HEAVY MACHINES, LLC has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan HEAVY MACHINES, INC. EMPLOYEE HEALTH & LIFE BENEFITS PLAN
401k plan membership statisitcs for HEAVY MACHINES, INC. EMPLOYEE HEALTH & LIFE BENEFITS PLAN
Measure | Date | Value |
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2022: HEAVY MACHINES, INC. EMPLOYEE HEALTH & LIFE BENEFITS PLAN 2022 401k membership |
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Total participants, beginning-of-year | 2022-06-01 | 112 |
Total number of active participants reported on line 7a of the Form 5500 | 2022-06-01 | 120 |
Total of all active and inactive participants | 2022-06-01 | 120 |
2021: HEAVY MACHINES, INC. EMPLOYEE HEALTH & LIFE BENEFITS PLAN 2021 401k membership |
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Total participants, beginning-of-year | 2021-06-01 | 112 |
Total number of active participants reported on line 7a of the Form 5500 | 2021-06-01 | 120 |
Total of all active and inactive participants | 2021-06-01 | 120 |
2020: HEAVY MACHINES, INC. EMPLOYEE HEALTH & LIFE BENEFITS PLAN 2020 401k membership |
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Total participants, beginning-of-year | 2020-06-01 | 128 |
Total number of active participants reported on line 7a of the Form 5500 | 2020-06-01 | 112 |
Total of all active and inactive participants | 2020-06-01 | 112 |
2019: HEAVY MACHINES, INC. EMPLOYEE HEALTH & LIFE BENEFITS PLAN 2019 401k membership |
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Total participants, beginning-of-year | 2019-06-01 | 147 |
Total number of active participants reported on line 7a of the Form 5500 | 2019-06-01 | 147 |
Total of all active and inactive participants | 2019-06-01 | 147 |
2018: HEAVY MACHINES, INC. EMPLOYEE HEALTH & LIFE BENEFITS PLAN 2018 401k membership |
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Total participants, beginning-of-year | 2018-06-01 | 140 |
Total number of active participants reported on line 7a of the Form 5500 | 2018-06-01 | 140 |
Total of all active and inactive participants | 2018-06-01 | 140 |
2017: HEAVY MACHINES, INC. EMPLOYEE HEALTH & LIFE BENEFITS PLAN 2017 401k membership |
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Total participants, beginning-of-year | 2017-06-01 | 134 |
Total number of active participants reported on line 7a of the Form 5500 | 2017-06-01 | 140 |
Total of all active and inactive participants | 2017-06-01 | 140 |
2016: HEAVY MACHINES, INC. EMPLOYEE HEALTH & LIFE BENEFITS PLAN 2016 401k membership |
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Total participants, beginning-of-year | 2016-06-01 | 137 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-06-01 | 134 |
Total of all active and inactive participants | 2016-06-01 | 134 |
2015: HEAVY MACHINES, INC. EMPLOYEE HEALTH & LIFE BENEFITS PLAN 2015 401k membership |
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Total participants, beginning-of-year | 2015-06-01 | 123 |
Total number of active participants reported on line 7a of the Form 5500 | 2015-06-01 | 136 |
Number of retired or separated participants receiving benefits | 2015-06-01 | 1 |
Number of other retired or separated participants entitled to future benefits | 2015-06-01 | 0 |
Total of all active and inactive participants | 2015-06-01 | 137 |
2014: HEAVY MACHINES, INC. EMPLOYEE HEALTH & LIFE BENEFITS PLAN 2014 401k membership |
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Total participants, beginning-of-year | 2014-06-01 | 117 |
Total number of active participants reported on line 7a of the Form 5500 | 2014-06-01 | 120 |
Number of retired or separated participants receiving benefits | 2014-06-01 | 3 |
Number of other retired or separated participants entitled to future benefits | 2014-06-01 | 0 |
Total of all active and inactive participants | 2014-06-01 | 123 |
2013: HEAVY MACHINES, INC. EMPLOYEE HEALTH & LIFE BENEFITS PLAN 2013 401k membership |
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Total participants, beginning-of-year | 2013-06-01 | 105 |
Total number of active participants reported on line 7a of the Form 5500 | 2013-06-01 | 116 |
Number of retired or separated participants receiving benefits | 2013-06-01 | 1 |
Number of other retired or separated participants entitled to future benefits | 2013-06-01 | 0 |
Total of all active and inactive participants | 2013-06-01 | 117 |
2012: HEAVY MACHINES, INC. EMPLOYEE HEALTH & LIFE BENEFITS PLAN 2012 401k membership |
