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HEARTLAND CATFISH COMPANY, INC. PRETAX BENEFIT PLAN 401k Plan overview

Plan NameHEARTLAND CATFISH COMPANY, INC. PRETAX BENEFIT PLAN
Plan identification number 501

HEARTLAND CATFISH COMPANY, INC. PRETAX BENEFIT PLAN Benefits

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

401k Sponsoring company profile

HEARTLAND CATFISH COMPANY, INC. has sponsored the creation of one or more 401k plans.

Company Name:HEARTLAND CATFISH COMPANY, INC.
Employer identification number (EIN):640784239
NAIC Classification:311710
NAIC Description:Seafood Product Preparation and Packaging

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HEARTLAND CATFISH COMPANY, INC. PRETAX BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012021-08-01BRAD GARRARD2023-03-02
5012020-08-01BRAD GARRARD2022-05-13
5012019-08-01BRAD GARRARD2021-05-05
5012018-08-01BRAD GARRARD2020-05-08
5012018-01-01
5012017-01-01
5012016-01-01
5012015-01-01
5012014-01-01
5012013-01-01
5012012-01-01BRAD GARRARD BRAD GARRARD2013-05-09
5012011-01-01BRAD GARRARD BRAD GARRARD2013-05-09
5012010-08-01BRAD GARRARD BRAD GARRARD2013-05-09
5012009-08-01BRAD GARRARD BRAD GARRARD2013-05-09
5012008-08-01BRAD GARRARD BRAD GARRARD2013-05-09
5012007-08-01BRAD GARRARD BRAD GARRARD2013-05-09
5012006-08-01BRAD GARRARD BRAD GARRARD2013-05-09
5012005-08-01BRAD GARRARD BRAD GARRARD2013-05-09
5012004-08-01BRAD GARRARD BRAD GARRARD2013-05-09
5012003-08-01BRAD GARRARD BRAD GARRARD2013-05-09
5012002-08-01BRAD GARRARD BRAD GARRARD2013-05-09
5012001-08-01BRAD GARRARD BRAD GARRARD2013-05-09
5012000-08-01BRAD GARRARD BRAD GARRARD2013-05-09

Plan Statistics for HEARTLAND CATFISH COMPANY, INC. PRETAX BENEFIT PLAN

401k plan membership statisitcs for HEARTLAND CATFISH COMPANY, INC. PRETAX BENEFIT PLAN

