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BOONE NEWSPAPER GROUP HEALTH INSURANCE PLAN 401k Plan overview

Plan NameBOONE NEWSPAPER GROUP HEALTH INSURANCE PLAN
Plan identification number 501

BOONE NEWSPAPER GROUP HEALTH INSURANCE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Temporary disability (accident and sickness)
  • Long-term disability cover

401k Sponsoring company profile

BOONE NEWSPAPERS, INC. has sponsored the creation of one or more 401k plans.

Company Name:BOONE NEWSPAPERS, INC.
Employer identification number (EIN):630330777
NAIC Classification:511110
NAIC Description:Newspaper Publishers

Additional information about BOONE NEWSPAPERS, INC.

Jurisdiction of Incorporation: Alabama Secretary of State
Incorporation Date: 1987-10-14
Company Identification Number: 120-051
Legal Registered Office Address: 2 NORTH JACKSON ST., SUITE 605 MONTGOMERY,


United States of America (USA)
36104

More information about BOONE NEWSPAPERS, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BOONE NEWSPAPER GROUP HEALTH INSURANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01
5012021-01-01
5012020-01-01
5012019-01-01
5012018-01-01
5012017-01-01SHERRI HOWARD SHERRI HOWARD2018-10-01
5012016-01-01SHERRI HOWARD SHERRI HOWARD2017-09-19
5012015-01-01SHERRI HOWARD SHERRI HOWARD2016-09-14
5012014-01-01SHERRI HOWARD SHERRI HOWARD2015-10-07
5012013-01-01JOSEPH C DAVIS JR JOSEPH C DAVIS JR2014-09-24
5012012-01-01JOSEPH C DAVIS JR JOSEPH C DAVIS JR2013-09-25
5012011-01-01JOSEPH C DAVIS JR JOSEPH C DAVIS JR2012-10-10
5012010-01-01JOSEPH C DAVIS JR JOSEPH C DAVIS JR2011-10-05
5012009-01-01JOSEPH C DAVIS JR JOSEPH C DAVIS JR2010-10-08

Plan Statistics for BOONE NEWSPAPER GROUP HEALTH INSURANCE PLAN

401k plan membership statisitcs for BOONE NEWSPAPER GROUP HEALTH INSURANCE PLAN

Measure Date Value
2022: BOONE NEWSPAPER GROUP HEALTH INSURANCE PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01355
Total number of active participants reported on line 7a of the Form 55002022-01-01493
Total of all active and inactive participants2022-01-01493
2021: BOONE NEWSPAPER GROUP HEALTH INSURANCE PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01355
Total number of active participants reported on line 7a of the Form 55002021-01-01355
Total of all active and inactive participants2021-01-01355
2020: BOONE NEWSPAPER GROUP HEALTH INSURANCE PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01468
Total number of active participants reported on line 7a of the Form 55002020-01-01355
Total of all active and inactive participants2020-01-01355
2019: BOONE NEWSPAPER GROUP HEALTH INSURANCE PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01548
Total number of active participants reported on line 7a of the Form 55002019-01-01468
Total of all active and inactive participants2019-01-01468
2018: BOONE NEWSPAPER GROUP HEALTH INSURANCE PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01609
Total number of active participants reported on line 7a of the Form 55002018-01-01548
Total of all active and inactive participants2018-01-01548
2017: BOONE NEWSPAPER GROUP HEALTH INSURANCE PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01583
Total number of active participants reported on line 7a of the Form 55002017-01-01609
Total of all active and inactive participants2017-01-01609
2016: BOONE NEWSPAPER GROUP HEALTH INSURANCE PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01556
Total number of active participants reported on line 7a of the Form 55002016-01-01583
Total of all active and inactive participants2016-01-01583
2015: BOONE NEWSPAPER GROUP HEALTH INSURANCE PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01548
Total number of active participants reported on line 7a of the Form 55002015-01-01556
Total of all active and inactive participants2015-01-01556
2014: BOONE NEWSPAPER GROUP HEALTH INSURANCE PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01395
Total number of active participants reported on line 7a of the Form 55002014-01-01548
Total of all active and inactive participants2014-01-01548
2013: BOONE NEWSPAPER GROUP HEALTH INSURANCE PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01355
Total number of active participants reported on line 7a of the Form 55002013-01-01395
Total of all active and inactive participants2013-01-01395
2012: BOONE NEWSPAPER GROUP HEALTH INSURANCE PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01355
Total number of active participants reported on line 7a of the Form 55002012-01-01355
Total of all active and inactive participants2012-01-01355
2011: BOONE NEWSPAPER GROUP HEALTH INSURANCE PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01375
Total number of active participants reported on line 7a of the Form 55002011-01-01355
Total of all active and inactive participants2011-01-01355
2010: BOONE NEWSPAPER GROUP HEALTH INSURANCE PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-01372
Total number of active participants reported on line 7a of the Form 55002010-01-01375
Total of all active and inactive participants2010-01-01375
2009: BOONE NEWSPAPER GROUP HEALTH INSURANCE PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01404
Total number of active participants reported on line 7a of the Form 55002009-01-01372
Total of all active and inactive participants2009-01-01372