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Total participants, beginning-of-year | 2012-06-01 | 146 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-06-01 | 104 |
Number of retired or separated participants receiving benefits | 2012-06-01 | 1 |
Total of all active and inactive participants | 2012-06-01 | 105 |
2011: HEAVY MACHINES, INC. EMPLOYEE HEALTH & LIFE BENEFITS PLAN 2011 401k membership |
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Total participants, beginning-of-year | 2011-06-01 | 145 |
Total number of active participants reported on line 7a of the Form 5500 | 2011-06-01 | 144 |
Number of retired or separated participants receiving benefits | 2011-06-01 | 2 |
Total of all active and inactive participants | 2011-06-01 | 146 |
2010: HEAVY MACHINES, INC. EMPLOYEE HEALTH & LIFE BENEFITS PLAN 2010 401k membership |
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Total participants, beginning-of-year | 2010-06-01 | 143 |
Total number of active participants reported on line 7a of the Form 5500 | 2010-06-01 | 148 |
Number of retired or separated participants receiving benefits | 2010-06-01 | 2 |
Number of other retired or separated participants entitled to future benefits | 2010-06-01 | 0 |
Total of all active and inactive participants | 2010-06-01 | 150 |
2009: HEAVY MACHINES, INC. EMPLOYEE HEALTH & LIFE BENEFITS PLAN 2009 401k membership |
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Total participants, beginning-of-year | 2009-06-01 | 145 |
Total number of active participants reported on line 7a of the Form 5500 | 2009-06-01 | 102 |
Number of retired or separated participants receiving benefits | 2009-06-01 | 1 |
Total of all active and inactive participants | 2009-06-01 | 103 |
Total participants | 2009-06-01 | 0 |
2022: HEAVY MACHINES, INC. EMPLOYEE HEALTH & LIFE BENEFITS PLAN 2022 form 5500 responses |
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2022-06-01 | Type of plan entity | Single employer plan |
2022-06-01 | Submission has been amended | No |
2022-06-01 | This submission is the final filing | No |
2022-06-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
2022-06-01 | Plan is a collectively bargained plan | No |
2022-06-01 | Plan funding arrangement – Insurance | Yes |
2022-06-01 | Plan benefit arrangement – Insurance | Yes |
2021: HEAVY MACHINES, INC. EMPLOYEE HEALTH & LIFE BENEFITS PLAN 2021 form 5500 responses |
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2021-06-01 | Type of plan entity | Single employer plan |
2021-06-01 | Submission has been amended | No |
2021-06-01 | This submission is the final filing | No |
2021-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2021-06-01 | Plan is a collectively bargained plan | No |
2021-06-01 | Plan funding arrangement – Insurance | Yes |
2021-06-01 | Plan benefit arrangement – Insurance | Yes |
2020: HEAVY MACHINES, INC. EMPLOYEE HEALTH & LIFE BENEFITS PLAN 2020 form 5500 responses |
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2020-06-01 | Type of plan entity | Single employer plan |
2020-06-01 | Submission has been amended | No |
2020-06-01 | This submission is the final filing | No |
2020-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2020-06-01 | Plan is a collectively bargained plan | No |
2020-06-01 | Plan funding arrangement – Insurance | Yes |
2020-06-01 | Plan benefit arrangement – Insurance | Yes |
2019: HEAVY MACHINES, INC. EMPLOYEE HEALTH & LIFE BENEFITS PLAN 2019 form 5500 responses |
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2019-06-01 | Type of plan entity | Single employer plan |
2019-06-01 | Submission has been amended | No |
2019-06-01 | This submission is the final filing | No |
2019-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2019-06-01 | Plan is a collectively bargained plan | No |
2019-06-01 | Plan funding arrangement – Insurance | Yes |
2019-06-01 | Plan benefit arrangement – Insurance | Yes |
2018: HEAVY MACHINES, INC. EMPLOYEE HEALTH & LIFE BENEFITS PLAN 2018 form 5500 responses |
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2018-06-01 | Type of plan entity | Single employer plan |
2018-06-01 | Submission has been amended | No |
2018-06-01 | This submission is the final filing | No |
2018-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2018-06-01 | Plan is a collectively bargained plan | No |
2018-06-01 | Plan funding arrangement – Insurance | Yes |
2018-06-01 | Plan benefit arrangement – Insurance | Yes |
