401k Plan data: NEW SOUTH COMMUNICATIONS, INC. LIFE AND HEALTH INSURANCE PLAN plan

NEW SOUTH COMMUNICATIONS, INC. LIFE AND HEALTH INSURANCE PLAN 401k Plan overview

Plan Name	NEW SOUTH COMMUNICATIONS, INC. LIFE AND HEALTH INSURANCE PLAN
Plan identification number	501

NEW SOUTH COMMUNICATIONS, INC. LIFE AND HEALTH INSURANCE PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Temporary disability (accident and sickness) Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

NEW SOUTH COMMUNICATIONS, INC. has sponsored the creation of one or more 401k plans.

Company Name: NEW SOUTH COMMUNICATIONS, INC.

Employer identification number (EIN): 640387140

NAIC Classification: 515100

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NEW SOUTH COMMUNICATIONS, INC. LIFE AND HEALTH INSURANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2018-01-01 MIKE STERLING 2019-10-03
501 2017-01-01 MICHAEL STERLING
501 2016-01-01 MICHAEL C. STERLING
501 2016-01-01
501 2015-01-01 MICHAEL C. STERLING
501 2014-01-01 MICHAEL C. STERLING
501 2014-01-01 ALAN L. WEBB
501 2013-01-01 MICHAEL C. STERLING
501 2012-01-01 MICHAEL C. STERLING
501 2011-01-01 MICHAEL C. STERLING
501 2009-01-01 MICHAEL C. STERLING

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
501	2018-01-01	MIKE STERLING	2019-10-03
501	2017-01-01	MICHAEL STERLING
501	2016-01-01	MICHAEL C. STERLING
501	2016-01-01
501	2015-01-01	MICHAEL C. STERLING
501	2014-01-01	MICHAEL C. STERLING
501	2014-01-01	ALAN L. WEBB
501	2013-01-01	MICHAEL C. STERLING
501	2012-01-01	MICHAEL C. STERLING
501	2011-01-01	MICHAEL C. STERLING
501	2009-01-01	MICHAEL C. STERLING

Plan Statistics for NEW SOUTH COMMUNICATIONS, INC. LIFE AND HEALTH INSURANCE PLAN

401k plan membership statisitcs for NEW SOUTH COMMUNICATIONS, INC. LIFE AND HEALTH INSURANCE PLAN

Measure Date Value
2018: NEW SOUTH COMMUNICATIONS, INC. LIFE AND HEALTH INSURANCE PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 472
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 119
Number of retired or separated participants receiving benefits 2018-01-01 0
Number of other retired or separated participants entitled to future benefits 2018-01-01 0
Total of all active and inactive participants 2018-01-01 119
2017: NEW SOUTH COMMUNICATIONS, INC. LIFE AND HEALTH INSURANCE PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 310
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 472
Total of all active and inactive participants 2017-01-01 472
Total participants 2017-01-01 472
2016: NEW SOUTH COMMUNICATIONS, INC. LIFE AND HEALTH INSURANCE PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 245
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 310
Total of all active and inactive participants 2016-01-01 310
Total participants 2016-01-01 310
2015: NEW SOUTH COMMUNICATIONS, INC. LIFE AND HEALTH INSURANCE PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 251
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 245
Total of all active and inactive participants 2015-01-01 245
Total participants 2015-01-01 245
2014: NEW SOUTH COMMUNICATIONS, INC. LIFE AND HEALTH INSURANCE PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 317
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 251
Total of all active and inactive participants 2014-01-01 251
Total participants 2014-01-01 251
2013: NEW SOUTH COMMUNICATIONS, INC. LIFE AND HEALTH INSURANCE PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 360
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 317
Total of all active and inactive participants 2013-01-01 317
Total participants 2013-01-01 317
2012: NEW SOUTH COMMUNICATIONS, INC. LIFE AND HEALTH INSURANCE PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 320
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 360
Total of all active and inactive participants 2012-01-01 360
Total participants 2012-01-01 360
2011: NEW SOUTH COMMUNICATIONS, INC. LIFE AND HEALTH INSURANCE PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 320
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 320
Total of all active and inactive participants 2011-01-01 320
Total participants 2011-01-01 320
2009: NEW SOUTH COMMUNICATIONS, INC. LIFE AND HEALTH INSURANCE PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 222
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 257
Total of all active and inactive participants 2009-01-01 257
Total participants 2009-01-01 257