Form 5500 Responses for BOONE NEWSPAPER GROUP HEALTH INSURANCE PLAN

2022: BOONE NEWSPAPER GROUP HEALTH INSURANCE PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – InsuranceYes
2021: BOONE NEWSPAPER GROUP HEALTH INSURANCE PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – InsuranceYes
2020: BOONE NEWSPAPER GROUP HEALTH INSURANCE PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – InsuranceYes
2019: BOONE NEWSPAPER GROUP HEALTH INSURANCE PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: BOONE NEWSPAPER GROUP HEALTH INSURANCE PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: BOONE NEWSPAPER GROUP HEALTH INSURANCE PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: BOONE NEWSPAPER GROUP HEALTH INSURANCE PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: BOONE NEWSPAPER GROUP HEALTH INSURANCE PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: BOONE NEWSPAPER GROUP HEALTH INSURANCE PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: BOONE NEWSPAPER GROUP HEALTH INSURANCE PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: BOONE NEWSPAPER GROUP HEALTH INSURANCE PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: BOONE NEWSPAPER GROUP HEALTH INSURANCE PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2010: BOONE NEWSPAPER GROUP HEALTH INSURANCE PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – InsuranceYes
2009: BOONE NEWSPAPER GROUP HEALTH INSURANCE PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01This submission is the final filingNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number926669
Policy instance 1
Insurance contract or identification number926669
Number of Individuals Covered493
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $14,396
Total amount of fees paid to insurance companyUSD $86,861
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,910,759
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,396
Amount paid for insurance broker fees86861
Additional information about fees paid to insurance brokerSERVICE FEE AGREEMENT
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF ALABAMA (National Association of Insurance Commissioners NAIC id number: 55433 )
Policy contract number9678
Policy instance 1
Insurance contract or identification number9678
Number of Individuals Covered283
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Other welfare benefits providedAIR MED SRVS/BABY YOURSELF
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
Policy contract number01-01337
Policy instance 2
Insurance contract or identification number01-01337
Number of Individuals Covered259
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $14,973
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $143,308
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees14973
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010168742
Policy instance 3
Insurance contract or identification number000010168742
Number of Individuals Covered0
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $259
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D & DEP LIFE
Welfare Benefit Premiums Paid to CarrierUSD $2,588
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees259
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010168743
Policy instance 4
Insurance contract or identification number000010168743
Number of Individuals Covered0
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $587
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,873
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees587
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000400168744
Policy instance 5
Insurance contract or identification number000400168744
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $244
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,435
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees244
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010168745
Policy instance 6
Insurance contract or identification number000010168745
Number of Individuals Covered0
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $403
Other welfare benefits providedWEEKLY INCOME
Welfare Benefit Premiums Paid to CarrierUSD $4,032
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees403
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000400210648
Policy instance 7
Insurance contract or identification number000400210648
Number of Individuals Covered0
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $-3
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $-28
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees-3
Insurance broker organization code?3
MONY (National Association of Insurance Commissioners NAIC id number: 78077 )
Policy contract number008513
Policy instance 8
Insurance contract or identification number008513
Number of Individuals Covered355
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $19,187
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $175,204
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MONY (National Association of Insurance Commissioners NAIC id number: 78077 )
Policy contract number009543
Policy instance 9
Insurance contract or identification number009543
Number of Individuals Covered217
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $2,185
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $21,873
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,185
BLUE CROSS BLUE SHIELD OF ALABAMA (National Association of Insurance Commissioners NAIC id number: 55433 )
Policy contract number9678
Policy instance 1
Insurance contract or identification number9678
Number of Individuals Covered274
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Other welfare benefits providedAIR MED SRVS/BABY YOURSELF
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
Policy contract number01-01337
Policy instance 2
Insurance contract or identification number01-01337
Number of Individuals Covered263
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $16,413
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $164,127
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,413
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010168742
Policy instance 3
Insurance contract or identification number000010168742
Number of Individuals Covered355
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $3,289
Total amount of fees paid to insurance companyUSD $676
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D & DEP LIFE
Welfare Benefit Premiums Paid to CarrierUSD $32,890
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,289
Amount paid for insurance broker fees676
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010168743
Policy instance 4
Insurance contract or identification number000010168743
Number of Individuals Covered355
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $7,118
Total amount of fees paid to insurance companyUSD $1,419
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $71,185