2017: HEAVY MACHINES, INC. EMPLOYEE HEALTH & LIFE BENEFITS PLAN 2017 form 5500 responses |
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2017-06-01 | Type of plan entity | Single employer plan |
2017-06-01 | Submission has been amended | No |
2017-06-01 | This submission is the final filing | No |
2017-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2017-06-01 | Plan is a collectively bargained plan | No |
2017-06-01 | Plan funding arrangement – Insurance | Yes |
2017-06-01 | Plan benefit arrangement – Insurance | Yes |
2016: HEAVY MACHINES, INC. EMPLOYEE HEALTH & LIFE BENEFITS PLAN 2016 form 5500 responses |
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2016-06-01 | Type of plan entity | Single employer plan |
2016-06-01 | Submission has been amended | No |
2016-06-01 | This submission is the final filing | No |
2016-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2016-06-01 | Plan is a collectively bargained plan | No |
2016-06-01 | Plan funding arrangement – Insurance | Yes |
2016-06-01 | Plan benefit arrangement – Insurance | Yes |
2015: HEAVY MACHINES, INC. EMPLOYEE HEALTH & LIFE BENEFITS PLAN 2015 form 5500 responses |
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2015-06-01 | Type of plan entity | Single employer plan |
2015-06-01 | Submission has been amended | No |
2015-06-01 | This submission is the final filing | No |
2015-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2015-06-01 | Plan is a collectively bargained plan | No |
2015-06-01 | Plan funding arrangement – Insurance | Yes |
2015-06-01 | Plan benefit arrangement – Insurance | Yes |
2014: HEAVY MACHINES, INC. EMPLOYEE HEALTH & LIFE BENEFITS PLAN 2014 form 5500 responses |
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2014-06-01 | Type of plan entity | Single employer plan |
2014-06-01 | Submission has been amended | No |
2014-06-01 | This submission is the final filing | No |
2014-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2014-06-01 | Plan is a collectively bargained plan | No |
2014-06-01 | Plan funding arrangement – Insurance | Yes |
2014-06-01 | Plan benefit arrangement – Insurance | Yes |
2013: HEAVY MACHINES, INC. EMPLOYEE HEALTH & LIFE BENEFITS PLAN 2013 form 5500 responses |
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2013-06-01 | Type of plan entity | Single employer plan |
2013-06-01 | Submission has been amended | No |
2013-06-01 | This submission is the final filing | No |
2013-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2013-06-01 | Plan is a collectively bargained plan | No |
2013-06-01 | Plan funding arrangement – Insurance | Yes |
2013-06-01 | Plan benefit arrangement – Insurance | Yes |
2012: HEAVY MACHINES, INC. EMPLOYEE HEALTH & LIFE BENEFITS PLAN 2012 form 5500 responses |
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2012-06-01 | Type of plan entity | Single employer plan |
2012-06-01 | Submission has been amended | No |
2012-06-01 | This submission is the final filing | No |
2012-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2012-06-01 | Plan is a collectively bargained plan | No |
2012-06-01 | Plan funding arrangement – Insurance | Yes |
2012-06-01 | Plan benefit arrangement – Insurance | Yes |
2011: HEAVY MACHINES, INC. EMPLOYEE HEALTH & LIFE BENEFITS PLAN 2011 form 5500 responses |
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2011-06-01 | Type of plan entity | Single employer plan |
2011-06-01 | Submission has been amended | No |
2011-06-01 | This submission is the final filing | No |
2011-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2011-06-01 | Plan is a collectively bargained plan | No |
2011-06-01 | Plan funding arrangement – Insurance | Yes |
2011-06-01 | Plan benefit arrangement – Insurance | Yes |
2010: HEAVY MACHINES, INC. EMPLOYEE HEALTH & LIFE BENEFITS PLAN 2010 form 5500 responses |
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2010-06-01 | Type of plan entity | Single employer plan |
2010-06-01 | Submission has been amended | No |
2010-06-01 | This submission is the final filing | No |
2010-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2010-06-01 | Plan is a collectively bargained plan | No |
2010-06-01 | Plan funding arrangement – Insurance | Yes |
2010-06-01 | Plan benefit arrangement – Insurance | Yes |
2009: HEAVY MACHINES, INC. EMPLOYEE HEALTH & LIFE BENEFITS PLAN 2009 form 5500 responses |
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2009-06-01 | Type of plan entity | Single employer plan |
