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METAL SALES MANUFACTURING CORPORATION SECTION 125 PREMIUM ONLY PLAN 401k Plan overview

Plan NameMETAL SALES MANUFACTURING CORPORATION SECTION 125 PREMIUM ONLY PLAN
Plan identification number 520

METAL SALES MANUFACTURING CORPORATION SECTION 125 PREMIUM ONLY PLAN Benefits

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

401k Sponsoring company profile

METAL SALES MANUFACTURING CORP has sponsored the creation of one or more 401k plans.

Company Name:METAL SALES MANUFACTURING CORP
Employer identification number (EIN):611008982
NAIC Classification:332300

Form 5500 Filing Information

Submission information for form 5500 for 401k plan METAL SALES MANUFACTURING CORPORATION SECTION 125 PREMIUM ONLY PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5202022-04-01MELANIE COMELLA2023-10-18
5202021-04-01MELANIE COMELLA2022-10-27
5202020-04-01JOHN KRUER2022-01-10
5202019-04-01JOHN KRUER2020-10-19
5202018-04-01JOHN KRUER2019-10-17
5202017-04-01
5202016-04-01
5202015-04-01CRAIG L. MACKIN
5202014-04-01CRAIG L MACKIN
5202014-01-01
5202013-01-01
5202012-01-01CRAIG L MACKIN
5202011-01-01CRAIG L. MACKIN
5202009-01-01CRAIG L MACKIN

Plan Statistics for METAL SALES MANUFACTURING CORPORATION SECTION 125 PREMIUM ONLY PLAN

401k plan membership statisitcs for METAL SALES MANUFACTURING CORPORATION SECTION 125 PREMIUM ONLY PLAN

Measure Date Value
2022: METAL SALES MANUFACTURING CORPORATION SECTION 125 PREMIUM ONLY PLAN 2022 401k membership
Total participants, beginning-of-year2022-04-01922
Total number of active participants reported on line 7a of the Form 55002022-04-01929
Number of retired or separated participants receiving benefits2022-04-010
Number of other retired or separated participants entitled to future benefits2022-04-010
Total of all active and inactive participants2022-04-01929
Number of employers contributing to the scheme2022-04-010
2021: METAL SALES MANUFACTURING CORPORATION SECTION 125 PREMIUM ONLY PLAN 2021 401k membership
Total participants, beginning-of-year2021-04-01911
Total number of active participants reported on line 7a of the Form 55002021-04-01922
Number of retired or separated participants receiving benefits2021-04-010
Number of other retired or separated participants entitled to future benefits2021-04-010
Total of all active and inactive participants2021-04-01922
Number of employers contributing to the scheme2021-04-010
2020: METAL SALES MANUFACTURING CORPORATION SECTION 125 PREMIUM ONLY PLAN 2020 401k membership
Total participants, beginning-of-year2020-04-01902
Total number of active participants reported on line 7a of the Form 55002020-04-01911
Number of retired or separated participants receiving benefits2020-04-010
Number of other retired or separated participants entitled to future benefits2020-04-010
Total of all active and inactive participants2020-04-01911
Number of employers contributing to the scheme2020-04-010
2019: METAL SALES MANUFACTURING CORPORATION SECTION 125 PREMIUM ONLY PLAN 2019 401k membership
Total participants, beginning-of-year2019-04-01893
Total number of active participants reported on line 7a of the Form 55002019-04-01902
Number of retired or separated participants receiving benefits2019-04-010
Number of other retired or separated participants entitled to future benefits2019-04-010
Total of all active and inactive participants2019-04-01902
Number of employers contributing to the scheme2019-04-010
2018: METAL SALES MANUFACTURING CORPORATION SECTION 125 PREMIUM ONLY PLAN 2018 401k membership
Total participants, beginning-of-year2018-04-01608
Total number of active participants reported on line 7a of the Form 55002018-04-010
Number of retired or separated participants receiving benefits2018-04-010
Number of other retired or separated participants entitled to future benefits2018-04-010
Total of all active and inactive participants2018-04-010
Number of employers contributing to the scheme2018-04-010
2017: METAL SALES MANUFACTURING CORPORATION SECTION 125 PREMIUM ONLY PLAN 2017 401k membership
Total participants, beginning-of-year2017-04-01595
Total number of active participants reported on line 7a of the Form 55002017-04-01600
Number of retired or separated participants receiving benefits2017-04-018
Number of other retired or separated participants entitled to future benefits2017-04-010
Total of all active and inactive participants2017-04-01608
2016: METAL SALES MANUFACTURING CORPORATION SECTION 125 PREMIUM ONLY PLAN 2016 401k membership
Total participants, beginning-of-year2016-04-01606
Total number of active participants reported on line 7a of the Form 55002016-04-01595
Number of retired or separated participants receiving benefits2016-04-010
Number of other retired or separated participants entitled to future benefits2016-04-010
Total of all active and inactive participants2016-04-01595
2015: METAL SALES MANUFACTURING CORPORATION SECTION 125 PREMIUM ONLY PLAN 2015 401k membership
Total participants, beginning-of-year2015-04-01593
Total number of active participants reported on line 7a of the Form 55002015-04-01559
Number of retired or separated participants receiving benefits2015-04-0121
Number of other retired or separated participants entitled to future benefits2015-04-010
Total of all active and inactive participants2015-04-01580
2014: METAL SALES MANUFACTURING CORPORATION SECTION 125 PREMIUM ONLY PLAN 2014 401k membership
Total participants, beginning-of-year2014-04-01605
Total number of active participants reported on line 7a of the Form 55002014-04-01556
Number of retired or separated participants receiving benefits2014-04-010
Number of other retired or separated participants entitled to future benefits2014-04-010
Total of all active and inactive participants2014-04-01556
Total participants, beginning-of-year2014-01-011,418
Total number of active participants reported on line 7a of the Form 55002014-01-011,212
Total of all active and inactive participants2014-01-011,212
Total participants2014-01-011,212
2013: METAL SALES MANUFACTURING CORPORATION SECTION 125 PREMIUM ONLY PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-011,418
Total number of active participants reported on line 7a of the Form 55002013-01-011,356
Total of all active and inactive participants2013-01-011,356
Total participants2013-01-011,356
2012: METAL SALES MANUFACTURING CORPORATION SECTION 125 PREMIUM ONLY PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-011,960
Total of all active and inactive participants2012-01-010
Total participants2012-01-010
2011: METAL SALES MANUFACTURING CORPORATION SECTION 125 PREMIUM ONLY PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-011,832
Total number of active participants reported on line 7a of the Form 55002011-01-011,832
Total of all active and inactive participants2011-01-011,832
Total participants2011-01-011,832
2009: METAL SALES MANUFACTURING CORPORATION SECTION 125 PREMIUM ONLY PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-011,629
Total number of active participants reported on line 7a of the Form 55002009-01-011,663
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-011,663
Total participants2009-01-011,663