Measure Date Value
2021: HEARTLAND CATFISH COMPANY, INC. PRETAX BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year2021-08-01215
Total number of active participants reported on line 7a of the Form 55002021-08-01174
Number of retired or separated participants receiving benefits2021-08-010
Number of other retired or separated participants entitled to future benefits2021-08-010
Total of all active and inactive participants2021-08-01174
Number of employers contributing to the scheme2021-08-010
2020: HEARTLAND CATFISH COMPANY, INC. PRETAX BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year2020-08-01401
Total number of active participants reported on line 7a of the Form 55002020-08-01215
Number of retired or separated participants receiving benefits2020-08-010
Number of other retired or separated participants entitled to future benefits2020-08-010
Total of all active and inactive participants2020-08-01215
Number of employers contributing to the scheme2020-08-010
2019: HEARTLAND CATFISH COMPANY, INC. PRETAX BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year2019-08-01461
Total number of active participants reported on line 7a of the Form 55002019-08-01401
Number of retired or separated participants receiving benefits2019-08-010
Number of other retired or separated participants entitled to future benefits2019-08-010
Total of all active and inactive participants2019-08-01401
Number of employers contributing to the scheme2019-08-010
2018: HEARTLAND CATFISH COMPANY, INC. PRETAX BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year2018-08-01461
Total number of active participants reported on line 7a of the Form 55002018-08-01461
Number of retired or separated participants receiving benefits2018-08-010
Number of other retired or separated participants entitled to future benefits2018-08-010
Total of all active and inactive participants2018-08-01461
Number of employers contributing to the scheme2018-08-010
Total participants, beginning-of-year2018-01-01414
Total number of active participants reported on line 7a of the Form 55002018-01-01461
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-01461
Number of employers contributing to the scheme2018-01-010
2017: HEARTLAND CATFISH COMPANY, INC. PRETAX BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01436
Total number of active participants reported on line 7a of the Form 55002017-01-01414
Total of all active and inactive participants2017-01-01414
2016: HEARTLAND CATFISH COMPANY, INC. PRETAX BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01593
Total number of active participants reported on line 7a of the Form 55002016-01-01436
Total of all active and inactive participants2016-01-01436
2015: HEARTLAND CATFISH COMPANY, INC. PRETAX BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01593
Total number of active participants reported on line 7a of the Form 55002015-01-01593
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-01593
2014: HEARTLAND CATFISH COMPANY, INC. PRETAX BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01596
Total number of active participants reported on line 7a of the Form 55002014-01-01596
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-01596
2013: HEARTLAND CATFISH COMPANY, INC. PRETAX BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01481
Total number of active participants reported on line 7a of the Form 55002013-01-01481
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-01481
2012: HEARTLAND CATFISH COMPANY, INC. PRETAX BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01489
Total number of active participants reported on line 7a of the Form 55002012-01-01489
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-01489
2011: HEARTLAND CATFISH COMPANY, INC. PRETAX BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01524
Total number of active participants reported on line 7a of the Form 55002011-01-01524
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-010
Total of all active and inactive participants2011-01-01524
2010: HEARTLAND CATFISH COMPANY, INC. PRETAX BENEFIT PLAN 2010 401k membership
Total participants, beginning-of-year2010-08-01567
Total number of active participants reported on line 7a of the Form 55002010-08-01567
Number of retired or separated participants receiving benefits2010-08-010
Number of other retired or separated participants entitled to future benefits2010-08-010
Total of all active and inactive participants2010-08-01567
2009: HEARTLAND CATFISH COMPANY, INC. PRETAX BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year2009-08-01556
Total number of active participants reported on line 7a of the Form 55002009-08-01556
Number of retired or separated participants receiving benefits2009-08-010
Number of other retired or separated participants entitled to future benefits2009-08-010
Total of all active and inactive participants2009-08-01556
Total participants2009-08-010
2008: HEARTLAND CATFISH COMPANY, INC. PRETAX BENEFIT PLAN 2008 401k membership
Total participants, beginning-of-year2008-08-01509
Total number of active participants reported on line 7a of the Form 55002008-08-01509
Number of retired or separated participants receiving benefits2008-08-010
Number of other retired or separated participants entitled to future benefits2008-08-010
Total of all active and inactive participants2008-08-01509
2007: HEARTLAND CATFISH COMPANY, INC. PRETAX BENEFIT PLAN 2007 401k membership
Total participants, beginning-of-year2007-08-01466
Total number of active participants reported on line 7a of the Form 55002007-08-01466
Number of retired or separated participants receiving benefits2007-08-010
Number of other retired or separated participants entitled to future benefits2007-08-010
Total of all active and inactive participants2007-08-01466
2006: HEARTLAND CATFISH COMPANY, INC. PRETAX BENEFIT PLAN 2006 401k membership
Total participants, beginning-of-year2006-08-01414
Total number of active participants reported on line 7a of the Form 55002006-08-01414
Number of retired or separated participants receiving benefits2006-08-010
Number of other retired or separated participants entitled to future benefits2006-08-010
Total of all active and inactive participants2006-08-01414
2005: HEARTLAND CATFISH COMPANY, INC. PRETAX BENEFIT PLAN 2005 401k membership
Total participants, beginning-of-year2005-08-01393
Total number of active participants reported on line 7a of the Form 55002005-08-01393
Number of retired or separated participants receiving benefits2005-08-010
Number of other retired or separated participants entitled to future benefits2005-08-010
Total of all active and inactive participants2005-08-01393
2004: HEARTLAND CATFISH COMPANY, INC. PRETAX BENEFIT PLAN 2004 401k membership
Total participants, beginning-of-year2004-08-01370
Total number of active participants reported on line 7a of the Form 55002004-08-01370
Number of retired or separated participants receiving benefits2004-08-010
Number of other retired or separated participants entitled to future benefits2004-08-010
Total of all active and inactive participants2004-08-01370
2003: HEARTLAND CATFISH COMPANY, INC. PRETAX BENEFIT PLAN 2003 401k membership
Total participants, beginning-of-year2003-08-01393
Total number of active participants reported on line 7a of the Form 55002003-08-01393
Number of retired or separated participants receiving benefits2003-08-010
Number of other retired or separated participants entitled to future benefits2003-08-010
Total of all active and inactive participants2003-08-01393
2002: HEARTLAND CATFISH COMPANY, INC. PRETAX BENEFIT PLAN 2002 401k membership
Total participants, beginning-of-year2002-08-01396
Total number of active participants reported on line 7a of the Form 55002002-08-01396
Number of retired or separated participants receiving benefits2002-08-010
Number of other retired or separated participants entitled to future benefits2002-08-010
Total of all active and inactive participants2002-08-01396
2001: HEARTLAND CATFISH COMPANY, INC. PRETAX BENEFIT PLAN 2001 401k membership
Total participants, beginning-of-year2001-08-01285
Total number of active participants reported on line 7a of the Form 55002001-08-01285
Number of retired or separated participants receiving benefits2001-08-010
Number of other retired or separated participants entitled to future benefits2001-08-010
Total of all active and inactive participants2001-08-01285
2000: HEARTLAND CATFISH COMPANY, INC. PRETAX BENEFIT PLAN 2000 401k membership
Total participants, beginning-of-year2000-08-01342
Total number of active participants reported on line 7a of the Form 55002000-08-01342
Number of retired or separated participants receiving benefits2000-08-010
Number of other retired or separated participants entitled to future benefits2000-08-010
Total of all active and inactive participants2000-08-01342

