0
Total of all active and inactive participants 2016-01-01 22,992
2015: BAYCARE HEALTH SYSTEM INC. GROUP WELFARE BENEFITS PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 20,016
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 21,459
Number of retired or separated participants receiving benefits 2015-01-01 89
Number of other retired or separated participants entitled to future benefits 2015-01-01 0
Total of all active and inactive participants 2015-01-01 21,548
2014: BAYCARE HEALTH SYSTEM INC. GROUP WELFARE BENEFITS PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 14,522
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 16,719
Number of retired or separated participants receiving benefits 2014-01-01 88
Total of all active and inactive participants 2014-01-01 16,807
2013: BAYCARE HEALTH SYSTEM INC. GROUP WELFARE BENEFITS PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 14,347
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 14,429
Number of retired or separated participants receiving benefits 2013-01-01 93
Number of other retired or separated participants entitled to future benefits 2013-01-01 0
Total of all active and inactive participants 2013-01-01 14,522
2012: BAYCARE HEALTH SYSTEM INC. GROUP WELFARE BENEFITS PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 14,123
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 14,235
Number of retired or separated participants receiving benefits 2012-01-01 110
Total of all active and inactive participants 2012-01-01 14,345
Total participants 2012-01-01 0
2011: BAYCARE HEALTH SYSTEM INC. GROUP WELFARE BENEFITS PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 13,433
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 13,385
Number of retired or separated participants receiving benefits 2011-01-01 74
Total of all active and inactive participants 2011-01-01 13,459
Total participants 2011-01-01 13,459
2009: BAYCARE HEALTH SYSTEM INC. GROUP WELFARE BENEFITS PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 12,317
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 12,651
Number of retired or separated participants receiving benefits 2009-01-01 166
Total of all active and inactive participants 2009-01-01 12,817
Total participants 2009-01-01 12,817

Measure	Date	Value
2022: BAYCARE HEALTH SYSTEM INC. GROUP WELFARE BENEFITS PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	24,468
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	25,119
Number of retired or separated participants receiving benefits	2022-01-01	115
Number of other retired or separated participants entitled to future benefits	2022-01-01	0
Total of all active and inactive participants	2022-01-01	25,234
2021: BAYCARE HEALTH SYSTEM INC. GROUP WELFARE BENEFITS PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	24,406
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	23,609
Number of retired or separated participants receiving benefits	2021-01-01	283
Number of other retired or separated participants entitled to future benefits	2021-01-01	0
Total of all active and inactive participants	2021-01-01	23,892
2020: BAYCARE HEALTH SYSTEM INC. GROUP WELFARE BENEFITS PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	25,387
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	24,846
Number of retired or separated participants receiving benefits	2020-01-01	136
Number of other retired or separated participants entitled to future benefits	2020-01-01	0
Total of all active and inactive participants	2020-01-01	24,982
2019: BAYCARE HEALTH SYSTEM INC. GROUP WELFARE BENEFITS PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	24,559
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	25,016
Number of retired or separated participants receiving benefits	2019-01-01	89
Number of other retired or separated participants entitled to future benefits	2019-01-01	0
Total of all active and inactive participants	2019-01-01	25,105
2018: BAYCARE HEALTH SYSTEM INC. GROUP WELFARE BENEFITS PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	23,742
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	24,461
Number of retired or separated participants receiving benefits	2018-01-01	97
Number of other retired or separated participants entitled to future benefits	2018-01-01	0
Total of all active and inactive participants	2018-01-01	24,558
2017: BAYCARE HEALTH SYSTEM INC. GROUP WELFARE BENEFITS PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	23,190
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	24,067
Number of retired or separated participants receiving benefits	2017-01-01	99
Number of other retired or separated participants entitled to future benefits	2017-01-01	0
Total of all active and inactive participants	2017-01-01	24,166
2016: BAYCARE HEALTH SYSTEM INC. GROUP WELFARE BENEFITS PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	21,921
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	22,826
Number of retired or separated participants receiving benefits	2016-01-01	166
Number of other retired or separated participants entitled to future benefits	2016-01-01	0
Total of all active and inactive participants	2016-01-01	22,992
2015: BAYCARE HEALTH SYSTEM INC. GROUP WELFARE BENEFITS PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	20,016
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	21,459
Number of retired or separated participants receiving benefits	2015-01-01	89
Number of other retired or separated participants entitled to future benefits	2015-01-01	0
Total of all active and inactive participants	2015-01-01	21,548
2014: BAYCARE HEALTH SYSTEM INC. GROUP WELFARE BENEFITS PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	14,522
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	16,719
Number of retired or separated participants receiving benefits	2014-01-01	88
Total of all active and inactive participants	2014-01-01	16,807
2013: BAYCARE HEALTH SYSTEM INC. GROUP WELFARE BENEFITS PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	14,347
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	14,429
Number of retired or separated participants receiving benefits	2013-01-01	93
Number of other retired or separated participants entitled to future benefits	2013-01-01	0
Total of all active and inactive participants	2013-01-01	14,522
2012: BAYCARE HEALTH SYSTEM INC. GROUP WELFARE BENEFITS PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	14,123
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	14,235
Number of retired or separated participants receiving benefits	2012-01-01	110
Total of all active and inactive participants	2012-01-01	14,345
Total participants	2012-01-01	0
2011: BAYCARE HEALTH SYSTEM INC. GROUP WELFARE BENEFITS PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	13,433
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	13,385
Number of retired or separated participants receiving benefits	2011-01-01	74
Total of all active and inactive participants	2011-01-01	13,459
Total participants	2011-01-01	13,459
2009: BAYCARE HEALTH SYSTEM INC. GROUP WELFARE BENEFITS PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	12,317
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	12,651
Number of retired or separated participants receiving benefits	2009-01-01	166
Total of all active and inactive participants	2009-01-01	12,817
Total participants	2009-01-01	12,817