Form 5500 Responses for METAL SALES MANUFACTURING CORPORATION SECTION 125 PREMIUM ONLY PLAN

2022: METAL SALES MANUFACTURING CORPORATION SECTION 125 PREMIUM ONLY PLAN 2022 form 5500 responses
2022-04-01Type of plan entitySingle employer plan
2022-04-01Plan funding arrangement – InsuranceYes
2022-04-01Plan funding arrangement – General assets of the sponsorYes
2022-04-01Plan benefit arrangement – InsuranceYes
2022-04-01Plan benefit arrangement – General assets of the sponsorYes
2021: METAL SALES MANUFACTURING CORPORATION SECTION 125 PREMIUM ONLY PLAN 2021 form 5500 responses
2021-04-01Type of plan entitySingle employer plan
2021-04-01Plan funding arrangement – InsuranceYes
2021-04-01Plan funding arrangement – General assets of the sponsorYes
2021-04-01Plan benefit arrangement – InsuranceYes
2021-04-01Plan benefit arrangement – General assets of the sponsorYes
2020: METAL SALES MANUFACTURING CORPORATION SECTION 125 PREMIUM ONLY PLAN 2020 form 5500 responses
2020-04-01Type of plan entitySingle employer plan
2020-04-01Plan funding arrangement – InsuranceYes
2020-04-01Plan funding arrangement – General assets of the sponsorYes
2020-04-01Plan benefit arrangement – InsuranceYes
2020-04-01Plan benefit arrangement – General assets of the sponsorYes
2019: METAL SALES MANUFACTURING CORPORATION SECTION 125 PREMIUM ONLY PLAN 2019 form 5500 responses
2019-04-01Type of plan entitySingle employer plan
2019-04-01Plan funding arrangement – InsuranceYes
2019-04-01Plan funding arrangement – General assets of the sponsorYes
2019-04-01Plan benefit arrangement – InsuranceYes
2019-04-01Plan benefit arrangement – General assets of the sponsorYes
2018: METAL SALES MANUFACTURING CORPORATION SECTION 125 PREMIUM ONLY PLAN 2018 form 5500 responses
2018-04-01Type of plan entitySingle employer plan
2018-04-01Plan funding arrangement – InsuranceYes
2018-04-01Plan funding arrangement – General assets of the sponsorYes
2018-04-01Plan benefit arrangement – InsuranceYes
2018-04-01Plan benefit arrangement – General assets of the sponsorYes
2017: METAL SALES MANUFACTURING CORPORATION SECTION 125 PREMIUM ONLY PLAN 2017 form 5500 responses
2017-04-01Type of plan entitySingle employer plan
2017-04-01Plan funding arrangement – InsuranceYes
2017-04-01Plan funding arrangement – General assets of the sponsorYes
2017-04-01Plan benefit arrangement – InsuranceYes
2017-04-01Plan benefit arrangement – General assets of the sponsorYes
2016: METAL SALES MANUFACTURING CORPORATION SECTION 125 PREMIUM ONLY PLAN 2016 form 5500 responses
2016-04-01Type of plan entitySingle employer plan
2016-04-01Submission has been amendedNo
2016-04-01This submission is the final filingNo
2016-04-01This return/report is a short plan year return/report (less than 12 months)No
2016-04-01Plan is a collectively bargained planNo
2016-04-01Plan funding arrangement – InsuranceYes
2016-04-01Plan funding arrangement – General assets of the sponsorYes
2016-04-01Plan benefit arrangement – InsuranceYes
2016-04-01Plan benefit arrangement – General assets of the sponsorYes
2015: METAL SALES MANUFACTURING CORPORATION SECTION 125 PREMIUM ONLY PLAN 2015 form 5500 responses
2015-04-01Type of plan entitySingle employer plan
2015-04-01Submission has been amendedNo
2015-04-01This submission is the final filingNo
2015-04-01This return/report is a short plan year return/report (less than 12 months)No
2015-04-01Plan is a collectively bargained planNo
2015-04-01Plan funding arrangement – InsuranceYes
2015-04-01Plan funding arrangement – General assets of the sponsorYes
2015-04-01Plan benefit arrangement – InsuranceYes
2015-04-01Plan benefit arrangement – General assets of the sponsorYes
2014: METAL SALES MANUFACTURING CORPORATION SECTION 125 PREMIUM ONLY PLAN 2014 form 5500 responses
2014-04-01Type of plan entitySingle employer plan
2014-04-01Submission has been amendedNo
2014-04-01This submission is the final filingNo
2014-04-01This return/report is a short plan year return/report (less than 12 months)No
2014-04-01Plan is a collectively bargained planNo
2014-04-01Plan funding arrangement – InsuranceYes
2014-04-01Plan funding arrangement – General assets of the sponsorYes
2014-04-01Plan benefit arrangement – InsuranceYes
2014-04-01Plan benefit arrangement – General assets of the sponsorYes
2014-01-01Type of plan entitySingle employer plan
2014-01-01This return/report is a short plan year return/report (less than 12 months)Yes
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – General assets of the sponsorYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – General assets of the sponsorYes
2013: METAL SALES MANUFACTURING CORPORATION SECTION 125 PREMIUM ONLY PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – General assets of the sponsorYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – General assets of the sponsorYes
2012: METAL SALES MANUFACTURING CORPORATION SECTION 125 PREMIUM ONLY PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – General assets of the sponsorYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – General assets of the sponsorYes
2011: METAL SALES MANUFACTURING CORPORATION SECTION 125 PREMIUM ONLY PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – General assets of the sponsorYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – General assets of the sponsorYes
2009: METAL SALES MANUFACTURING CORPORATION SECTION 125 PREMIUM ONLY PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – General assets of the sponsorYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30081797
Policy instance 3
Insurance contract or identification number30081797
Number of Individuals Covered533
Insurance policy start date2022-04-01
Insurance policy end date2023-03-31
Total amount of commissions paid to insurance brokerUSD $1,252
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $62,538
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,252
Amount paid for insurance broker fees0
Insurance broker organization code?3
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number70554-3
Policy instance 2
Insurance contract or identification number70554-3
Number of Individuals Covered1329
Insurance policy start date2022-04-01
Insurance policy end date2023-03-31
Total amount of commissions paid to insurance brokerUSD $68,513
Total amount of fees paid to insurance companyUSD $35,964
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, ACCIDENT, CRITICAL ILLNESS, HOSPITAL
Welfare Benefit Premiums Paid to CarrierUSD $691,918
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $68,513
Amount paid for insurance broker fees35964
Additional information about fees paid to insurance brokerSERVICE FEE, SUPPLEMENTAL COMPENSATION
Insurance broker organization code?3
DELTA DENTAL OF KENTUCKY (National Association of Insurance Commissioners NAIC id number: 54674 )
Policy contract number708660
Policy instance 1
Insurance contract or identification number708660
Number of Individuals Covered1107
Insurance policy start date2022-04-01
Insurance policy end date2023-03-31
Total amount of commissions paid to insurance brokerUSD $6,542
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,314
Amount paid for insurance broker fees0
Insurance broker organization code?3