Measure	Date	Value
2018: NEW SOUTH COMMUNICATIONS, INC. LIFE AND HEALTH INSURANCE PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	472
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	119
Number of retired or separated participants receiving benefits	2018-01-01	0
Number of other retired or separated participants entitled to future benefits	2018-01-01	0
Total of all active and inactive participants	2018-01-01	119
2017: NEW SOUTH COMMUNICATIONS, INC. LIFE AND HEALTH INSURANCE PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	310
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	472
Total of all active and inactive participants	2017-01-01	472
Total participants	2017-01-01	472
2016: NEW SOUTH COMMUNICATIONS, INC. LIFE AND HEALTH INSURANCE PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	245
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	310
Total of all active and inactive participants	2016-01-01	310
Total participants	2016-01-01	310
2015: NEW SOUTH COMMUNICATIONS, INC. LIFE AND HEALTH INSURANCE PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	251
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	245
Total of all active and inactive participants	2015-01-01	245
Total participants	2015-01-01	245
2014: NEW SOUTH COMMUNICATIONS, INC. LIFE AND HEALTH INSURANCE PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	317
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	251
Total of all active and inactive participants	2014-01-01	251
Total participants	2014-01-01	251
2013: NEW SOUTH COMMUNICATIONS, INC. LIFE AND HEALTH INSURANCE PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	360
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	317
Total of all active and inactive participants	2013-01-01	317
Total participants	2013-01-01	317
2012: NEW SOUTH COMMUNICATIONS, INC. LIFE AND HEALTH INSURANCE PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	320
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	360
Total of all active and inactive participants	2012-01-01	360
Total participants	2012-01-01	360
2011: NEW SOUTH COMMUNICATIONS, INC. LIFE AND HEALTH INSURANCE PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	320
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	320
Total of all active and inactive participants	2011-01-01	320
Total participants	2011-01-01	320
2009: NEW SOUTH COMMUNICATIONS, INC. LIFE AND HEALTH INSURANCE PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	222
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	257
Total of all active and inactive participants	2009-01-01	257
Total participants	2009-01-01	257

Form 5500 Responses for NEW SOUTH COMMUNICATIONS, INC. LIFE AND HEALTH INSURANCE PLAN

2018: NEW SOUTH COMMUNICATIONS, INC. LIFE AND HEALTH INSURANCE PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2017: NEW SOUTH COMMUNICATIONS, INC. LIFE AND HEALTH INSURANCE PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement – Section 412(e)(3) insurance Contracts	Yes
2016: NEW SOUTH COMMUNICATIONS, INC. LIFE AND HEALTH INSURANCE PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	Yes
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement – Section 412(e)(3) insurance Contracts	Yes
2015: NEW SOUTH COMMUNICATIONS, INC. LIFE AND HEALTH INSURANCE PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement – Section 412(e)(3) insurance Contracts	Yes
2014: NEW SOUTH COMMUNICATIONS, INC. LIFE AND HEALTH INSURANCE PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	Yes
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement – Section 412(e)(3) insurance Contracts	Yes
2013: NEW SOUTH COMMUNICATIONS, INC. LIFE AND HEALTH INSURANCE PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement – Section 412(e)(3) insurance Contracts	Yes
2012: NEW SOUTH COMMUNICATIONS, INC. LIFE AND HEALTH INSURANCE PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – Section 412(e)(3) insurance Contracts	Yes
2011: NEW SOUTH COMMUNICATIONS, INC. LIFE AND HEALTH INSURANCE PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	Yes
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement – Section 412(e)(3) insurance Contracts	Yes
2009: NEW SOUTH COMMUNICATIONS, INC. LIFE AND HEALTH INSURANCE PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement – Section 412(e)(3) insurance Contracts	Yes

Insurance Providers Used on plan

USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 )

Policy contract number

50012461

Policy instance

Insurance contract or identification number	50012461
Number of Individuals Covered	17
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $214
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	AD&D
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $1,422
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $142
Insurance broker organization code?	3

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

662535

Policy instance

Insurance contract or identification number	662535
Number of Individuals Covered	62
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $256
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ADD
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $2,557
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $256
Insurance broker organization code?	3

BLUE CROSS BLUE SHIELD OF ALABAMA (National Association of Insurance Commissioners NAIC id number: 55433 )

Policy contract number

79531

Policy instance

Insurance contract or identification number	79531
Number of Individuals Covered	8
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $28,563
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

BLUE CROSS BLUE SHIELD OF MS, INC. (National Association of Insurance Commissioners NAIC id number: 60111 )

Policy contract number

0014455

Policy instance

Insurance contract or identification number	0014455
Number of Individuals Covered	6
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $17,058
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )

Policy contract number

762167

Policy instance

Insurance contract or identification number	762167
Number of Individuals Covered	18
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $5,616
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $80,784
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,616
Insurance broker organization code?	3

BLUE CROSS BLUE SHIELD OF ALABAMA (National Association of Insurance Commissioners NAIC id number: 55433 )

Policy contract number

44856

Policy instance

Insurance contract or identification number	44856
Number of Individuals Covered	18
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $117,218
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

BLUE CROSS BLUE SHIELD OF MS, INC. (National Association of Insurance Commissioners NAIC id number: 60111 )

Policy contract number

0016814 ET AL

Policy instance

Insurance contract or identification number	0016814 ET AL
Number of Individuals Covered	3
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $288
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $288
Insurance broker organization code?	3

BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 )

Policy contract number

B6815

Policy instance

Insurance contract or identification number	B6815
Number of Individuals Covered	7
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $87,975
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )

Policy contract number

H I MANAGEMENT

Policy instance

Insurance contract or identification number	H I MANAGEMENT
Number of Individuals Covered	24
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $3,288
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	CANCER
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $12,656
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,276
Insurance broker organization code?	3