Form 5500 Responses for HEARTLAND CATFISH COMPANY, INC. PRETAX BENEFIT PLAN

2021: HEARTLAND CATFISH COMPANY, INC. PRETAX BENEFIT PLAN 2021 form 5500 responses
2021-08-01Type of plan entitySingle employer plan
2021-08-01Plan funding arrangement – InsuranceYes
2021-08-01Plan funding arrangement – General assets of the sponsorYes
2021-08-01Plan benefit arrangement – InsuranceYes
2021-08-01Plan benefit arrangement – General assets of the sponsorYes
2020: HEARTLAND CATFISH COMPANY, INC. PRETAX BENEFIT PLAN 2020 form 5500 responses
2020-08-01Type of plan entitySingle employer plan
2020-08-01Plan funding arrangement – InsuranceYes
2020-08-01Plan funding arrangement – General assets of the sponsorYes
2020-08-01Plan benefit arrangement – InsuranceYes
2020-08-01Plan benefit arrangement – General assets of the sponsorYes
2019: HEARTLAND CATFISH COMPANY, INC. PRETAX BENEFIT PLAN 2019 form 5500 responses
2019-08-01Type of plan entitySingle employer plan
2019-08-01Plan funding arrangement – InsuranceYes
2019-08-01Plan funding arrangement – General assets of the sponsorYes
2019-08-01Plan benefit arrangement – InsuranceYes
2019-08-01Plan benefit arrangement – General assets of the sponsorYes
2018: HEARTLAND CATFISH COMPANY, INC. PRETAX BENEFIT PLAN 2018 form 5500 responses
2018-08-01Type of plan entitySingle employer plan
2018-08-01Plan funding arrangement – InsuranceYes
2018-08-01Plan funding arrangement – General assets of the sponsorYes
2018-08-01Plan benefit arrangement – InsuranceYes
2018-08-01Plan benefit arrangement – General assets of the sponsorYes
2018-01-01Type of plan entitySingle employer plan
2018-01-01This return/report is a short plan year return/report (less than 12 months)Yes
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – General assets of the sponsorYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – General assets of the sponsorYes
2017: HEARTLAND CATFISH COMPANY, INC. PRETAX BENEFIT PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: HEARTLAND CATFISH COMPANY, INC. PRETAX BENEFIT PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: HEARTLAND CATFISH COMPANY, INC. PRETAX BENEFIT PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: HEARTLAND CATFISH COMPANY, INC. PRETAX BENEFIT PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: HEARTLAND CATFISH COMPANY, INC. PRETAX BENEFIT PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: HEARTLAND CATFISH COMPANY, INC. PRETAX BENEFIT PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: HEARTLAND CATFISH COMPANY, INC. PRETAX BENEFIT PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2010: HEARTLAND CATFISH COMPANY, INC. PRETAX BENEFIT PLAN 2010 form 5500 responses
2010-08-01Type of plan entitySingle employer plan
2010-08-01Submission has been amendedNo
2010-08-01This submission is the final filingNo
2010-08-01This return/report is a short plan year return/report (less than 12 months)Yes
2010-08-01Plan is a collectively bargained planNo
2010-08-01Plan funding arrangement – InsuranceYes
2010-08-01Plan benefit arrangement – InsuranceYes
2009: HEARTLAND CATFISH COMPANY, INC. PRETAX BENEFIT PLAN 2009 form 5500 responses
2009-08-01Type of plan entitySingle employer plan
2009-08-01Submission has been amendedNo
2009-08-01This submission is the final filingNo
2009-08-01This return/report is a short plan year return/report (less than 12 months)No
2009-08-01Plan is a collectively bargained planNo
2009-08-01Plan funding arrangement – InsuranceYes
2009-08-01Plan benefit arrangement – InsuranceYes
2008: HEARTLAND CATFISH COMPANY, INC. PRETAX BENEFIT PLAN 2008 form 5500 responses
2008-08-01Type of plan entitySingle employer plan
2008-08-01Submission has been amendedNo
2008-08-01This submission is the final filingNo
2008-08-01This return/report is a short plan year return/report (less than 12 months)No
2008-08-01Plan is a collectively bargained planNo
2008-08-01Plan funding arrangement – InsuranceYes
2008-08-01Plan benefit arrangement – InsuranceYes
2007: HEARTLAND CATFISH COMPANY, INC. PRETAX BENEFIT PLAN 2007 form 5500 responses
2007-08-01Type of plan entitySingle employer plan
2007-08-01Submission has been amendedNo
2007-08-01This submission is the final filingNo
2007-08-01This return/report is a short plan year return/report (less than 12 months)No
2007-08-01Plan is a collectively bargained planNo
2007-08-01Plan funding arrangement – InsuranceYes
2007-08-01Plan benefit arrangement – InsuranceYes
2006: HEARTLAND CATFISH COMPANY, INC. PRETAX BENEFIT PLAN 2006 form 5500 responses