Form 5500 Responses for BAYCARE HEALTH SYSTEM INC. GROUP WELFARE BENEFITS PLAN

2022: BAYCARE HEALTH SYSTEM INC. GROUP WELFARE BENEFITS PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2021: BAYCARE HEALTH SYSTEM INC. GROUP WELFARE BENEFITS PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2020: BAYCARE HEALTH SYSTEM INC. GROUP WELFARE BENEFITS PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2019: BAYCARE HEALTH SYSTEM INC. GROUP WELFARE BENEFITS PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2018: BAYCARE HEALTH SYSTEM INC. GROUP WELFARE BENEFITS PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2017: BAYCARE HEALTH SYSTEM INC. GROUP WELFARE BENEFITS PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2016: BAYCARE HEALTH SYSTEM INC. GROUP WELFARE BENEFITS PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2015: BAYCARE HEALTH SYSTEM INC. GROUP WELFARE BENEFITS PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2014: BAYCARE HEALTH SYSTEM INC. GROUP WELFARE BENEFITS PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2013: BAYCARE HEALTH SYSTEM INC. GROUP WELFARE BENEFITS PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2012: BAYCARE HEALTH SYSTEM INC. GROUP WELFARE BENEFITS PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2011: BAYCARE HEALTH SYSTEM INC. GROUP WELFARE BENEFITS PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2009: BAYCARE HEALTH SYSTEM INC. GROUP WELFARE BENEFITS PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )

Policy contract number

72300-2

Policy instance

Insurance contract or identification number	72300-2
Number of Individuals Covered	8258
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $853,991
Total amount of fees paid to insurance company	USD $0
Other welfare benefits provided	ACCIDENT PLANS
Welfare Benefit Premiums Paid to Carrier	USD $1,606,599
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $853,991
Insurance broker organization code?	3

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )

Policy contract number

00605103

Policy instance

Insurance contract or identification number	00605103
Number of Individuals Covered	21004
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $7,639
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $7,980,997
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	7639
Additional information about fees paid to insurance broker	INCENTIVE COMPENSATION PAYMENTS
Insurance broker organization code?	3

HYATT LEGAL PLANS OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

9902728

Policy instance

Insurance contract or identification number	9902728
Number of Individuals Covered	2335
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-01
Total amount of commissions paid to insurance broker	USD $43,858
Total amount of fees paid to insurance company	USD $9,461
Other welfare benefits provided	LEGAL
Welfare Benefit Premiums Paid to Carrier	USD $438,572
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $43,858
Amount paid for insurance broker fees	9461
Additional information about fees paid to insurance broker	SUPPLEMENTAL COMPENSATION
Insurance broker organization code?	3

NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 )

Policy contract number

28594

Policy instance

Insurance contract or identification number	28594
Number of Individuals Covered	16455
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,970,511
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

0130454

Policy instance

Insurance contract or identification number	0130454
Number of Individuals Covered	74
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $90,714
Total amount of fees paid to insurance company	USD $14,032
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	DISABILITY INCOME
Welfare Benefit Premiums Paid to Carrier	USD $399,888
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $90,714
Amount paid for insurance broker fees	14032
Additional information about fees paid to insurance broker	SUPPLEMENTAL COMPENSATION
Insurance broker organization code?	3

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )

Policy contract number

768086G

Policy instance

Insurance contract or identification number	768086G
Number of Individuals Covered	619
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $57,624
Total amount of fees paid to insurance company	USD $0
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,259,051
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $57,624
Insurance broker organization code?	3

SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )

Policy contract number

934868

Policy instance

Insurance contract or identification number	934868
Number of Individuals Covered	1892
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $4,851
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $402,903
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	4851
Additional information about fees paid to insurance broker	BONUSES AND ADDITIONAL PAYMENTS
Insurance broker organization code?	3

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

0130454

Policy instance

Insurance contract or identification number	0130454
Number of Individuals Covered	77
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $79,822
Total amount of fees paid to insurance company	USD $13,973
Other welfare benefits provided	DISABILITY INCOME
Welfare Benefit Premiums Paid to Carrier	USD $423,133
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $79,822
Amount paid for insurance broker fees	13973
Additional information about fees paid to insurance broker	SUPPLEMENTAL COMPENSATION
Insurance broker organization code?	3

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )

Policy contract number

768086G

Policy instance

Insurance contract or identification number	768086G
Number of Individuals Covered	573
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $56,690
Total amount of fees paid to insurance company	USD $0
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,133,801
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $56,690
Insurance broker organization code?	3

SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )

Policy contract number

934868

Policy instance

Insurance contract or identification number	934868
Number of Individuals Covered	1927
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $3,388
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $424,525
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	3388
Additional information about fees paid to insurance broker	BONUSES AND ADDITIONAL PYAMENTS
Insurance broker organization code?	3

NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 )

Policy contract number

28594

Policy instance

Insurance contract or identification number	28594
Number of Individuals Covered	16008
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,960,412
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )

Policy contract number

00605103

Policy instance

Insurance contract or identification number	00605103
Number of Individuals Covered	20891
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $8,229,159
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )

Policy contract number

G0563

Policy instance

Insurance contract or identification number	G0563
Number of Individuals Covered	2655
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $140,363
Total amount of fees paid to insurance company	USD $648
Other welfare benefits provided	ACCIDENT PLANS
Welfare Benefit Premiums Paid to Carrier	USD $635,565
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $104,565
Insurance broker organization code?	3
Amount paid for insurance broker fees	648
Additional information about fees paid to insurance broker	SUPPLEMENTAL COMPENSATION

AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )

Policy contract number

0000093576

Policy instance

Insurance contract or identification number	0000093576
Number of Individuals Covered	2776
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $160,641
Total amount of fees paid to insurance company	USD $0
Welfare Benefit Premiums Paid to Carrier	USD $989,126
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $171,614
Insurance broker organization code?	3

HYATT LEGAL PLANS OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

9902728

Policy instance

Insurance contract or identification number	9902728
Number of Individuals Covered	2122
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-01
Total amount of commissions paid to insurance broker	USD $46,352
Total amount of fees paid to insurance company	USD $5,266
Other welfare benefits provided	LEGAL
Welfare Benefit Premiums Paid to Carrier	USD $501,210
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $46,352
Amount paid for insurance broker fees	4856
Additional information about fees paid to insurance broker	SUPPLEMENTAL COMPENSATION
Insurance broker organization code?	3

NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 )

Policy contract number

28594

Policy instance

Insurance contract or identification number	28594
Number of Individuals Covered	16451
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,998,596
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

0130454

Policy instance

Insurance contract or identification number	0130454
Number of Individuals Covered	84
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $88,870
Total amount of fees paid to insurance company	USD $14,305
Other welfare benefits provided	DISABILITY INSURANCE
Welfare Benefit Premiums Paid to Carrier	USD $416,486
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $88,870
Amount paid for insurance broker fees	14305
Additional information about fees paid to insurance broker	ADMIN FEES
Insurance broker organization code?	3