BLUE CROSS BLUE SHIELD OF MS, INC. (National Association of Insurance Commissioners NAIC id number: 60111 )

Policy contract number

16105 ET AL

Policy instance

Insurance contract or identification number	16105 ET AL
Number of Individuals Covered	20
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $5,252
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,252
Insurance broker organization code?	3

BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 )

Policy contract number

029Z01ERC

Policy instance

Insurance contract or identification number	029Z01ERC
Number of Individuals Covered	17
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $156,595
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

BLUE CROSS BLUE SHIELD OF MS, INC. (National Association of Insurance Commissioners NAIC id number: 60111 )

Policy contract number

00495556 ET AL

Policy instance

Insurance contract or identification number	00495556 ET AL
Number of Individuals Covered	2
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $823
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $823
Insurance broker organization code?	3

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

Policy contract number

5944042

Policy instance

Insurance contract or identification number	5944042
Number of Individuals Covered	151
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $3,190
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $34,885
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,190
Insurance broker organization code?	3

BLUE CROSS BLUE SHIELD OF MS, INC. (National Association of Insurance Commissioners NAIC id number: 60111 )

Policy contract number

0038426 ET AL

Policy instance

Insurance contract or identification number	0038426 ET AL
Number of Individuals Covered	4
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $312
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $312
Insurance broker organization code?	3

AMFIRST INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60250 )

Policy contract number

PREMIUM SAVER

Policy instance

Insurance contract or identification number	PREMIUM SAVER
Number of Individuals Covered	0
Insurance policy start date	2017-01-01
Insurance policy end date	2017-03-31
Total amount of commissions paid to insurance broker	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,004
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Insurance broker organization code?	3
Insurance broker name	MWL

DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )

Policy contract number

16327

Policy instance

Insurance contract or identification number	16327
Number of Individuals Covered	1
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $883
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $8,834
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $883
Insurance broker organization code?	3
Insurance broker name	BOBBY SHERRILL

BLUE CROSS BLUE SHIELD OF ALABAMA (National Association of Insurance Commissioners NAIC id number: 55433 )

Policy contract number

44856

Policy instance

Insurance contract or identification number	44856
Number of Individuals Covered	34
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $131,612
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

2NSCO411

Policy instance

Insurance contract or identification number	2NSCO411
Number of Individuals Covered	128
Insurance policy start date	2018-01-01
Insurance policy end date	2017-03-31
Total amount of commissions paid to insurance broker	USD $78
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $779
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $78
Insurance broker organization code?	3
Insurance broker name	INSURANCE ADVISORY GROUP LLC

BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 )

Policy contract number

029Z01ERC

Policy instance

Insurance contract or identification number	029Z01ERC
Number of Individuals Covered	15
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $165,078
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )

Policy contract number

537592

Policy instance

Insurance contract or identification number	537592
Number of Individuals Covered	18
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $146,022
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Insurance broker organization code?	3
Insurance broker name	BOBBY SHERRILL

BLUE CROSS BLUE SHIELD OF MS, INC. (National Association of Insurance Commissioners NAIC id number: 60111 )

Policy contract number

14455

Policy instance

Insurance contract or identification number	14455
Number of Individuals Covered	2
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $11,999
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Insurance broker organization code?	3
Insurance broker name	BOBBY SHERRILL

BLUE CROSS BLUE SHIELD OF ALABAMA (National Association of Insurance Commissioners NAIC id number: 55433 )

Policy contract number

79531

Policy instance

Insurance contract or identification number	79531
Number of Individuals Covered	6
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $19,709
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

BLUE CROSS BLUE SHIELD OF MS, INC. (National Association of Insurance Commissioners NAIC id number: 60111 )

Policy contract number

16814

Policy instance

Insurance contract or identification number	16814
Number of Individuals Covered	4
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $360
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $21,746
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $360
Insurance broker organization code?	3
Insurance broker name	BOBBY SHERRILL

BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 )

Policy contract number

B6815

Policy instance

Insurance contract or identification number	B6815
Number of Individuals Covered	8
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $86,827
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 )

Policy contract number

50012461

Policy instance

Insurance contract or identification number	50012461
Number of Individuals Covered	18
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $204
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	GROUP LIFE & AD&D
Welfare Benefit Premiums Paid to Carrier	USD $1,354
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $135
Insurance broker organization code?	3
Insurance broker name	WILLIAMS, JOHN

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

662535

Policy instance

Insurance contract or identification number	662535
Number of Individuals Covered	28
Insurance policy start date	2017-04-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $155
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $1,990
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $155
Insurance broker organization code?	3
Insurance broker name	INSURANCE ADVISORY GROUP, LLC

BLUE CROSS BLUE SHIELD OF MS, INC. (National Association of Insurance Commissioners NAIC id number: 60111 )

Policy contract number

38426

Policy instance

Insurance contract or identification number	38426
Number of Individuals Covered	3
Insurance policy start date	2017-04-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $252
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $20,912
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $252
Insurance broker organization code?	3
Insurance broker name	BOBBY SHERRILL

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

Policy contract number

TM05944042

Policy instance

Insurance contract or identification number	TM05944042
Number of Individuals Covered	155
Insurance policy start date	2017-04-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $2,660
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $26,605
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,660
Insurance broker organization code?	3
Insurance broker name	INSURANCE ADVISORY GROUP LLC