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number70554-3
Policy instance 2
Insurance contract or identification number70554-3
Number of Individuals Covered1390
Insurance policy start date2021-04-01
Insurance policy end date2022-03-31
Total amount of commissions paid to insurance brokerUSD $74,691
Total amount of fees paid to insurance companyUSD $27,628
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, ACCIDENT, CRITICAL ILLNESS, HOSPITAL
Welfare Benefit Premiums Paid to CarrierUSD $721,594
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $74,691
Amount paid for insurance broker fees27628
Additional information about fees paid to insurance brokerSERVICE FEES
Insurance broker organization code?3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30081797
Policy instance 3
Insurance contract or identification number30081797
Number of Individuals Covered567
Insurance policy start date2021-04-01
Insurance policy end date2022-03-31
Total amount of commissions paid to insurance brokerUSD $1,222
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $66,267
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,222
Amount paid for insurance broker fees0
Insurance broker organization code?3
DELTA DENTAL OF KENTUCKY (National Association of Insurance Commissioners NAIC id number: 54674 )
Policy contract number708660
Policy instance 1
Insurance contract or identification number708660
Number of Individuals Covered1158
Insurance policy start date2021-04-01
Insurance policy end date2022-03-31
Total amount of commissions paid to insurance brokerUSD $7,097
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,097
Amount paid for insurance broker fees0
Insurance broker organization code?3
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number70554-3
Policy instance 2
Insurance contract or identification number70554-3
Number of Individuals Covered1387
Insurance policy start date2020-04-01
Insurance policy end date2021-03-31
Total amount of commissions paid to insurance brokerUSD $70,499
Total amount of fees paid to insurance companyUSD $20,076
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM, ACCIDENT, CRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $721,705
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $70,499
Amount paid for insurance broker fees19617
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION SERVICE FEE
Insurance broker organization code?3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30081797
Policy instance 3
Insurance contract or identification number30081797
Number of Individuals Covered543
Insurance policy start date2020-04-01
Insurance policy end date2021-03-31
Total amount of commissions paid to insurance brokerUSD $1,262
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $63,092
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,262
Amount paid for insurance broker fees0
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberR0636613
Policy instance 4
Insurance contract or identification numberR0636613
Number of Individuals Covered3
Insurance policy start date2020-04-01
Insurance policy end date2021-03-31
Total amount of commissions paid to insurance brokerUSD $114
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedACCIDENT, CRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $1,256
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $114
Amount paid for insurance broker fees0
Insurance broker organization code?3
DELTA DENTAL OF KENTUCKY (National Association of Insurance Commissioners NAIC id number: 54674 )
Policy contract number708660
Policy instance 1
Insurance contract or identification number708660
Number of Individuals Covered1243
Insurance policy start date2020-04-01
Insurance policy end date2021-03-31
Total amount of commissions paid to insurance brokerUSD $6,509
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,132
Amount paid for insurance broker fees0
Insurance broker organization code?3
DELTA DENTAL OF KENTUCKY (National Association of Insurance Commissioners NAIC id number: 54674 )
Policy contract number708660
Policy instance 1
Insurance contract or identification number708660
Number of Individuals Covered1207
Insurance policy start date2019-04-01
Insurance policy end date2020-03-31
Total amount of commissions paid to insurance brokerUSD $7,107
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,107
Amount paid for insurance broker fees0
Insurance broker organization code?3
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number70554-3
Policy instance 2
Insurance contract or identification number70554-3
Number of Individuals Covered2266
Insurance policy start date2019-04-01
Insurance policy end date2020-03-31
Total amount of commissions paid to insurance brokerUSD $171,553
Total amount of fees paid to insurance companyUSD $29,798
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM, ACCIDENT, CRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $714,795
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $171,553
Amount paid for insurance broker fees24683
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
Insurance broker organization code?3
PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 )
Policy contract number11005927
Policy instance 3
Insurance contract or identification number11005927
Number of Individuals Covered139
Insurance policy start date2019-04-01
Insurance policy end date2020-03-31
Total amount of commissions paid to insurance brokerUSD $742
Total amount of fees paid to insurance companyUSD $77
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,944
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $742
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30081797
Policy instance 4
Insurance contract or identification number30081797
Number of Individuals Covered506
Insurance policy start date2019-04-01
Insurance policy end date2020-03-31
Total amount of commissions paid to insurance brokerUSD $645
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $63,287
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $645
Amount paid for insurance broker fees0
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberR0636613
Policy instance 5
Insurance contract or identification numberR0636613
Number of Individuals Covered533
Insurance policy start date2019-04-01
Insurance policy end date2020-03-31
Total amount of commissions paid to insurance brokerUSD $3,541
Total amount of fees paid to insurance companyUSD $350
Other welfare benefits providedACCIDENT, CRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $21,558
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,541
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
DELTA DENTAL OF KENTUCKY (National Association of Insurance Commissioners NAIC id number: 54674 )
Policy contract number708660
Policy instance 1
Insurance contract or identification number708660
Number of Individuals Covered1244
Insurance policy start date2018-04-01
Insurance policy end date2019-03-31
Total amount of commissions paid to insurance brokerUSD $6,584
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,584
Amount paid for insurance broker fees0
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberR0636613
Policy instance 5