2009-06-01 | Submission has been amended | No |
2009-06-01 | This submission is the final filing | No |
2009-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2009-06-01 | Plan is a collectively bargained plan | No |
2009-06-01 | Plan funding arrangement – Insurance | Yes |
2009-06-01 | Plan benefit arrangement – Insurance | Yes |
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00553656 |
Policy instance | 3 |
Insurance contract or identification number | 00553656 | Number of Individuals Covered | 153 | Insurance policy start date | 2022-06-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $24,707 | Total amount of fees paid to insurance company | USD $10,529 | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D, OPTIONAL AD&D, OPTIONAL LIFE, VOLUNTARY CRITICAL ILLNESS | Welfare Benefit Premiums Paid to Carrier | USD $197,276 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $24,707 | Amount paid for insurance broker fees | 10529 | Insurance broker organization code? | 3 |
|
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 ) |
Policy contract number | HCCLOT40099 |
Policy instance | 2 |
Insurance contract or identification number | HCCLOT40099 | Number of Individuals Covered | 119 | Insurance policy start date | 2022-06-01 | 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 | Other welfare benefits provided | ORGAN TRANSPLANT | Welfare Benefit Premiums Paid to Carrier | USD $20,816 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 ) |
Policy contract number | HCL32651 |
Policy instance | 1 |
Insurance contract or identification number | HCL32651 | Number of Individuals Covered | 119 | Insurance policy start date | 2022-06-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $43,102 | Total amount of fees paid to insurance company | USD $0 | Welfare Benefit Premiums Paid to Carrier | USD $433,172 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $43,102 | Insurance broker organization code? | 3 |
|
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00553656 |
Policy instance | 3 |
Insurance contract or identification number | 00553656 | Number of Individuals Covered | 153 | Insurance policy start date | 2021-10-01 | Insurance policy end date | 2022-05-31 | Total amount of commissions paid to insurance broker | USD $24,707 | Total amount of fees paid to insurance company | USD $10,529 | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D, OPTIONAL AD&D, OPTIONAL LIFE, VOLUNTARY CRITICAL ILLNESS | Welfare Benefit Premiums Paid to Carrier | USD $197,276 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $24,707 | Amount paid for insurance broker fees | 10529 | Insurance broker organization code? | 3 |
|
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 ) |
Policy contract number | HCCLOT40099 |
Policy instance | 2 |
Insurance contract or identification number | HCCLOT40099 | Number of Individuals Covered | 119 | Insurance policy start date | 2021-06-01 | Insurance policy end date | 2022-05-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | ORGAN TRANSPLANT | Welfare Benefit Premiums Paid to Carrier | USD $20,816 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 ) |
Policy contract number | HCL32651 |
Policy instance | 1 |
Insurance contract or identification number | HCL32651 | Number of Individuals Covered | 119 | Insurance policy start date | 2021-06-01 | Insurance policy end date | 2022-05-31 | Total amount of commissions paid to insurance broker | USD $43,102 | Total amount of fees paid to insurance company | USD $0 | Welfare Benefit Premiums Paid to Carrier | USD $433,172 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $43,102 | Insurance broker organization code? | 3 |
|
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 ) |
Policy contract number | HCL32651 |
Policy instance | 1 |
Insurance contract or identification number | HCL32651 | Number of Individuals Covered | 102 | Insurance policy start date | 2020-06-01 | Insurance policy end date | 2021-05-31 | Total amount of commissions paid to insurance broker | USD $46,257 | Total amount of fees paid to insurance company | USD $0 | Welfare Benefit Premiums Paid to Carrier | USD $464,756 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $46,257 | Insurance broker organization code? | 3 |
|
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 ) |
Policy contract number | HCCLOT40099 |
Policy instance | 2 |