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,118
Amount paid for insurance broker fees1419
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000400168744
Policy instance 5
Insurance contract or identification number000400168744
Number of Individuals Covered178
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $2,967
Total amount of fees paid to insurance companyUSD $579
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $29,670
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,967
Amount paid for insurance broker fees579
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010168745
Policy instance 6
Insurance contract or identification number000010168745
Number of Individuals Covered355
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $4,904
Total amount of fees paid to insurance companyUSD $980
Other welfare benefits providedWEEKLY INCOME
Welfare Benefit Premiums Paid to CarrierUSD $49,042
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,904
Amount paid for insurance broker fees980
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000400210648
Policy instance 7
Insurance contract or identification number000400210648
Number of Individuals Covered205
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $2,935
Total amount of fees paid to insurance companyUSD $263
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $29,348
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,935
Amount paid for insurance broker fees263
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF ALABAMA (National Association of Insurance Commissioners NAIC id number: 55433 )
Policy contract number9678
Policy instance 1
Insurance contract or identification number9678
Number of Individuals Covered367
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Other welfare benefits providedAIR MED SRVS/BABY YOURSELF
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 number000010168742
Policy instance 3
Insurance contract or identification number000010168742
Number of Individuals Covered465
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $4,508
Total amount of fees paid to insurance companyUSD $470
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D & DEP LIFE
Welfare Benefit Premiums Paid to CarrierUSD $45,080
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,508
Amount paid for insurance broker fees470
Insurance broker organization code?3
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
Policy contract number01-01337
Policy instance 2
Insurance contract or identification number01-01337
Number of Individuals Covered328
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $20,044
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $200,437
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $20,044
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010168743
Policy instance 4
Insurance contract or identification number000010168743
Number of Individuals Covered465
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $9,462
Total amount of fees paid to insurance companyUSD $1,078
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $94,619
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,462
Amount paid for insurance broker fees1078
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000400168744
Policy instance 5
Insurance contract or identification number000400168744
Number of Individuals Covered221
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $3,862
Total amount of fees paid to insurance companyUSD $434
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $38,615
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,862
Amount paid for insurance broker fees434
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010168745
Policy instance 6
Insurance contract or identification number000010168745
Number of Individuals Covered468
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $6,532
Total amount of fees paid to insurance companyUSD $754
Other welfare benefits providedWEEKLY INCOME
Welfare Benefit Premiums Paid to CarrierUSD $65,316
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,532
Amount paid for insurance broker fees754
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000400210648
Policy instance 7
Insurance contract or identification number000400210648
Number of Individuals Covered243
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $3,511
Total amount of fees paid to insurance companyUSD $203
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $35,113
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,511
Amount paid for insurance broker fees203
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000400210648
Policy instance 7
Insurance contract or identification number000400210648
Number of Individuals Covered257
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $3,342
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $33,419
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,342
Insurance broker organization code?3
Insurance broker nameGALLAGHER BENEFIT SERVICES, INC.
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010168745
Policy instance 6
Insurance contract or identification number000010168745
Number of Individuals Covered609
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $7,671
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedWEEKLY INCOME
Welfare Benefit Premiums Paid to CarrierUSD $76,706
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,671
Insurance broker organization code?3
Insurance broker nameGALLAGHER BENEFIT SERVICES, INC.
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000400168744
Policy instance 5
Insurance contract or identification number000400168744
Number of Individuals Covered232
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $4,019
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $40,185
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,019
Insurance broker organization code?3
Insurance broker nameGALLAGHER BENEFIT SERVICES, INC.
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010168743
Policy instance 4
Insurance contract or identification number000010168743
Number of Individuals Covered609
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $11,154
Total amount of fees paid to insurance companyUSD $0
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $111,539
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,154
Insurance broker organization code?3
Insurance broker nameGALLAGHER BENEFIT SERVICES, INC.
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010168742
Policy instance 3
Insurance contract or identification number000010168742
Number of Individuals Covered609
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $4,727
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D & DEP LIFE
Welfare Benefit Premiums Paid to CarrierUSD $47,267
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,727
Insurance broker organization code?3
Insurance broker nameGALLAGHER BENEFIT SERVICES, INC.