Insurance contract or identification numberR0636613
Number of Individuals Covered640
Insurance policy start date2018-04-01
Insurance policy end date2019-03-31
Total amount of commissions paid to insurance brokerUSD $32,323
Total amount of fees paid to insurance companyUSD $3,444
Other welfare benefits providedACCIDENT, CRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $181,057
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $32,323
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30081797
Policy instance 4
Insurance contract or identification number30081797
Number of Individuals Covered538
Insurance policy start date2018-04-01
Insurance policy end date2019-03-31
Total amount of commissions paid to insurance brokerUSD $1,321
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $66,038
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,321
Amount paid for insurance broker fees0
Insurance broker organization code?3
PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 )
Policy contract numberR0636613
Policy instance 3
Insurance contract or identification numberR0636613
Number of Individuals Covered227
Insurance policy start date2018-04-01
Insurance policy end date2019-03-31
Total amount of commissions paid to insurance brokerUSD $12,329
Total amount of fees paid to insurance companyUSD $1,209
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $58,568
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,311
Amount paid for insurance broker fees1209
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number70554-3
Policy instance 2
Insurance contract or identification number70554-3
Number of Individuals Covered1348
Insurance policy start date2018-04-01
Insurance policy end date2019-03-31
Total amount of commissions paid to insurance brokerUSD $54,502
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $506,502
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $54,502
Amount paid for insurance broker fees0
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5935215
Policy instance 1
Insurance contract or identification number5935215
Number of Individuals Covered1147
Insurance policy start date2017-04-01
Insurance policy end date2018-03-31
Total amount of commissions paid to insurance brokerUSD $7,458
Total amount of fees paid to insurance companyUSD $6,136
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $372,727
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,458
Amount paid for insurance broker fees57
Additional information about fees paid to insurance brokerNON-MONETARY COMPENSATION
Insurance broker organization code?3
Insurance broker nameLOCKTON COMPANIES, LLC
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number243812
Policy instance 2
Insurance contract or identification number243812
Number of Individuals Covered880
Insurance policy start date2017-04-01
Insurance policy end date2018-03-31
Total amount of commissions paid to insurance brokerUSD $63,223
Total amount of fees paid to insurance companyUSD $17,629
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $639,041
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $63,223
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerBONUS
Insurance broker nameLOCKTON COMPANIES, LLC
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberR0636613
Policy instance 3
Insurance contract or identification numberR0636613
Number of Individuals Covered629
Insurance policy start date2017-04-01
Insurance policy end date2018-03-31
Total amount of commissions paid to insurance brokerUSD $48,777
Total amount of fees paid to insurance companyUSD $6,379
Other welfare benefits providedACCIDENT, CRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $177,337
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $48,777
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker nameHODGES-MACE BENEFITS GROUP INC
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract number136-006176
Policy instance 1
Insurance contract or identification number136-006176
Number of Individuals Covered1148
Insurance policy start date2015-04-01
Insurance policy end date2016-03-31
Total amount of commissions paid to insurance brokerUSD $64,777
Total amount of fees paid to insurance companyUSD $6,871
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $769,823
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $40,309
Amount paid for insurance broker fees6871
Additional information about fees paid to insurance brokerADMINISTRATIVE AND OTHER FEES
Insurance broker organization code?3
Insurance broker nameLOCKTON COMPANIES, LLC
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract number136-006176
Policy instance 1
Insurance contract or identification number136-006176
Number of Individuals Covered1071
Insurance policy start date2014-04-01
Insurance policy end date2015-03-31
Total amount of commissions paid to insurance brokerUSD $47,402
Total amount of fees paid to insurance companyUSD $5,309
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $671,233
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $47,402
Amount paid for insurance broker fees5309
Additional information about fees paid to insurance brokerADMINISTRATIVE AND OTHER FEES
Insurance broker organization code?3
Insurance broker nameB B AND T INSURANCE SERVICES, INC.
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL 147063
Policy instance 3
Insurance contract or identification numberGL 147063
Number of Individuals Covered850
Insurance policy start date2014-01-01
Insurance policy end date2014-03-31
Total amount of commissions paid to insurance brokerUSD $5,405
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $54,052
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,405
Insurance broker organization code?3
Insurance broker nameBB&T INSURANCE SERVICES
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract number136-006176
Policy instance 1
Insurance contract or identification number136-006176
Number of Individuals Covered1212
Insurance policy start date2014-01-01
Insurance policy end date2014-03-31
Total amount of commissions paid to insurance brokerUSD $393
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $29,020
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $393
Insurance broker organization code?3
Insurance broker nameBB&T INSURANCE SERVICES
ANTHEM HEALTH PLAN OF KENTUCKY D.B.A. ANTHEM BLUECROSS BLUESHIELD (National Association of Insurance Commissioners NAIC id number: 95120 )
Policy contract number00210700
Policy instance 5
Insurance contract or identification number00210700
Number of Individuals Covered1208
Insurance policy start date2014-01-01
Insurance policy end date2014-03-31
Welfare Benefit Premiums Paid to CarrierUSD $344,794
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberVPL 300667
Policy instance 6
Insurance contract or identification numberVPL 300667
Number of Individuals Covered214
Insurance policy start date2014-01-01
Insurance policy end date2014-03-31
Total amount of commissions paid to insurance brokerUSD $1,211
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,055
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,211
Insurance broker organization code?3
Insurance broker nameBB&T INSURANCE SERVICES, INC.