Insurance contract or identification number | HCCLOT40099 | Number of Individuals Covered | 102 | Insurance policy start date | 2020-06-01 | Insurance policy end date | 2021-05-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Other welfare benefits provided | ORGAN TRANSPLANT | Welfare Benefit Premiums Paid to Carrier | USD $22,324 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00553656 |
Policy instance | 3 |
Insurance contract or identification number | 00553656 | Number of Individuals Covered | 134 | Insurance policy start date | 2020-10-01 | Insurance policy end date | 2021-05-31 | Total amount of commissions paid to insurance broker | USD $24,515 | Total amount of fees paid to insurance company | USD $54 | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D, OPTIONAL AD&D, OPTIONAL LIFE, VOLUNTARY CRITICAL ILLNESS | Welfare Benefit Premiums Paid to Carrier | USD $197,193 | Commission paid to Insurance Broker | USD $24,515 | Amount paid for insurance broker fees | 54 | Insurance broker organization code? | 3 |
|
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00553656 |
Policy instance | 3 |
Insurance contract or identification number | 00553656 | Number of Individuals Covered | 159 | Insurance policy start date | 2019-10-01 | Insurance policy end date | 2020-05-31 | Total amount of commissions paid to insurance broker | USD $25,188 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D, OPTIONAL AD&D, OPTIONAL LIFE | Welfare Benefit Premiums Paid to Carrier | USD $207,237 | Commission paid to Insurance Broker | USD $25,188 | Insurance broker organization code? | 3 |
|
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 ) |
Policy contract number | HCCLOT40099 |
Policy instance | 2 |
Insurance contract or identification number | HCCLOT40099 | Number of Individuals Covered | 132 | Insurance policy start date | 2019-06-01 | Insurance policy end date | 2020-05-31 | Other welfare benefits provided | ORGAN TRANSPLANT | Welfare Benefit Premiums Paid to Carrier | USD $20,194 |
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NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 ) |
Policy contract number | HCL32651 |
Policy instance | 1 |
Insurance contract or identification number | HCL32651 | Number of Individuals Covered | 135 | Insurance policy start date | 2019-06-01 | Insurance policy end date | 2020-05-31 | Total amount of commissions paid to insurance broker | USD $54,350 | Total amount of fees paid to insurance company | USD $0 | Welfare Benefit Premiums Paid to Carrier | USD $547,762 | Commission paid to Insurance Broker | USD $2,024 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 0 |
|
BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 ) |
Policy contract number | 129336 |
Policy instance | 5 |
Insurance contract or identification number | 129336 | Number of Individuals Covered | 0 | Insurance policy start date | 2018-10-01 | Insurance policy end date | 2018-09-30 | Total amount of commissions paid to insurance broker | USD $1,987 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $25,213 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,987 | Insurance broker organization code? | 3 |
|
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 000010221464 |
Policy instance | 4 |
Insurance contract or identification number | 000010221464 | Number of Individuals Covered | 136 | Insurance policy start date | 2018-10-01 | Insurance policy end date | 2019-05-31 | Total amount of commissions paid to insurance broker | USD $1,654 | Total amount of fees paid to insurance company | USD $0 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $11,028 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,654 | Insurance broker organization code? | 3 |
|
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00553656 |
Policy instance | 3 |
Insurance contract or identification number | 00553656 | Number of Individuals Covered | 152 | Insurance policy start date | 2018-10-01 | Insurance policy end date | 2019-05-31 | Total amount of commissions paid to insurance broker | USD $16,569 | Total amount of fees paid to insurance company | USD $1,184 | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D, OPTIONAL AD&D, OPTIONAL LIFE | Welfare Benefit Premiums Paid to Carrier | USD $138,102 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $16,569 | Amount paid for insurance broker fees | 1184 | Insurance broker organization code? | 3 |
|
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 000010221463 |
Policy instance | 2 |