BLUE CROSS BLUE SHIELD OF MS, INC. (National Association of Insurance Commissioners NAIC id number: 60111 )

Policy contract number

49556

Policy instance

Insurance contract or identification number	49556
Number of Individuals Covered	2
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $823
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $10,002
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $823
Insurance broker organization code?	3
Insurance broker name	BOBBY SHERRILL

BLUE CROSS BLUE SHIELD OF MS, INC. (National Association of Insurance Commissioners NAIC id number: 60111 )

Policy contract number

16105

Policy instance

Insurance contract or identification number	16105
Number of Individuals Covered	22
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $5,382
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $111,048
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,382
Insurance broker organization code?	3
Insurance broker name	BOBBY SHERRILL

BLUE CROSS BLUE SHIELD OF MS, INC. (National Association of Insurance Commissioners NAIC id number: 60111 )

Policy contract number

49559

Policy instance

Insurance contract or identification number	49559
Number of Individuals Covered	4
Insurance policy start date	2017-01-01
Insurance policy end date	2017-03-31
Total amount of commissions paid to insurance broker	USD $309
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $6,541
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $309
Insurance broker organization code?	3
Insurance broker name	BOBBY SHERRILL

HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )

Policy contract number

H-C NEWSOU

Policy instance

Insurance contract or identification number	H-C NEWSOU
Number of Individuals Covered	24
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $13,057
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 number

44856

Policy instance

Insurance contract or identification number	44856
Number of Individuals Covered	18
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Other welfare benefits provided	EXPANDED PSYCHIATRIC SERVICES
Welfare Benefit Premiums Paid to Carrier	USD $133,193
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

2NSCO411

Policy instance

Insurance contract or identification number	2NSCO411
Number of Individuals Covered	57
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $271
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $2,865
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $271
Insurance broker organization code?	3
Insurance broker name	INSURANCE ADVISORY GROUP LLC

USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 )

Policy contract number

50012461

Policy instance

Insurance contract or identification number	50012461
Number of Individuals Covered	17
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	GROUP LIFE & AD&D
Welfare Benefit Premiums Paid to Carrier	USD $1,498
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

BLUE CROSS BLUE SHIELD OF MS (National Association of Insurance Commissioners NAIC id number: 60111 )

Policy contract number

16105

Policy instance

Insurance contract or identification number	16105
Number of Individuals Covered	15
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $114,956
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 number

79531

Policy instance

Insurance contract or identification number	79531
Number of Individuals Covered	15
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Other welfare benefits provided	EXPANDED PSYCHIATRIC SERVICES
Welfare Benefit Premiums Paid to Carrier	USD $36,904
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

BLUE CROSS BLUE SHIELD OF MS, INC. (National Association of Insurance Commissioners NAIC id number: 60111 )

Policy contract number

14455

Policy instance

Insurance contract or identification number	14455
Number of Individuals Covered	2
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $1,470
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $8,167
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,470
Insurance broker organization code?	3
Insurance broker name	BOBBY SHERRILL

DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )

Policy contract number

16327

Policy instance

Insurance contract or identification number	16327
Number of Individuals Covered	62
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $3,156
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $31,565
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,156
Insurance broker organization code?	3
Insurance broker name	BOBBY SHERRILL

AMFIRST (National Association of Insurance Commissioners NAIC id number: 60250 )

Policy contract number

PREMIUM SAVER

Policy instance

Insurance contract or identification number	PREMIUM SAVER
Number of Individuals Covered	3
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $667
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $4,552
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $445
Insurance broker organization code?	3
Insurance broker name	MWL

AMFIRST (National Association of Insurance Commissioners NAIC id number: 60250 )

Policy contract number

PREMIUM SAVER

Policy instance

Insurance contract or identification number	PREMIUM SAVER
Number of Individuals Covered	4
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $825
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $5,736
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $550
Insurance broker organization code?	3
Insurance broker name	MWL

BLUE CROSS BLUE SHIELD OF MS (National Association of Insurance Commissioners NAIC id number: 60111 )

Policy contract number

49559

Policy instance

Insurance contract or identification number	49559
Number of Individuals Covered	6
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $1,200
Health Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,200
Insurance broker organization code?	3
Insurance broker name	BOBBY L SHERRILL

BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 )

Policy contract number

B6815

Policy instance

Insurance contract or identification number	B6815
Number of Individuals Covered	8
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $89,079
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

VANTAGE HEALTH INSURANCE (National Association of Insurance Commissioners NAIC id number: 95584 )

Policy contract number

C02158123

Policy instance

Insurance contract or identification number	C02158123
Number of Individuals Covered	23
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $135,098
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )

Policy contract number

CS0266

Policy instance

Insurance contract or identification number	CS0266
Number of Individuals Covered	17
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $7,875
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $91,822
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,155
Insurance broker organization code?	3
Insurance broker name	KEY BENEFIT ADMINISTRATORS

HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )

Policy contract number

537592

Policy instance

Insurance contract or identification number	537592
Number of Individuals Covered	30
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $2,393
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $13,601
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,393
Insurance broker organization code?	3
Insurance broker name	BOBBY SHERRILL

COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )

Policy contract number

CS0265

Policy instance

Insurance contract or identification number	CS0265
Number of Individuals Covered	15
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $11,308
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $91,523
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,828
Insurance broker organization code?	3
Insurance broker name	KEY BENEFIT ADMINISTRATORS

COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )

Policy contract number

CS0266

Policy instance

Insurance contract or identification number	CS0266
Number of Individuals Covered	17
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $8,819
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $72,779
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,405
Insurance broker organization code?	3
Insurance broker name	KEY BENEFIT ADMINISTRATORS

BLUE CROSS BLUE SHIELD OF ALABAMA (National Association of Insurance Commissioners NAIC id number: 55433 )

Policy contract number

44856

Policy instance

Insurance contract or identification number	44856
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Other welfare benefits provided	EXPANDED PSYCHIATRIC SERVICES

BLUE CROSS BLUE SHIELD OF MS, INC. (National Association of Insurance Commissioners NAIC id number: 60111 )

Policy contract number

9456,49559,4955

Policy instance

Insurance contract or identification number	9456,49559,4955
Health Insurance Welfare Benefit	Yes

USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 )

Policy contract number

50012461

Policy instance

Insurance contract or identification number	50012461
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	GROUP LIFE & AD&D
Number of Individuals Covered	20
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Welfare Benefit Premiums Paid to Carrier	USD $1,590
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )

Policy contract number

537592

Policy instance

Insurance contract or identification number	537592
Health Insurance Welfare Benefit	Yes
Number of Individuals Covered	26
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $2,189
Welfare Benefit Premiums Paid to Carrier	USD $12,497
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,189
Insurance broker organization code?	3
Insurance broker name	BOBBY SHERRILL

BLUE CROSS BLUE SHIELD OF LA (National Association of Insurance Commissioners NAIC id number: 51511 )

Policy contract number

78988ERC

Policy instance

Insurance contract or identification number	78988ERC
Health Insurance Welfare Benefit	Yes
Insurance policy start date	2014-01-01
Insurance policy end date	2014-02-28
Welfare Benefit Premiums Paid to Carrier	USD $19,953
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 number

79531

Policy instance

Insurance contract or identification number	79531
Dental Insurance Welfare Benefit	Yes

DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )

Policy contract number

16327

Policy instance

Insurance contract or identification number	16327
Health Insurance Welfare Benefit	Yes
Number of Individuals Covered	69
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $2,976
Welfare Benefit Premiums Paid to Carrier	USD $29,634
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,976
Insurance broker organization code?	3
Insurance broker name	BOBBY SHERRILL

AMFIRST (National Association of Insurance Commissioners NAIC id number: 60250 )

Policy contract number

PREMIUM SAVER

Policy instance

Insurance contract or identification number	PREMIUM SAVER
Health Insurance Welfare Benefit	Yes
Number of Individuals Covered	3
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $692
Welfare Benefit Premiums Paid to Carrier	USD $4,723
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $461
Insurance broker organization code?	3
Insurance broker name	MWL

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

Policy contract number

2NSCO411

Policy instance

Insurance contract or identification number	2NSCO411
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Number of Individuals Covered	116
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $236
Welfare Benefit Premiums Paid to Carrier	USD $2,581
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $236
Insurance broker organization code?	3
Insurance broker name	INSURANCE ADVISORY GROUP LLC

AMFIRST (National Association of Insurance Commissioners NAIC id number: 60250 )

Policy contract number

PREMIUM SAVER

Policy instance

Insurance contract or identification number	PREMIUM SAVER
Health Insurance Welfare Benefit	Yes
Number of Individuals Covered	3
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $916
Welfare Benefit Premiums Paid to Carrier	USD $6,168
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $610
Insurance broker organization code?	3
Insurance broker name	MWL

AMFIRST (National Association of Insurance Commissioners NAIC id number: 60250 )

Policy contract number

PREMIUM SAVER

Policy instance

Insurance contract or identification number	PREMIUM SAVER
Health Insurance Welfare Benefit	Yes

VANTAGE HEALTH INSURANCE (National Association of Insurance Commissioners NAIC id number: 95584 )

Policy contract number

C02158123

Policy instance

Insurance contract or identification number	C02158123
Number of Individuals Covered	20
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $1,896
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $94,303
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,896
Insurance broker organization code?	3
Insurance broker name	KIMBERLY HUDSON

BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 )

Policy contract number

B6815

Policy instance

Insurance contract or identification number	B6815
Number of Individuals Covered	8
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $82,276
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

BLUE CROSS BLUE SHIELD OF MS (National Association of Insurance Commissioners NAIC id number: 60111 )

Policy contract number

49559

Policy instance

Insurance contract or identification number	49559
Number of Individuals Covered	3
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $21,717
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

BLUE CROSS BLUE SHIELD OF MS (National Association of Insurance Commissioners NAIC id number: 60111 )

Policy contract number

49556

Policy instance

Insurance contract or identification number	49556
Number of Individuals Covered	7
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $17,030
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AMFIRST (National Association of Insurance Commissioners NAIC id number: 60250 )