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
Policy contract number01-01337
Policy instance 2
Insurance contract or identification number01-01337
Number of Individuals Covered432
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $22,131
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $221,312
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $22,131
Insurance broker organization code?3
Insurance broker nameGALLAGHER BENEFIT SERVICES, INC.
BLUE CROSS BLUE SHIELD OF ALABAMA (National Association of Insurance Commissioners NAIC id number: 55433 )
Policy contract number9678
Policy instance 1
Insurance contract or identification number9678
Number of Individuals Covered489
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Other welfare benefits providedAIR MED SRVS/BABY YOURSELF
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
Policy contract number01-01337
Policy instance 2
Insurance contract or identification number01-01337
Number of Individuals Covered353
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $19,433
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $194,327
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $19,433
Insurance broker organization code?3
Insurance broker nameGALLAGHER BENEFIT SERVICES, INC.
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010168742
Policy instance 3
Insurance contract or identification number000010168742
Number of Individuals Covered556
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $3,735
Total amount of fees paid to insurance companyUSD $1,492
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D & DEP LIFE
Welfare Benefit Premiums Paid to CarrierUSD $37,349
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,735
Insurance broker organization code?3
Amount paid for insurance broker fees1492
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker nameGALLAGHER BENEFIT SERVICES, INC.
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010168743
Policy instance 4
Insurance contract or identification number000010168743
Number of Individuals Covered555
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $11,108
Total amount of fees paid to insurance companyUSD $4,371
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $111,077
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,108
Insurance broker organization code?3
Amount paid for insurance broker fees4371
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker nameGALLAGHER BENEFIT SERVICES, INC.
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000400168744
Policy instance 5
Insurance contract or identification number000400168744
Number of Individuals Covered170
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $3,103
Total amount of fees paid to insurance companyUSD $1,336
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $31,034
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,103
Insurance broker organization code?3
Amount paid for insurance broker fees1336
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker nameGALLAGHER BENEFIT SERVICES, INC.
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010168745
Policy instance 6
Insurance contract or identification number000010168745
Number of Individuals Covered555
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $6,731
Total amount of fees paid to insurance companyUSD $2,707
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $67,310
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,731
Insurance broker organization code?3
Amount paid for insurance broker fees2707
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker nameGALLAGHER BENEFIT SERVICES, INC.
BLUE CROSS BLUE SHIELD OF ALABAMA (National Association of Insurance Commissioners NAIC id number: 55433 )
Policy contract number9678
Policy instance 1
Insurance contract or identification number9678
Number of Individuals Covered401
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Other welfare benefits providedAIR MED SRVS/YOURSELF/EXP PSYCH
Welfare Benefit Premiums Paid to CarrierUSD $31,049
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 number000400168744
Policy instance 5
Insurance contract or identification number000400168744
Number of Individuals Covered172
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $3,144
Total amount of fees paid to insurance companyUSD $1,088
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $31,434
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,403
Insurance broker organization code?3
Amount paid for insurance broker fees1088
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker nameBENEFIT DEVELOPMENT GROUP, INC.
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010168743
Policy instance 4
Insurance contract or identification number000010168743
Number of Individuals Covered548
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $10,284
Total amount of fees paid to insurance companyUSD $3,009
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $102,843
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,867
Insurance broker organization code?3
Amount paid for insurance broker fees3009
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker nameBENEFIT DEVELOPMENT GROUP, INC.
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010168742
Policy instance 3
Insurance contract or identification number000010168742
Number of Individuals Covered548
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $3,510
Total amount of fees paid to insurance companyUSD $1,060
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D & DEP LIFE
Welfare Benefit Premiums Paid to CarrierUSD $35,105
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,678
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker nameBENEFIT DEVELOPMENT GROUP, INC.
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
Policy contract number01-01337
Policy instance 2
Insurance contract or identification number01-01337
Number of Individuals Covered335
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $18,545
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $185,456
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,225
Insurance broker organization code?3
Insurance broker nameBENEFIT DEVELOPMENT GROUP, INC.
BLUE CROSS BLUE SHIELD OF ALABAMA (National Association of Insurance Commissioners NAIC id number: 55433 )
Policy contract number9678
Policy instance 1
Insurance contract or identification number9678
Number of Individuals Covered384
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Other welfare benefits providedAIR MED SRVS/YOURSELF/EXP PSYCH
Welfare Benefit Premiums Paid to CarrierUSD $29,953
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 number000010168745
Policy instance 6
Insurance contract or identification number000010168745
Number of Individuals Covered548
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $6,368
Total amount of fees paid to insurance companyUSD $1,838
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $63,684