2006-08-01Type of plan entitySingle employer plan
2006-08-01Submission has been amendedNo
2006-08-01This submission is the final filingNo
2006-08-01This return/report is a short plan year return/report (less than 12 months)No
2006-08-01Plan is a collectively bargained planNo
2006-08-01Plan funding arrangement – InsuranceYes
2006-08-01Plan benefit arrangement – InsuranceYes
2005: HEARTLAND CATFISH COMPANY, INC. PRETAX BENEFIT PLAN 2005 form 5500 responses
2005-08-01Type of plan entitySingle employer plan
2005-08-01Submission has been amendedNo
2005-08-01This submission is the final filingNo
2005-08-01This return/report is a short plan year return/report (less than 12 months)No
2005-08-01Plan is a collectively bargained planNo
2005-08-01Plan funding arrangement – InsuranceYes
2005-08-01Plan benefit arrangement – InsuranceYes
2004: HEARTLAND CATFISH COMPANY, INC. PRETAX BENEFIT PLAN 2004 form 5500 responses
2004-08-01Type of plan entitySingle employer plan
2004-08-01Submission has been amendedNo
2004-08-01This submission is the final filingNo
2004-08-01This return/report is a short plan year return/report (less than 12 months)No
2004-08-01Plan is a collectively bargained planNo
2004-08-01Plan funding arrangement – InsuranceYes
2004-08-01Plan benefit arrangement – InsuranceYes
2003: HEARTLAND CATFISH COMPANY, INC. PRETAX BENEFIT PLAN 2003 form 5500 responses
2003-08-01Type of plan entitySingle employer plan
2003-08-01Submission has been amendedNo
2003-08-01This submission is the final filingNo
2003-08-01This return/report is a short plan year return/report (less than 12 months)No
2003-08-01Plan is a collectively bargained planNo
2003-08-01Plan funding arrangement – InsuranceYes
2003-08-01Plan benefit arrangement – InsuranceYes
2002: HEARTLAND CATFISH COMPANY, INC. PRETAX BENEFIT PLAN 2002 form 5500 responses
2002-08-01Type of plan entitySingle employer plan
2002-08-01Submission has been amendedNo
2002-08-01This submission is the final filingNo
2002-08-01This return/report is a short plan year return/report (less than 12 months)No
2002-08-01Plan is a collectively bargained planNo
2002-08-01Plan funding arrangement – InsuranceYes
2002-08-01Plan benefit arrangement – InsuranceYes
2001: HEARTLAND CATFISH COMPANY, INC. PRETAX BENEFIT PLAN 2001 form 5500 responses
2001-08-01Type of plan entitySingle employer plan
2001-08-01Submission has been amendedNo
2001-08-01This submission is the final filingNo
2001-08-01This return/report is a short plan year return/report (less than 12 months)No
2001-08-01Plan is a collectively bargained planNo
2001-08-01Plan funding arrangement – InsuranceYes
2001-08-01Plan benefit arrangement – InsuranceYes
2000: HEARTLAND CATFISH COMPANY, INC. PRETAX BENEFIT PLAN 2000 form 5500 responses
2000-08-01Type of plan entitySingle employer plan
2000-08-01First time form 5500 has been submittedYes
2000-08-01Submission has been amendedYes
2000-08-01This submission is the final filingNo
2000-08-01This return/report is a short plan year return/report (less than 12 months)No
2000-08-01Plan is a collectively bargained planNo
2000-08-01Plan funding arrangement – InsuranceYes
2000-08-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number10-48448
Policy instance 3
Insurance contract or identification number10-48448
Number of Individuals Covered602
Insurance policy start date2021-08-01
Insurance policy end date2022-07-31
Total amount of commissions paid to insurance brokerUSD $10,699
Total amount of fees paid to insurance companyUSD $754
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $106,994
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,699
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerFEES
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number947148
Policy instance 2
Insurance contract or identification number947148
Number of Individuals Covered410
Insurance policy start date2021-08-01
Insurance policy end date2022-07-31
Total amount of commissions paid to insurance brokerUSD $5,119
Total amount of fees paid to insurance companyUSD $3,150
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $51,193
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,691
Amount paid for insurance broker fees3150
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 )
Policy contract numberGTU-5091792
Policy instance 1
Insurance contract or identification numberGTU-5091792
Number of Individuals Covered70
Insurance policy start date2021-08-01
Insurance policy end date2022-07-31
Total amount of commissions paid to insurance brokerUSD $1,924