Insurance contract or identification number | 000010221463 | Number of Individuals Covered | 273 | Insurance policy start date | 2018-10-01 | Insurance policy end date | 2019-05-31 | Total amount of commissions paid to insurance broker | USD $1,041 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $6,940 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,041 | Insurance broker organization code? | 3 |
|
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 000400001000 |
Policy instance | 1 |
Insurance contract or identification number | 000400001000 | Number of Individuals Covered | 150 | Insurance policy start date | 2018-10-01 | Insurance policy end date | 2019-05-31 | Total amount of commissions paid to insurance broker | USD $1,648 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | VOLUNTARY, SPOUSE, CHILD AD&D | Welfare Benefit Premiums Paid to Carrier | USD $10,986 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,648 | Insurance broker organization code? | 3 |
|
BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 ) |
Policy contract number | 129336 |
Policy instance | 4 |
Insurance contract or identification number | 129336 | Number of Individuals Covered | 243 | Insurance policy start date | 2017-10-01 | Insurance policy end date | 2018-05-31 | Total amount of commissions paid to insurance broker | USD $9,664 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $82,826 |
|
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 000010221464 |
Policy instance | 3 |
Insurance contract or identification number | 000010221464 | Number of Individuals Covered | 145 | Insurance policy start date | 2017-10-01 | Insurance policy end date | 2018-05-31 | Total amount of commissions paid to insurance broker | USD $4,882 | Total amount of fees paid to insurance company | USD $79 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $32,549 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 000010221463 |
Policy instance | 2 |
Insurance contract or identification number | 000010221463 | Number of Individuals Covered | 289 | Insurance policy start date | 2017-10-01 | Insurance policy end date | 2018-05-31 | Total amount of commissions paid to insurance broker | USD $3,052 | Total amount of fees paid to insurance company | USD $49 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $20,345 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 000400001000 |
Policy instance | 1 |
Insurance contract or identification number | 000400001000 | Number of Individuals Covered | 153 | Insurance policy start date | 2017-10-01 | Insurance policy end date | 2018-05-31 | Total amount of commissions paid to insurance broker | USD $5,431 | Total amount of fees paid to insurance company | USD $96 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | VOLUNTARY, SPOUSE, CHILD AD&D | Welfare Benefit Premiums Paid to Carrier | USD $36,204 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000ARMI |
Policy instance | 1 |
Insurance contract or identification number | G000ARMI | Number of Individuals Covered | 338 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $12,714 | Total amount of fees paid to insurance company | USD $2,292 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $84,752 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $11,713 | Amount paid for insurance broker fees | 2292 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | JAS. D. COLLIER & CO. |
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BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 ) |
Policy contract number | 129336 |
Policy instance | 2 |
Insurance contract or identification number | 129336 | Number of Individuals Covered | 293 | Insurance policy start date | 2015-01-01 | Insurance policy end date | 2015-12-31 | Total amount of commissions paid to insurance broker | USD $51,355 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $890,261 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $51,355 | Insurance broker organization code? | 3 | Insurance broker name | WENDELL DYSON |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000ARMI |
Policy instance | 1 |
Insurance contract or identification number | G000ARMI | Number of Individuals Covered | 387 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $13,111 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $87,407 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $13,111 | Insurance broker organization code? | 3 | Insurance broker name | CLAY & LAND INS INC |