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )

Policy contract number

768086G

Policy instance

Insurance contract or identification number	768086G
Number of Individuals Covered	572
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $57,971
Total amount of fees paid to insurance company	USD $6,080
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,159,430
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $57,971
Amount paid for insurance broker fees	6080
Additional information about fees paid to insurance broker	BONUS PAID
Insurance broker organization code?	3

AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )

Policy contract number

G0563

Policy instance

Insurance contract or identification number	G0563
Number of Individuals Covered	3197
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $150,576
Total amount of fees paid to insurance company	USD $0
Other welfare benefits provided	ACCIDENT PLANS
Welfare Benefit Premiums Paid to Carrier	USD $709,046
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $143,416
Insurance broker organization code?	3

AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )

Policy contract number

0000093576

Policy instance

Insurance contract or identification number	0000093576
Number of Individuals Covered	2949
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $147,811
Total amount of fees paid to insurance company	USD $0
Welfare Benefit Premiums Paid to Carrier	USD $1,405,080
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $147,811
Insurance broker organization code?	3

SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )

Policy contract number

934868

Policy instance

Insurance contract or identification number	934868
Number of Individuals Covered	1667
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $455,354
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HYATT LEGAL PLANS OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

9902728

Policy instance

Insurance contract or identification number	9902728
Number of Individuals Covered	2113
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-01
Total amount of commissions paid to insurance broker	USD $46,508
Total amount of fees paid to insurance company	USD $25,535
Other welfare benefits provided	LEGAL
Welfare Benefit Premiums Paid to Carrier	USD $427,050
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $46,508
Amount paid for insurance broker fees	25535
Additional information about fees paid to insurance broker	SUPPLEMENTAL COMPENSATION BROKER ADVANTAGE PROGRAM
Insurance broker organization code?	3

NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 )

Policy contract number

28594

Policy instance

Insurance contract or identification number	28594
Number of Individuals Covered	16595
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,977,008
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )

Policy contract number

5398624

Policy instance

Insurance contract or identification number	5398624
Number of Individuals Covered	1818
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $493,097
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

FLK980022

Policy instance

Insurance contract or identification number	FLK980022
Number of Individuals Covered	22601
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $33,613
Total amount of fees paid to insurance company	USD $10,915
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $2,942,245
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $33,613
Amount paid for insurance broker fees	10915
Additional information about fees paid to insurance broker	SALES & SERVICES, OVERRIDE
Insurance broker organization code?	3

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

FLX980275

Policy instance

Insurance contract or identification number	FLX980275
Number of Individuals Covered	24475
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $224,847
Total amount of fees paid to insurance company	USD $7,249
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $4,083,816
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $178,597
Amount paid for insurance broker fees	7249
Additional information about fees paid to insurance broker	OVERRIDE
Insurance broker organization code?	3

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

OK 980295

Policy instance

Insurance contract or identification number	OK 980295
Number of Individuals Covered	12642
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $17,500
Total amount of fees paid to insurance company	USD $1,022
Other welfare benefits provided	ACCIDENTAL DEATH
Welfare Benefit Premiums Paid to Carrier	USD $667,328
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $13,750
Amount paid for insurance broker fees	1022
Additional information about fees paid to insurance broker	OVERRIDE
Insurance broker organization code?	3

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

0130454

Policy instance

Insurance contract or identification number	0130454
Number of Individuals Covered	91
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $90,720
Total amount of fees paid to insurance company	USD $0
Other welfare benefits provided	DISABILITY INSURANCE
Welfare Benefit Premiums Paid to Carrier	USD $415,298
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $90,720
Insurance broker organization code?	3

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )

Policy contract number

768086G

Policy instance

Insurance contract or identification number	768086G
Number of Individuals Covered	554
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $56,084
Total amount of fees paid to insurance company	USD $5,568
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,215,938
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $56,084
Amount paid for insurance broker fees	5568
Additional information about fees paid to insurance broker	BONUS PAID
Insurance broker organization code?	3

AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )

Policy contract number

G0563

Policy instance

Insurance contract or identification number	G0563
Number of Individuals Covered	3276
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $141,586
Total amount of fees paid to insurance company	USD $0
Other welfare benefits provided	ACCIDENT PLANS
Welfare Benefit Premiums Paid to Carrier	USD $690,962
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $127,667
Insurance broker organization code?	3

AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )

Policy contract number

0000093576

Policy instance

Insurance contract or identification number	0000093576
Number of Individuals Covered	3321
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $154,517
Total amount of fees paid to insurance company	USD $0
Welfare Benefit Premiums Paid to Carrier	USD $1,241,546
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $154,517
Insurance broker organization code?	3

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

OK 980424

Policy instance

Insurance contract or identification number	OK 980424
Number of Individuals Covered	24473
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $5,034
Total amount of fees paid to insurance company	USD $600
Other welfare benefits provided	ACCIDENTAL DEATH
Welfare Benefit Premiums Paid to Carrier	USD $181,529
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,034
Amount paid for insurance broker fees	600
Additional information about fees paid to insurance broker	SALES AND SERVICES, OVERRIDE
Insurance broker organization code?	3

COMPBENEFITS COMPANY (National Association of Insurance Commissioners NAIC id number: 52015 )

Policy contract number

205055

Policy instance

Insurance contract or identification number	205055
Number of Individuals Covered	5215
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $769,505
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

OK 980295

Policy instance

Insurance contract or identification number	OK 980295
Number of Individuals Covered	13818
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $18,504
Total amount of fees paid to insurance company	USD $0
Other welfare benefits provided	ACCIDENTAL DEATH
Welfare Benefit Premiums Paid to Carrier	USD $671,389
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $9,754
Insurance broker organization code?	3
Insurance broker name	CRAWFORD ADVISORS LLC

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

FLX980275

Policy instance

Insurance contract or identification number	FLX980275
Number of Individuals Covered	23079
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $151,812
Total amount of fees paid to insurance company	USD $0
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $4,640,373
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $98,750
Insurance broker organization code?	3
Insurance broker name	MERCER HEALTH & BENEFITS

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

FLK980022

Policy instance

Insurance contract or identification number	FLK980022
Number of Individuals Covered	21433
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $3,694,072
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

VS1150

Policy instance

Insurance contract or identification number	VS1150
Number of Individuals Covered	29
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $3,487
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

0130454

Policy instance

Insurance contract or identification number	0130454
Number of Individuals Covered	91
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $91,263
Total amount of fees paid to insurance company	USD $0
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $341,848
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $91,263
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Insurance broker name	LARSON INSURANCE GROUP

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )

Policy contract number

768086G

Policy instance

Insurance contract or identification number	768086G
Number of Individuals Covered	511
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $48,548
Total amount of fees paid to insurance company	USD $51,765
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $970,963
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $48,548
Amount paid for insurance broker fees	51765
Additional information about fees paid to insurance broker	BONUS PAID
Insurance broker organization code?	2
Insurance broker name	LARSON INSURANCE GROUP

AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )

Policy contract number

G0563

Policy instance

Insurance contract or identification number	G0563
Number of Individuals Covered	3887
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $127,137
Total amount of fees paid to insurance company	USD $0
Other welfare benefits provided	ACCIDENT PLANS
Welfare Benefit Premiums Paid to Carrier	USD $508,388
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $127,137
Insurance broker organization code?	3
Insurance broker name	BENEPLACE INC

AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )

Policy contract number

0000093576

Policy instance

Insurance contract or identification number	0000093576
Number of Individuals Covered	1979
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $93,531
Total amount of fees paid to insurance company	USD $0
Welfare Benefit Premiums Paid to Carrier	USD $748,250
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $93,531
Insurance broker organization code?	3
Insurance broker name	BENEPLACE INC

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

OK 980424

Policy instance

Insurance contract or identification number	OK 980424
Number of Individuals Covered	23079
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $801
Total amount of fees paid to insurance company	USD $0
Other welfare benefits provided	ACCIDENTAL DEATH
Welfare Benefit Premiums Paid to Carrier	USD $148,326
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $801
Insurance broker organization code?	3
Insurance broker name	MERCER HEALTH & BENEFITS

UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )

Policy contract number

5398624

Policy instance

Insurance contract or identification number	5398624
Number of Individuals Covered	2347
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $605,172
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 )