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberLTD 120720
Policy instance 4
Insurance contract or identification numberLTD 120720
Number of Individuals Covered214
Insurance policy start date2014-01-01
Insurance policy end date2014-03-31
Total amount of commissions paid to insurance brokerUSD $1,087
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $10,871
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,087
Insurance broker organization code?3
Insurance broker nameBB&T INSUARANCE SERVICES
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberG161027
Policy instance 2
Insurance contract or identification numberG161027
Number of Individuals Covered240
Insurance policy start date2014-01-01
Insurance policy end date2014-03-31
Total amount of commissions paid to insurance brokerUSD $723
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,228
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $723
Insurance broker organization code?3
Insurance broker nameBB&T INSURANCE SERVICES. INC.
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL 147063
Policy instance 5
Insurance contract or identification numberGL 147063
Number of Individuals Covered756
Insurance policy start date2013-04-01
Insurance policy end date2014-03-31
Total amount of commissions paid to insurance brokerUSD $17,227
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $172,270
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17,227
Insurance broker organization code?3
Insurance broker nameBB&T INSURANCE SERVICES
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number873234G
Policy instance 12
Insurance contract or identification number873234G
Number of Individuals Covered111
Insurance policy start date2013-03-01
Insurance policy end date2014-02-28
Total amount of commissions paid to insurance brokerUSD $7,173
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits provided0 ACCIDENTAL DEATH
Welfare Benefit Premiums Paid to CarrierUSD $43,837
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,173
Insurance broker organization code?3
Insurance broker nameR H CLARKSON FINANCIAL SERVICES
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract number136-006176
Policy instance 1
Insurance contract or identification number136-006176
Number of Individuals Covered1212
Insurance policy start date2013-04-01
Insurance policy end date2014-03-31
Total amount of commissions paid to insurance brokerUSD $5,068
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $373,608
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,068
Insurance broker organization code?3
Insurance broker nameBB&T INSURANCE SERVICES
HUMANA HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95885 )
Policy contract number641508
Policy instance 2
Insurance contract or identification number641508
Number of Individuals Covered75
Insurance policy start date2013-03-01
Insurance policy end date2014-02-28
Total amount of commissions paid to insurance brokerUSD $29,021
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $669,859
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $29,021
Insurance broker organization code?3
Insurance broker nameR H CLARKSON FINANCIAL SERVICES
KANAWHA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65110 )
Policy contract numberK101107
Policy instance 3
Insurance contract or identification numberK101107
Number of Individuals Covered76
Insurance policy start date2013-03-01
Insurance policy end date2014-02-28
Total amount of commissions paid to insurance brokerUSD $2,498
Other welfare benefits provided0 CRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $13,647
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,498
Insurance broker organization code?3
Insurance broker nameR H CLARKSON FINANCIAL SERVICES
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberG161027
Policy instance 4
Insurance contract or identification numberG161027
Number of Individuals Covered240
Insurance policy start date2013-04-01
Insurance policy end date2014-03-31
Total amount of commissions paid to insurance brokerUSD $2,648
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $26,482
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,648
Insurance broker organization code?3
Insurance broker nameBB&T INSURANCE SERVICES. INC.
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberLTD 120720
Policy instance 6
Insurance contract or identification numberLTD 120720
Number of Individuals Covered228
Insurance policy start date2013-04-01
Insurance policy end date2014-03-31
Total amount of commissions paid to insurance brokerUSD $4,112
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $41,122
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,112
Insurance broker organization code?3
Insurance broker nameBB&T INSUARANCE SERVICES
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000AEE6
Policy instance 7
Insurance contract or identification numberG000AEE6
Number of Individuals Covered34
Insurance policy start date2012-11-01
Insurance policy end date2013-11-01
Total amount of commissions paid to insurance brokerUSD $1,931
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $19,307
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,931
Insurance broker organization code?3
Insurance broker nameR H CLARKSON FINANCIAL SERVICES
NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 )
Policy contract number29419
Policy instance 8
Insurance contract or identification number29419
Number of Individuals Covered144
Insurance policy start date2013-03-01
Insurance policy end date2014-02-28
Total amount of commissions paid to insurance brokerUSD $878
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $9,296
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $878
Insurance broker organization code?3
Insurance broker nameR H CLARKSON FINANCIAL SERVICES
ANTHEM HEALTH PLAN OF KENTUCKY D.B.A. ANTHEM BLUECROSS BLUESHIELD (National Association of Insurance Commissioners NAIC id number: 95120 )
Policy contract number001005831
Policy instance 9
Insurance contract or identification number001005831
Number of Individuals Covered1208
Insurance policy start date2013-04-01
Insurance policy end date2014-03-31
Welfare Benefit Premiums Paid to CarrierUSD $344,794
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberVPL 300667
Policy instance 10
Insurance contract or identification numberVPL 300667
Number of Individuals Covered136
Insurance policy start date2013-04-01
Insurance policy end date2014-03-31
Total amount of commissions paid to insurance brokerUSD $3,734
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $18,672
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,734
Insurance broker organization code?3
Insurance broker nameBB&T INSURANCE SERVICES, INC.