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BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 ) |
Policy contract number | 129336 |
Policy instance | 2 |
Insurance contract or identification number | 129336 | Number of Individuals Covered | 286 | Insurance policy start date | 2014-01-01 | Insurance policy end date | 2014-12-31 | Total amount of commissions paid to insurance broker | USD $49,775 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $960,466 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $49,775 | Insurance broker organization code? | 3 | Insurance broker name | WENDELL DYSON |
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AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 837852 |
Policy instance | 1 |
Insurance contract or identification number | 837852 | Number of Individuals Covered | 356 | Insurance policy start date | 2013-01-01 | Insurance policy end date | 2013-12-31 | Total amount of commissions paid to insurance broker | USD $65,956 | Total amount of fees paid to insurance company | USD $1,139 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $1,060,237 | Commission paid to Insurance Broker | USD $65,956 | Amount paid for insurance broker fees | 1139 | Additional information about fees paid to insurance broker | PM CROSS-SALE | Insurance broker organization code? | 3 | Insurance broker name | CLAY AND LAND INSURANCE INC |
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AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
Policy contract number | 837852 |
Policy instance | 1 |
Insurance contract or identification number | 837852 | Number of Individuals Covered | 229 | Insurance policy start date | 2012-02-01 | Insurance policy end date | 2012-12-31 | Total amount of commissions paid to insurance broker | USD $51,562 | Total amount of fees paid to insurance company | USD $5,721 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $905,416 | Commission paid to Insurance Broker | USD $51,562 | Amount paid for insurance broker fees | 5721 | Additional information about fees paid to insurance broker | PM CROSS-SALE | Insurance broker organization code? | 3 | Insurance broker name | CLAY AND LAND INSURANCE INC |
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BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 ) |
Policy contract number | 118646 |
Policy instance | 1 |
Insurance contract or identification number | 118646 | Number of Individuals Covered | 242 | Insurance policy start date | 2011-02-01 | Insurance policy end date | 2012-01-31 | Total amount of commissions paid to insurance broker | USD $44,458 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,008,868 |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 004156828 |
Policy instance | 2 |
Insurance contract or identification number | 004156828 | Number of Individuals Covered | 148 | Insurance policy start date | 2010-08-01 | Insurance policy end date | 2012-01-31 | Total amount of commissions paid to insurance broker | USD $17,043 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $177,748 |
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BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 ) |
Policy contract number | 118646 |
Policy instance | 1 |
Insurance contract or identification number | 118646 | Number of Individuals Covered | 245 | Insurance policy start date | 2010-02-01 | Insurance policy end date | 2011-01-31 | Total amount of commissions paid to insurance broker | USD $43,053 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $978,880 |
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AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 ) |
Policy contract number | 010-032068 |
Policy instance | 3 |
Insurance contract or identification number | 010-032068 | Number of Individuals Covered | 180 | Insurance policy start date | 2009-08-09 | Insurance policy end date | 2010-07-31 | Total amount of commissions paid to insurance broker | USD $2,696 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $60,064 |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
Policy contract number | G000AAAZ |
Policy instance | 2 |
Insurance contract or identification number | G000AAAZ | Number of Individuals Covered | 144 | Insurance policy start date | 2010-04-01 | Insurance policy end date | 2011-04-01 | Total amount of commissions paid to insurance broker | USD $6,880 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $39,203 |
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