Policy contract number

28594

Policy instance

Insurance contract or identification number	28594
Number of Individuals Covered	19250
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,319,609
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

TM05591359

Policy instance

Insurance contract or identification number	TM05591359
Number of Individuals Covered	56
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $4,664
Total amount of fees paid to insurance company	USD $26
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $63,423
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,664
Amount paid for insurance broker fees	26
Additional information about fees paid to insurance broker	NON-MONETARY COMPENSATION
Insurance broker organization code?	3
Insurance broker name	LARSON INSURANCE GROUP

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

OK 980295

Policy instance

Insurance contract or identification number	OK 980295
Number of Individuals Covered	14486
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Other welfare benefits provided	ACCIDENTAL DEATH
Welfare Benefit Premiums Paid to Carrier	USD $577,650
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 )

Policy contract number

28594

Policy instance

Insurance contract or identification number	28594
Number of Individuals Covered	17831
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,145,489
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )

Policy contract number

5398624

Policy instance

Insurance contract or identification number	5398624
Number of Individuals Covered	1285
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $346,793
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

FLK980022

Policy instance

Insurance contract or identification number	FLK980022
Number of Individuals Covered	21190
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $3,070,384
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

BAYCARE HEALTH

Policy instance

Insurance contract or identification number	BAYCARE HEALTH
Number of Individuals Covered	77
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $48,855
Total amount of fees paid to insurance company	USD $8,289
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $253,443
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $48,855
Amount paid for insurance broker fees	8289
Additional information about fees paid to insurance broker	ADDITIONAL COMPENSATION
Insurance broker organization code?	3
Insurance broker name	LARSON INSURANCE

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

FLX980275

Policy instance

Insurance contract or identification number	FLX980275
Number of Individuals Covered	21190
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $3,829,428
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

VS1150

Policy instance

Insurance contract or identification number	VS1150
Number of Individuals Covered	14
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,180
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

205055

Policy instance

Insurance contract or identification number	205055
Number of Individuals Covered	4418
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $547,659
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

205055

Policy instance

Insurance contract or identification number	205055
Number of Individuals Covered	3985
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $500,484
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

OK 980295

Policy instance

Insurance contract or identification number	OK 980295
Number of Individuals Covered	13652
Insurance policy start date	2014-01-01
Insurance policy end date	2015-01-01
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Other welfare benefits provided	ACCIDENTAL DEATH
Welfare Benefit Premiums Paid to Carrier	USD $611,385
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

FLX980275

Policy instance

Insurance contract or identification number	FLX980275
Number of Individuals Covered	19801
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $4,379,268
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

FLK980022

Policy instance

Insurance contract or identification number	FLK980022
Number of Individuals Covered	19801
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $3,801,822
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )

Policy contract number

5398624

Policy instance

Insurance contract or identification number	5398624
Number of Individuals Covered	1184
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $320,284
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 )

Policy contract number

28594

Policy instance

Insurance contract or identification number	28594
Number of Individuals Covered	16718
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,095,849
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 )

Policy contract number

28594

Policy instance

Insurance contract or identification number	28594
Number of Individuals Covered	15006
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $972,998
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

FLX980275

Policy instance

Insurance contract or identification number	FLX980275
Number of Individuals Covered	17127
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $3,101,370
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

OK 980295

Policy instance

Insurance contract or identification number	OK 980295
Number of Individuals Covered	17127
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Other welfare benefits provided	ACCIDENTAL DEATH
Welfare Benefit Premiums Paid to Carrier	USD $387,961
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

FLK980022

Policy instance

Insurance contract or identification number	FLK980022
Number of Individuals Covered	17127
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $2,724,962
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

205055

Policy instance

Insurance contract or identification number	205055
Number of Individuals Covered	2897
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $373,748
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )

Policy contract number

5398624

Policy instance

Insurance contract or identification number	5398624
Number of Individuals Covered	1243
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $301,983
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 )

Policy contract number

28594

Policy instance

Insurance contract or identification number	28594
Number of Individuals Covered	13992
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $896,993
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )

Policy contract number

44525-3

Policy instance

Insurance contract or identification number	44525-3
Number of Individuals Covered	11704
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $315,988
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )

Policy contract number

44525-2

Policy instance

Insurance contract or identification number	44525-2
Number of Individuals Covered	20214
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $2,421,617
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )

Policy contract number

44525-1

Policy instance

Insurance contract or identification number	44525-1
Number of Individuals Covered	16292
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of fees paid to insurance company	USD $4,253
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $912,347
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	4253
Additional information about fees paid to insurance broker	THIRD PARTY FEES
Insurance broker organization code?	5
Insurance broker name	AXA ASSISTANCE USA, INC.