DENTAL CARE PLUS, INC. (National Association of Insurance Commissioners NAIC id number: 96265 )
Policy contract number05683801
Policy instance 11
Insurance contract or identification number05683801
Number of Individuals Covered167
Insurance policy start date2013-03-01
Insurance policy end date2014-02-28
Total amount of commissions paid to insurance brokerUSD $2,593
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $24,616
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,593
Insurance broker organization code?3
Insurance broker nameR H CLARKSON FINANCIAL SERVICES
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000AEE6
Policy instance 12
Insurance contract or identification numberG000AEE6
Number of Individuals Covered88
Insurance policy start date2011-11-01
Insurance policy end date2012-11-01
Total amount of commissions paid to insurance brokerUSD $3,345
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $33,451
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,345
Insurance broker organization code?3
Insurance broker nameRH CLARKSON FINANCIAL SERVICES
ANTHEM HEALTH PLAN OF KENTUCKY D.B.A. ANTHEM BLUECROSS BLUESHIELD (National Association of Insurance Commissioners NAIC id number: 95120 )
Policy contract number00210629
Policy instance 2
Insurance contract or identification number00210629
Number of Individuals Covered115
Insurance policy start date2012-02-01
Insurance policy end date2013-01-31
Total amount of commissions paid to insurance brokerUSD $19,190
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $669,355
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $19,190
Insurance broker organization code?3
Insurance broker nameRH CLARKSON FINANCIAL SERVICES
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberF015830
Policy instance 18
Insurance contract or identification numberF015830
Number of Individuals Covered350
Insurance policy start date2012-03-01
Insurance policy end date2013-02-28
Total amount of commissions paid to insurance brokerUSD $5,082
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $33,883
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,082
Insurance broker organization code?3
Insurance broker nameRH CLARKSON FINANCIAL SERVICES
DENTAL CARE PLUS, INC. (National Association of Insurance Commissioners NAIC id number: 96265 )
Policy contract number05683801
Policy instance 17
Insurance contract or identification number05683801
Number of Individuals Covered207
Insurance policy start date2012-03-01
Insurance policy end date2013-02-28
Total amount of commissions paid to insurance brokerUSD $3,927
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,927
Insurance broker organization code?3
Insurance broker nameRH CLARKSON FINANCIAL SERVICES INC
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberVPL 300667
Policy instance 16
Insurance contract or identification numberVPL 300667
Number of Individuals Covered128
Insurance policy start date2012-04-01
Insurance policy end date2013-03-31
Total amount of commissions paid to insurance brokerUSD $3,231
Total amount of fees paid to insurance companyUSD $171
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $16,154
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,231
Amount paid for insurance broker fees171
Additional information about fees paid to insurance brokerOTHER ADMIN
Insurance broker organization code?3
Insurance broker nameBB&T INSURANCE SERVICE INC
ANTHEM HEALTH PLAN OF KENTUCKY D.B.A. ANTHEM BLUECROSS BLUESHIELD (National Association of Insurance Commissioners NAIC id number: 95120 )
Policy contract number001005831
Policy instance 15
Insurance contract or identification number001005831
Number of Individuals Covered1211
Insurance policy start date2012-04-01
Insurance policy end date2013-03-31
Welfare Benefit Premiums Paid to CarrierUSD $337,846
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 number29419
Policy instance 14
Insurance contract or identification number29419
Number of Individuals Covered192
Insurance policy start date2012-03-01
Insurance policy end date2013-02-28
Total amount of commissions paid to insurance brokerUSD $1,295
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $12,559
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,295
Insurance broker organization code?3
Insurance broker nameRH CLARKSON FINANCIAL SERVICES
DELTA DENTAL OF KENTUCKY (National Association of Insurance Commissioners NAIC id number: 54674 )
Policy contract number000DU7249
Policy instance 13
Insurance contract or identification number000DU7249
Number of Individuals Covered542
Insurance policy start date2011-11-01
Insurance policy end date2012-10-31
Total amount of commissions paid to insurance brokerUSD $3,094
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,094
Insurance broker organization code?3
Insurance broker nameBROWN & BROWN OF KENTUCKY INC
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number9255370
Policy instance 11
Insurance contract or identification number9255370
Number of Individuals Covered65
Insurance policy start date2012-01-01
Insurance policy end date2013-01-01
Total amount of commissions paid to insurance brokerUSD $11,723
Total amount of fees paid to insurance companyUSD $49
Welfare Benefit Premiums Paid to CarrierUSD $16,745
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,690
Amount paid for insurance broker fees49
Insurance broker organization code?3
Insurance broker nameWELLNESS OF AMERICA LLC
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberF017811
Policy instance 10
Insurance contract or identification numberF017811
Number of Individuals Covered585
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $14,244
Total amount of fees paid to insurance companyUSD $200
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedADD
Welfare Benefit Premiums Paid to CarrierUSD $159,781
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,244
Amount paid for insurance broker fees200
Additional information about fees paid to insurance brokerOTHER ADMIN
Insurance broker organization code?3
Insurance broker nameBROWN & BROWN OF KY INC
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberLTD 120720
Policy instance 9
Insurance contract or identification numberLTD 120720
Number of Individuals Covered228
Insurance policy start date2012-04-01
Insurance policy end date2013-03-31
Total amount of commissions paid to insurance brokerUSD $4,784
Total amount of fees paid to insurance companyUSD $566
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $47,842
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,784
Amount paid for insurance broker fees566
Additional information about fees paid to insurance brokerOTHER ADMIN
Insurance broker nameBB&T INSUANCE SERVICES
COMPBENEFITS (National Association of Insurance Commissioners NAIC id number: 54739 )
Policy contract number549604
Policy instance 3
Insurance contract or identification number549604
Number of Individuals Covered233
Insurance policy start date2011-11-01
Insurance policy end date2012-10-31
Total amount of commissions paid to insurance brokerUSD $1,998
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $29,067
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,998
Insurance broker organization code?3
Insurance broker nameBROWN & BROWN OF KY INC. - WEST
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberG161027
Policy instance 5
Insurance contract or identification numberG161027
Number of Individuals Covered240
Insurance policy start date2012-04-01
Insurance policy end date2013-03-31
Total amount of commissions paid to insurance brokerUSD $2,767
Total amount of fees paid to insurance companyUSD $305
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $27,666
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,767
Amount paid for insurance broker fees305
Additional information about fees paid to insurance brokerOTHER ADMIN
Insurance broker organization code?3
Insurance broker nameBB&T INSURANCE SERVICES INC.
PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 )
Policy contract number9255370
Policy instance 4
Insurance contract or identification number9255370
Number of Individuals Covered232
Insurance policy start date2012-01-01
Insurance policy end date2013-01-01
Total amount of commissions paid to insurance brokerUSD $40,069
Total amount of fees paid to insurance companyUSD $1,294
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $51,803
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,773
Amount paid for insurance broker fees226
Insurance broker organization code?3
Insurance broker nameWELLNESS OF AMERICA LLC
HUMANA HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95885 )
Policy contract number549604
Policy instance 6
Insurance contract or identification number549604
Number of Individuals Covered304
Insurance policy start date2011-11-01
Insurance policy end date2012-10-31
Total amount of commissions paid to insurance brokerUSD $43,937
Welfare Benefit Premiums Paid to CarrierUSD $241,407
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $43,937
Insurance broker organization code?3
Insurance broker nameBROWN & BROWN OF KY INC. - WEST
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL 147063
Policy instance 7
Insurance contract or identification numberGL 147063
Number of Individuals Covered748
Insurance policy start date2012-04-01
Insurance policy end date2013-03-31
Total amount of commissions paid to insurance brokerUSD $17,378
Total amount of fees paid to insurance companyUSD $1,950
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $173,782
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17,378
Amount paid for insurance broker fees1950
Additional information about fees paid to insurance brokerOTHER ADMIN
Insurance broker organization code?3
Insurance broker nameBB&T INSURANCE SERVICES INC
DENTAL CHOICE, INC. (National Association of Insurance Commissioners NAIC id number: 48127 )
Policy contract number000DU7249
Policy instance 8
Insurance contract or identification number000DU7249
Number of Individuals Covered29
Insurance policy start date2012-11-01
Insurance policy end date2012-10-31
Total amount of commissions paid to insurance brokerUSD $80
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $80
Insurance broker organization code?3
Insurance broker nameBROWN & BROWN OF KENTUCKY INC
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract number136-006176
Policy instance 1
Insurance contract or identification number136-006176
Number of Individuals Covered1183
Insurance policy start date2012-04-01
Insurance policy end date2013-03-31
Total amount of commissions paid to insurance brokerUSD $4,242
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $313,000
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,242
Insurance broker organization code?3
Insurance broker nameBB&T INSURANCE SERVICES INC
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00373730
Policy instance 16
Insurance contract or identification number00373730
Number of Individuals Covered107
Insurance policy start date2010-11-01
Insurance policy end date2011-10-31
Total amount of commissions paid to insurance brokerUSD $2,529
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $39,883
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberF015830
Policy instance 17
Insurance contract or identification numberF015830
Number of Individuals Covered156
Insurance policy start date2010-07-01
Insurance policy end date2011-06-30
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $25,596
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000AEE6
Policy instance 11
Insurance contract or identification numberG000AEE6
Number of Individuals Covered81
Insurance policy start date2010-11-01
Insurance policy end date2011-11-01
Total amount of commissions paid to insurance brokerUSD $4,178
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $32,250
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HUMANA HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95885 )
Policy contract number549604
Policy instance 6
Insurance contract or identification number549604
Number of Individuals Covered293
Insurance policy start date2010-11-01
Insurance policy end date2011-10-31
Total amount of commissions paid to insurance brokerUSD $42,833
Total amount of fees paid to insurance companyUSD $2,296
Welfare Benefit Premiums Paid to CarrierUSD $230,451
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberVPL 300667
Policy instance 15
Insurance contract or identification numberVPL 300667
Number of Individuals Covered138
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
Total amount of commissions paid to insurance brokerUSD $3,291
Total amount of fees paid to insurance companyUSD $242
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $16,455
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ANTHEM HEALTH PLAN OF KENTUCKY D.B.A. ANTHEM BLUECROSS BLUESHIELD (National Association of Insurance Commissioners NAIC id number: 95120 )
Policy contract number001005831
Policy instance 14
Insurance contract or identification number001005831
Number of Individuals Covered1144
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
Welfare Benefit Premiums Paid to CarrierUSD $277,684
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITED DENTAL CARE OF MISSOURI, INC. (National Association of Insurance Commissioners NAIC id number: 47044 )
Policy contract numberDE46
Policy instance 1
Insurance contract or identification numberDE46
Number of Individuals Covered28
Insurance policy start date2011-04-01
Insurance policy end date2011-10-31
Total amount of commissions paid to insurance brokerUSD $124
Total amount of fees paid to insurance companyUSD $49
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,439
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ANTHEM HEALTH PLAN OF KENTUCKY D.B.A. ANTHEM BLUECROSS BLUESHIELD (National Association of Insurance Commissioners NAIC id number: 95120 )
Policy contract number00210629
Policy instance 2
Insurance contract or identification number00210629
Number of Individuals Covered121
Insurance policy start date2011-02-01
Insurance policy end date2012-01-31
Total amount of commissions paid to insurance brokerUSD $10,360
Total amount of fees paid to insurance companyUSD $2,916
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $590,544
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COMPBENEFITS (National Association of Insurance Commissioners NAIC id number: 60984 )
Policy contract number549604
Policy instance 3
Insurance contract or identification number549604
Number of Individuals Covered218
Insurance policy start date2010-11-01
Insurance policy end date2011-10-31
Total amount of commissions paid to insurance brokerUSD $2,849
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $30,963
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00348469
Policy instance 4
Insurance contract or identification number00348469
Number of Individuals Covered544
Insurance policy start date2011-01-01
Insurance policy end date2012-03-31
Total amount of commissions paid to insurance brokerUSD $9,555
Total amount of fees paid to insurance companyUSD $9,959
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $370,342
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberG161027
Policy instance 5
Insurance contract or identification numberG161027
Number of Individuals Covered291
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
Total amount of commissions paid to insurance brokerUSD $2,966
Total amount of fees paid to insurance companyUSD $389
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $29,658
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL 147063
Policy instance 7
Insurance contract or identification numberGL 147063
Number of Individuals Covered724
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
Total amount of commissions paid to insurance brokerUSD $17,796