Policy contract number

PREMIUM SAVER

Policy instance

Insurance contract or identification number

PREMIUM SAVER

BLUE CROSS BLUE SHIELD OF ALABAMA (National Association of Insurance Commissioners NAIC id number: 55433 )

Policy contract number

44856

Policy instance

Insurance contract or identification number	44856
Number of Individuals Covered	36
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $146,891
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

BLUE CROSS BLUE SHIELD OF MS, INC. (National Association of Insurance Commissioners NAIC id number: 60111 )

Policy contract number

14455

Policy instance

Insurance contract or identification number	14455
Number of Individuals Covered	2
Insurance policy start date	2014-02-28
Insurance policy end date	2014-12-31
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $9,129
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 number

79531

Policy instance

Insurance contract or identification number	79531
Number of Individuals Covered	14
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Other welfare benefits provided	EXPANDED PSYCHIATRIC SERVICES
Welfare Benefit Premiums Paid to Carrier	USD $37,469
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 number

44856

Policy instance

Insurance contract or identification number	44856
Number of Individuals Covered	28
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Other welfare benefits provided	EXPANDED PSYCHIATRIC SERVICES
Welfare Benefit Premiums Paid to Carrier	USD $95,603
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AMFIRST (National Association of Insurance Commissioners NAIC id number: 60250 )

Policy contract number

PREMIUM SAVER

Policy instance

Insurance contract or identification number	PREMIUM SAVER
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $2,363
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $16,246
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $788
Insurance broker organization code?	3
Insurance broker name	MWL

AMFIRST (National Association of Insurance Commissioners NAIC id number: 60250 )

Policy contract number

PREMIUM SAVER

Policy instance

Insurance contract or identification number	PREMIUM SAVER
Number of Individuals Covered	5
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $861
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $5,909
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $574
Insurance broker organization code?	3
Insurance broker name	MWL

BLUE CROSS BLUE SHIELD OF MS, INC. (National Association of Insurance Commissioners NAIC id number: 60111 )

Policy contract number

9456,49559,4955

Policy instance

Insurance contract or identification number	9456,49559,4955
Number of Individuals Covered	47
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $11,333
Total amount of fees paid to insurance company	USD $2,005
Health Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $11,333
Amount paid for insurance broker fees	2005
Additional information about fees paid to insurance broker	ADMINISTRATIVE FEES
Insurance broker organization code?	3
Insurance broker name	BOBBY SHERRILL

HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )

Policy contract number

537592

Policy instance

Insurance contract or identification number	537592
Number of Individuals Covered	26
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $2,048
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $11,915
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,048
Insurance broker organization code?	3
Insurance broker name	BOBBY SHERRILL

USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 )

Policy contract number

50012461

Policy instance

Insurance contract or identification number	50012461
Number of Individuals Covered	15
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $194
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	GROUP LIFE & AD&D
Welfare Benefit Premiums Paid to Carrier	USD $1,290
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $194
Insurance broker organization code?	3
Insurance broker name	ABLE BENEFIT SOLUTIONS

BLUE CROSS BLUE SHIELD OF LA (National Association of Insurance Commissioners NAIC id number: 51511 )

Policy contract number

78988ERC

Policy instance

Insurance contract or identification number	78988ERC
Number of Individuals Covered	21
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $145,001
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 number

79531

Policy instance

Insurance contract or identification number	79531
Number of Individuals Covered	10
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $9,820
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 number

16327

Policy instance

Insurance contract or identification number	16327
Number of Individuals Covered	50
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $2,027
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $20,269
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,027
Insurance broker organization code?	3
Insurance broker name	BOBBY SHERRILL

AMFIRST (National Association of Insurance Commissioners NAIC id number: 60250 )

Policy contract number

PREMIUM SAVER

Policy instance

Insurance contract or identification number	PREMIUM SAVER
Number of Individuals Covered	3
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $692
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $4,723
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $461
Insurance broker organization code?	3
Insurance broker name	MWL

AMFIRST (National Association of Insurance Commissioners NAIC id number: 60250 )

Policy contract number

PREMIUM SAVER

Policy instance

Insurance contract or identification number	PREMIUM SAVER
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $3,228
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $16,585
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,417
Insurance broker organization code?	3
Insurance broker name	MWL

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

Policy contract number

2NSCO411

Policy instance

Insurance contract or identification number	2NSCO411
Number of Individuals Covered	112
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-13
Total amount of commissions paid to insurance broker	USD $199
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $2,235
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $199
Insurance broker organization code?	3
Insurance broker name	INSURANCE ADVISORY GROUP LLC

AMFIRST (National Association of Insurance Commissioners NAIC id number: 60250 )

Policy contract number

PREMIUM SAVER

Policy instance

Insurance contract or identification number	PREMIUM SAVER
Number of Individuals Covered	4
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $912
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $6,324
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $608
Insurance broker organization code?	3
Insurance broker name	MWL

HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )

Policy contract number

537592

Policy instance

Insurance contract or identification number	537592
Number of Individuals Covered	16
Insurance policy start date	2012-01-01
Insurance policy end date	2012-03-31
Total amount of commissions paid to insurance broker	USD $4,816
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $15,733
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,816
Insurance broker organization code?	3
Insurance broker name	MEYER & ROSENBAUM

AMFIRST (National Association of Insurance Commissioners NAIC id number: 60250 )

Policy contract number

PREMIUM SAVER

Policy instance

Insurance contract or identification number	PREMIUM SAVER
Number of Individuals Covered	16
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $2,732
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $14,032
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,049
Insurance broker organization code?	3
Insurance broker name	MWL

AMFIRST (National Association of Insurance Commissioners NAIC id number: 60250 )

Policy contract number

PREMIUM SAVER

Policy instance

Insurance contract or identification number	PREMIUM SAVER
Number of Individuals Covered	3
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $700
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $4,894
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $467
Insurance broker organization code?	3
Insurance broker name	MWL

BLUE CROSS BLUE SHIELD OF ALABAMA (National Association of Insurance Commissioners NAIC id number: 55433 )

Policy contract number

44856

Policy instance

Insurance contract or identification number	44856
Number of Individuals Covered	18
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Other welfare benefits provided	EXPANDED PSYCHIATRIC SERVICES
Welfare Benefit Premiums Paid to Carrier	USD $91,866
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

2NSCO411

Policy instance

Insurance contract or identification number	2NSCO411
Number of Individuals Covered	176
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $3,387
Dental Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $40,414
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,387
Insurance broker organization code?	3
Insurance broker name	INSURANCE ADVISORY GROUP LLC

AMFIRST (National Association of Insurance Commissioners NAIC id number: 60250 )

Policy contract number

PREMIUM SAVER

Policy instance

Insurance contract or identification number	PREMIUM SAVER
Number of Individuals Covered	13
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $2,896
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $20,157
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,931
Insurance broker organization code?	3
Insurance broker name	MWL

BLUE CROSS BLUE SHIELD OF LA (National Association of Insurance Commissioners NAIC id number: 51511 )

Policy contract number

78988ERC

Policy instance

Insurance contract or identification number	78988ERC
Number of Individuals Covered	27
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $160,838
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 )

Policy contract number

50012461

Policy instance

Insurance contract or identification number	50012461
Number of Individuals Covered	17
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $138
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	GROUP LIFE & AD&D
Welfare Benefit Premiums Paid to Carrier	USD $1,328
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $138
Insurance broker organization code?	3
Insurance broker name	ABLE BENEFIT SOLUTIONS

HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )

Policy contract number

537592

Policy instance

Insurance contract or identification number	537592
Number of Individuals Covered	38
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $2,447
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $13,529
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,447
Insurance broker organization code?	3
Insurance broker name	BOBBY SHERRILL

BLUE CROSS BLUE SHIELD OF MS, INC. (National Association of Insurance Commissioners NAIC id number: 60111 )

Policy contract number

4956,49559,4955

Policy instance

Insurance contract or identification number	4956,49559,4955
Number of Individuals Covered	53
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $11,993
Total amount of fees paid to insurance company	USD $1,623
Health Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $11,993
Amount paid for insurance broker fees	1623
Additional information about fees paid to insurance broker	ADMINISTRATIVE FEES
Insurance broker organization code?	3
Insurance broker name	BOBBY SHERRILL

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

Policy contract number

Policy instance

Number of Individuals Covered	118
Insurance policy start date	2011-04-01
Insurance policy end date	2011-12-31
Total amount of fees paid to insurance company	USD $2,779
Dental Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $27,787
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 number

77493

Policy instance

Insurance contract or identification number	77493
Number of Individuals Covered	3
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,275
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )

Policy contract number

537592

Policy instance

Insurance contract or identification number	537592
Number of Individuals Covered	15
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $2,278
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $57,238
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

VANTAGE HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95584 )

Policy contract number

S24600-001

Policy instance

Insurance contract or identification number	S24600-001
Number of Individuals Covered	35
Insurance policy start date	2011-01-01
Insurance policy end date	2011-02-28
Welfare Benefit Premiums Paid to Carrier	USD $8,002
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

00457340

Policy instance

Insurance contract or identification number	00457340
Number of Individuals Covered	88
Insurance policy start date	2011-01-01
Insurance policy end date	2011-03-31
Total amount of fees paid to insurance company	USD $1,065
Dental Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $9,651
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )

Policy contract number

Policy instance

Number of Individuals Covered	39
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of fees paid to insurance company	USD $1,896
Other welfare benefits provided	CANCER
Welfare Benefit Premiums Paid to Carrier	USD $10,492
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 )

Policy contract number

603000

Policy instance

Insurance contract or identification number	603000
Number of Individuals Covered	13
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of fees paid to insurance company	USD $172
Other welfare benefits provided	GROUP LIFE & AD&D
Welfare Benefit Premiums Paid to Carrier	USD $1,146
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

VANTAGE HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95584 )

Policy contract number

S27700

Policy instance

Insurance contract or identification number	S27700
Number of Individuals Covered	7
Insurance policy start date	2011-01-01
Insurance policy end date	2011-02-28
Welfare Benefit Premiums Paid to Carrier	USD $1,794
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