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,902
Insurance broker organization code?3
Amount paid for insurance broker fees1838
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker nameBENEFIT DEVELOPMENT GROUP, INC.
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000400168744
Policy instance 5
Insurance contract or identification number000400168744
Number of Individuals Covered141
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $2,721
Total amount of fees paid to insurance companyUSD $1,433
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $27,210
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,721
Amount paid for insurance broker fees1433
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
Insurance broker nameBENEFIT DEVELOPMENT GROUP, INC.
BLUE CROSS BLUE SHIELD OF ALABAMA (National Association of Insurance Commissioners NAIC id number: 55433 )
Policy contract number9678
Policy instance 1
Insurance contract or identification number9678
Number of Individuals Covered241
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Other welfare benefits providedAIR MED SRVS/YOURSELF/EXP PSYCH
Welfare Benefit Premiums Paid to CarrierUSD $22,198
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
Policy contract number01-01337
Policy instance 2
Insurance contract or identification number01-01337
Number of Individuals Covered223
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $13,783
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $137,833
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,783
Insurance broker organization code?3
Insurance broker nameBENEFIT DEVELOPMENT GROUP, INC.
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010168742
Policy instance 3
Insurance contract or identification number000010168742
Number of Individuals Covered395
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $2,649
Total amount of fees paid to insurance companyUSD $1,481
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D & DEP LIFE
Welfare Benefit Premiums Paid to CarrierUSD $26,490
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,649
Amount paid for insurance broker fees1481
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
Insurance broker nameBENEFIT DEVELOPMENT GROUP, INC.
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010168745
Policy instance 6
Insurance contract or identification number000010168745
Number of Individuals Covered394
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $4,596
Total amount of fees paid to insurance companyUSD $2,303
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $45,955
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,596
Amount paid for insurance broker fees2303
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
Insurance broker nameBENEFIT DEVELOPMENT GROUP, INC.
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010168743
Policy instance 4
Insurance contract or identification number000010168743
Number of Individuals Covered395
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $7,522
Total amount of fees paid to insurance companyUSD $3,751
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $75,224
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,522
Amount paid for insurance broker fees3751
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
Insurance broker nameBENEFIT DEVELOPMENT GROUP, INC.
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
Policy contract number01-01337
Policy instance 2
Insurance contract or identification number01-01337
Number of Individuals Covered248
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $14,088
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $140,879
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,088
Insurance broker nameBENEFIT DEVELOPMENT GROUP, INC.
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number3211-1
Policy instance 3
Insurance contract or identification number3211-1
Number of Individuals Covered355
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $32,019
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D & DEP LIFE
Welfare Benefit Premiums Paid to CarrierUSD $325,264
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $32,019
Insurance broker organization code?3
Insurance broker nameBENEFIT DEVELOPMENT GROUP, INC.
BLUE CROSS BLUE SHIELD OF ALABAMA (National Association of Insurance Commissioners NAIC id number: 55433 )
Policy contract number9678
Policy instance 1
Insurance contract or identification number9678
Number of Individuals Covered264
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Other welfare benefits providedAIR MED SRVS/YOURSELF/EXP PSYCH
Welfare Benefit Premiums Paid to CarrierUSD $23,281
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number3211-1
Policy instance 3
Insurance contract or identification number3211-1
Number of Individuals Covered355
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $23,948
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D & DEP LIFE
Welfare Benefit Premiums Paid to CarrierUSD $319,308
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
Policy contract number01-01337
Policy instance 2
Insurance contract or identification number01-01337
Number of Individuals Covered245
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $15,579
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $155,788
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF ALABAMA (National Association of Insurance Commissioners NAIC id number: 55433 )
Policy contract number9678
Policy instance 1
Insurance contract or identification number9678
Number of Individuals Covered257
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Other welfare benefits providedAIR MED SRVS/YOURSELF/EXP PSYCH
Welfare Benefit Premiums Paid to CarrierUSD $10,683
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number3211-1
Policy instance 3
Insurance contract or identification number3211-1
Number of Individuals Covered375
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $25,920
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D & DEP LIFE
Welfare Benefit Premiums Paid to CarrierUSD $303,082
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF ALABAMA (National Association of Insurance Commissioners NAIC id number: 55433 )
Policy contract number9678
Policy instance 1
Insurance contract or identification number9678
Number of Individuals Covered303
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Other welfare benefits providedAIR MED SRVS/YOURSELF/EXP PSYCH
Welfare Benefit Premiums Paid to CarrierUSD $13,024
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
Policy contract number01-01337
Policy instance 2
Insurance contract or identification number01-01337
Number of Individuals Covered286
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $16,130
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $201,910
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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