Total amount of fees paid to insurance companyUSD $2,535
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $177,959
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DENTAL CHOICE, INC. (National Association of Insurance Commissioners NAIC id number: 48127 )
Policy contract number000DU7249
Policy instance 8
Insurance contract or identification number000DU7249
Number of Individuals Covered36
Insurance policy start date2010-11-01
Insurance policy end date2011-10-31
Total amount of commissions paid to insurance brokerUSD $93
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberLTD 120720
Policy instance 9
Insurance contract or identification numberLTD 120720
Number of Individuals Covered261
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
Total amount of commissions paid to insurance brokerUSD $4,770
Total amount of fees paid to insurance companyUSD $731
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $47,708
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberF017811
Policy instance 10
Insurance contract or identification numberF017811
Number of Individuals Covered510
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $10,963
Total amount of fees paid to insurance companyUSD $175
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedADD
Welfare Benefit Premiums Paid to CarrierUSD $101,432
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 number29419
Policy instance 13
Insurance contract or identification number29419
Number of Individuals Covered178
Insurance policy start date2010-11-01
Insurance policy end date2011-10-31
Total amount of commissions paid to insurance brokerUSD $1,324
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $13,152
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL OF KENTUCKY (National Association of Insurance Commissioners NAIC id number: 54674 )
Policy contract number000DU7249
Policy instance 12
Insurance contract or identification number000DU7249
Number of Individuals Covered499
Insurance policy start date2010-11-01
Insurance policy end date2011-10-31
Total amount of commissions paid to insurance brokerUSD $3,273
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000AEE6
Policy instance 9
Insurance contract or identification numberG000AEE6
Number of Individuals Covered86
Insurance policy start date2009-11-01
Insurance policy end date2010-11-01
Total amount of commissions paid to insurance brokerUSD $4,615
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $36,188
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberF009906
Policy instance 8
Insurance contract or identification numberF009906
Number of Individuals Covered739
Insurance policy start date2010-01-01
Insurance policy end date2010-03-31
Total amount of commissions paid to insurance brokerUSD $6,632
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $62,977
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DENTAL CHOICE, INC. (National Association of Insurance Commissioners NAIC id number: 48127 )
Policy contract number000DU7249
Policy instance 6
Insurance contract or identification number000DU7249
Number of Individuals Covered39
Insurance policy start date2009-11-01
Insurance policy end date2010-10-31
Total amount of commissions paid to insurance brokerUSD $107
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL OF KENTUCKY (National Association of Insurance Commissioners NAIC id number: 54674 )
Policy contract number000DU7249
Policy instance 10
Insurance contract or identification number000DU7249
Number of Individuals Covered513
Insurance policy start date2009-11-01
Insurance policy end date2010-10-31
Total amount of commissions paid to insurance brokerUSD $3,126
Dental Insurance Welfare BenefitYes
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 number29419
Policy instance 11
Insurance contract or identification number29419
Number of Individuals Covered195
Insurance policy start date2009-11-01
Insurance policy end date2010-10-31
Total amount of commissions paid to insurance brokerUSD $1,405
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $15,205
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ANTHEM HEALTH PLAN OF KENTUCKY D.B.A. ANTHEM BLUECROSS BLUESHIELD (National Association of Insurance Commissioners NAIC id number: 95120 )
Policy contract number001005831
Policy instance 12
Insurance contract or identification number001005831
Number of Individuals Covered1119
Insurance policy start date2010-04-01
Insurance policy end date2011-03-31
Welfare Benefit Premiums Paid to CarrierUSD $74,527
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00373730
Policy instance 13
Insurance contract or identification number00373730
Number of Individuals Covered112
Insurance policy start date2009-11-01
Insurance policy end date2010-10-31
Total amount of commissions paid to insurance brokerUSD $2,551
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $41,139
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberF015830
Policy instance 14
Insurance contract or identification numberF015830
Number of Individuals Covered165
Insurance policy start date2009-11-01
Insurance policy end date2010-10-31
Total amount of commissions paid to insurance brokerUSD $3,981
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $26,543
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITED DENTAL CARE OF MISSOURI, INC. (National Association of Insurance Commissioners NAIC id number: 47044 )
Policy contract numberDE46
Policy instance 1
Insurance contract or identification numberDE46
Number of Individuals Covered29
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $255
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,553
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ANTHEM HEALTH PLAN OF KENTUCKY D.B.A. ANTHEM BLUECROSS BLUESHIELD (National Association of Insurance Commissioners NAIC id number: 95120 )
Policy contract number00210629
Policy instance 2
Insurance contract or identification number00210629
Number of Individuals Covered150
Insurance policy start date2010-02-01
Insurance policy end date2011-01-31
Total amount of commissions paid to insurance brokerUSD $5,060
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $188,487
HUMANA HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95885 )
Policy contract number549604
Policy instance 5
Insurance contract or identification number549604
Number of Individuals Covered333
Insurance policy start date2009-11-01
Insurance policy end date2010-10-31
Total amount of commissions paid to insurance brokerUSD $42,437
Welfare Benefit Premiums Paid to CarrierUSD $189,981
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00348469
Policy instance 4
Insurance contract or identification number00348469
Number of Individuals Covered524
Insurance policy start date2010-04-01
Insurance policy end date2011-03-31
Total amount of commissions paid to insurance brokerUSD $9,254
Total amount of fees paid to insurance companyUSD $11,817
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $350,545
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COMPBENEFITS (National Association of Insurance Commissioners NAIC id number: 60984 )
Policy contract number549604
Policy instance 3
Insurance contract or identification number549604
Number of Individuals Covered237
Insurance policy start date2009-11-01
Insurance policy end date2010-10-31
Total amount of commissions paid to insurance brokerUSD $3,138
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $31,916
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0140930
Policy instance 7
Insurance contract or identification number0140930
Number of Individuals Covered705
Insurance policy start date2010-04-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $10,462
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedADD
Welfare Benefit Premiums Paid to CarrierUSD $68,482
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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