BLUE CROSS BLUE SHIELD OF MS, INC. (National Association of Insurance Commissioners NAIC id number: 60111 )

Policy contract number

49556,57,59

Policy instance

Insurance contract or identification number	49556,57,59
Number of Individuals Covered	21
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $6,779
Health Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

VANTAGE HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95584 )

Policy contract number

S24600-003

Policy instance

Insurance contract or identification number	S24600-003
Number of Individuals Covered	9
Insurance policy start date	2011-01-01
Insurance policy end date	2011-02-28
Welfare Benefit Premiums Paid to Carrier	USD $3,252
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 number

44856

Policy instance

Insurance contract or identification number	44856
Number of Individuals Covered	19
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Health Insurance Welfare Benefit	Yes
Other welfare benefits provided	EXPANDED PSYCHIATRIC SERVICES
Welfare Benefit Premiums Paid to Carrier	USD $91,830
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AMFIRST INSURANCE (National Association of Insurance Commissioners NAIC id number: )

Policy contract number

R18-502

Policy instance

Insurance contract or identification number	R18-502
Number of Individuals Covered	4
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $566
Total amount of fees paid to insurance company	USD $0
Other welfare benefits provided	MEDICAL SUPPLEMENT
Welfare Benefit Premiums Paid to Carrier	USD $4,462

AMFIRST INSURANCE (National Association of Insurance Commissioners NAIC id number: )

Policy contract number

L77-502

Policy instance

Insurance contract or identification number	L77-502
Number of Individuals Covered	16
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $2,122
Total amount of fees paid to insurance company	USD $0
Other welfare benefits provided	MEDICAL SUPPLEMENT
Welfare Benefit Premiums Paid to Carrier	USD $12,541

BLUE CROSS BLUE SHIELD OF ALABAMA (National Association of Insurance Commissioners NAIC id number: 55433 )

Policy contract number

44856

Policy instance

Insurance contract or identification number	44856
Number of Individuals Covered	16
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Other welfare benefits provided	EXPANDED PSYCHIATRIC SERVICES
Welfare Benefit Premiums Paid to Carrier	USD $103,092

VANTAGE HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95584 )

Policy contract number

S27700

Policy instance

Insurance contract or identification number	S27700
Number of Individuals Covered	7
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Welfare Benefit Premiums Paid to Carrier	USD $16,233

AMFIRST INSURANCE (National Association of Insurance Commissioners NAIC id number: )

Policy contract number

R18-504

Policy instance

Insurance contract or identification number	R18-504
Number of Individuals Covered	20
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $3,990
Total amount of fees paid to insurance company	USD $0
Other welfare benefits provided	MEDICAL SUPPLEMENT
Welfare Benefit Premiums Paid to Carrier	USD $26,593

DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )

Policy contract number

MS-01169

Policy instance

Insurance contract or identification number	MS-01169
Number of Individuals Covered	2
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $881
Total amount of fees paid to insurance company	USD $0
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $12,559

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

00457340

Policy instance

Insurance contract or identification number	00457340
Number of Individuals Covered	88
Insurance policy start date	2010-04-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $3,366
Total amount of fees paid to insurance company	USD $0
Dental Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $30,536

COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )

Policy contract number

901-15-60014

Policy instance

Insurance contract or identification number	901-15-60014
Number of Individuals Covered	48
Insurance policy start date	2009-04-01
Insurance policy end date	2010-03-31
Total amount of commissions paid to insurance broker	USD $503
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 $2,232

AMFIRST INSURANCE (National Association of Insurance Commissioners NAIC id number: )

Policy contract number

R18-503

Policy instance

Insurance contract or identification number	R18-503
Number of Individuals Covered	3
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $930
Total amount of fees paid to insurance company	USD $0
Other welfare benefits provided	MEDICAL SUPPLEMENT
Welfare Benefit Premiums Paid to Carrier	USD $5,496

HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )

Policy contract number

537592

Policy instance

Insurance contract or identification number	537592
Number of Individuals Covered	15
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $5,730
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $64,036

BLUE CROSS BLUE SHIELD OF MS, INC. (National Association of Insurance Commissioners NAIC id number: 60111 )

Policy contract number

49556,57,59

Policy instance

Insurance contract or identification number	49556,57,59
Number of Individuals Covered	44
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $7,097
Total amount of fees paid to insurance company	USD $1,461
Health Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

VANTAGE HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95584 )

Policy contract number

S24600-003

Policy instance

Insurance contract or identification number	S24600-003
Number of Individuals Covered	9
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Welfare Benefit Premiums Paid to Carrier	USD $38,012

VANTAGE HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95584 )

Policy contract number

S24600-001

Policy instance

Insurance contract or identification number	S24600-001
Number of Individuals Covered	34
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Welfare Benefit Premiums Paid to Carrier	USD $96,418

USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 )

Policy contract number

603000

Policy instance

Insurance contract or identification number	603000
Number of Individuals Covered	14
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $149
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 $987

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Company Name:	NEW SOUTH COMMUNICATIONS, INC.
Employer identification number (EIN):	640387140
NAIC Classification:	515100