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

FLK980022

Policy instance

Insurance contract or identification number	FLK980022
Number of Individuals Covered	15350
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $2,641,274
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

205055

Policy instance

Insurance contract or identification number	205055
Number of Individuals Covered	2937
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $322,055
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )

Policy contract number

5398624

Policy instance

Insurance contract or identification number	5398624
Number of Individuals Covered	1309
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $463,127
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )

Policy contract number

44525-2

Policy instance

Insurance contract or identification number	44525-2
Number of Individuals Covered	18834
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $2,223,708
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )

Policy contract number

44525-3

Policy instance

Insurance contract or identification number	44525-3
Number of Individuals Covered	11079
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $288,883
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

205055

Policy instance

Insurance contract or identification number	205055
Number of Individuals Covered	2892
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $382,025
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )

Policy contract number

5398624

Policy instance

Insurance contract or identification number	5398624
Number of Individuals Covered	1405
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $312,370
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

FLK980022

Policy instance

Insurance contract or identification number	FLK980022
Number of Individuals Covered	10186
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $2,489,302
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )

Policy contract number

44525-1

Policy instance

Insurance contract or identification number	44525-1
Number of Individuals Covered	15213
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of fees paid to insurance company	USD $7,724
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $805,821
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 )

Policy contract number

28594

Policy instance

Insurance contract or identification number	28594
Number of Individuals Covered	12352
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $802,307
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

VS1150

Policy instance

Insurance contract or identification number	VS1150
Number of Individuals Covered	29
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $2,035
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )

Policy contract number

5398624

Policy instance

Insurance contract or identification number	5398624
Number of Individuals Covered	2939
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $418,825
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

VS1150

Policy instance

Insurance contract or identification number	VS1150
Number of Individuals Covered	44
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $3,873
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 )

Policy contract number

28594

Policy instance

Insurance contract or identification number	28594
Number of Individuals Covered	10999
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $703,293
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )

Policy contract number

44525-3

Policy instance

Insurance contract or identification number	44525-3
Number of Individuals Covered	11032
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $277,846
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )

Policy contract number

44525-2

Policy instance

Insurance contract or identification number	44525-2
Number of Individuals Covered	18470
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $2,120,738
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

205055

Policy instance

Insurance contract or identification number	205055
Number of Individuals Covered	3418
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $336,705
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )

Policy contract number

44525-1

Policy instance

Insurance contract or identification number	44525-1
Number of Individuals Covered	15227
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of fees paid to insurance company	USD $314
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $760,902
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	314
Additional information about fees paid to insurance broker	THIRD PARTY FEES
Insurance broker organization code?	5
Insurance broker name	AXA ASSISTANCE USA, INC.

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

FLK980022

Policy instance

Insurance contract or identification number	FLK980022
Number of Individuals Covered	14525
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $2,844,799
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

Potentially related plans

Was this data useful?

If you found the data here useful, PLEASE HELP US. We are a start-up and believe in making information freely available. By linking to us, posting on twitter, facebook and linkedin about us and generally spreading the word, you'll help us to grow. Our vision is to provide high quality data about the activities of all the companies in the world and where possible make it free to use and view. Finding and integrating data from thousands of data sources is time consuming and needs lots of effort. By simply spreading the word about us, you will help us. Please use the share buttons. It will only take a few seconds of your time. Thanks for helping

Information Disclaimer

The information provided on this website is not advice, endorsement or recommendation
The information published is supplied by third parties so we make no warranty on the accuracy, completeness etc. This information is provided "as-is". The information is subject to change as we obtain updates and corrections from the primary information sources.
You are free to use the information for your own personal research on the understanding to do so is at your own risk.

See full terms and conditions

Company Name:	BAYCARE HEALTH SYSTEM INC.
Employer identification number (EIN):	592796965
NAIC Classification:	622000
NAIC Description:	Hospitals