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $12,825
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,924
Amount paid for insurance broker fees0
Insurance broker organization code?3
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number010-48448
Policy instance 3
Insurance contract or identification number010-48448
Number of Individuals Covered633
Insurance policy start date2020-08-01
Insurance policy end date2021-07-31
Total amount of commissions paid to insurance brokerUSD $9,975
Total amount of fees paid to insurance companyUSD $801
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $99,747
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,975
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerFEES
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number556861
Policy instance 2
Insurance contract or identification number556861
Number of Individuals Covered215
Insurance policy start date2020-08-01
Insurance policy end date2021-07-31
Total amount of commissions paid to insurance brokerUSD $4,700
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $46,999
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,276
Amount paid for insurance broker fees0
Insurance broker organization code?3
ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 )
Policy contract numberGTU-5091792-05
Policy instance 1
Insurance contract or identification numberGTU-5091792-05
Number of Individuals Covered215
Insurance policy start date2020-08-01
Insurance policy end date2021-07-31
Total amount of commissions paid to insurance brokerUSD $2,117
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $14,115
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $1,266
Amount paid for insurance broker fees0
Insurance broker organization code?3
ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 )
Policy contract numberGTU-5091792-05
Policy instance 1
Insurance contract or identification numberGTU-5091792-05
Number of Individuals Covered401
Insurance policy start date2019-08-01
Insurance policy end date2020-07-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number556861
Policy instance 2
Insurance contract or identification number556861
Number of Individuals Covered344
Insurance policy start date2019-08-01
Insurance policy end date2020-07-31
Total amount of commissions paid to insurance brokerUSD $3,984
Total amount of fees paid to insurance companyUSD $2,594
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $50,245
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,025
Amount paid for insurance broker fees2594
Insurance broker organization code?3
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number010-48448
Policy instance 3
Insurance contract or identification number010-48448
Number of Individuals Covered882
Insurance policy start date2019-08-01
Insurance policy end date2020-07-31
Total amount of commissions paid to insurance brokerUSD $13,899
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $129,083
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,908
Amount paid for insurance broker fees0
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number56861
Policy instance 2
Insurance contract or identification number56861
Number of Individuals Covered461
Insurance policy start date2018-08-01
Insurance policy end date2019-07-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
AMERITAS LIFE INSURANCE CORP (National Association of Insurance Commissioners NAIC id number: 60033 )
Policy contract number010-48448
Policy instance 3
Insurance contract or identification number010-48448
Number of Individuals Covered461
Insurance policy start date2018-08-01
Insurance policy end date2019-07-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 )
Policy contract numberGTU-5091792-05
Policy instance 1
Insurance contract or identification numberGTU-5091792-05
Number of Individuals Covered461
Insurance policy start date2018-08-01
Insurance policy end date2019-07-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 )
Policy contract numberGTU-5091792-05
Policy instance 1
Insurance contract or identification numberGTU-5091792-05
Number of Individuals Covered461
Insurance policy start date2018-01-01
Insurance policy end date2018-07-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number5479028
Policy instance 2
Insurance contract or identification number5479028
Number of Individuals Covered461
Insurance policy start date2018-01-01
Insurance policy end date2018-07-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number5479028
Policy instance 2
Insurance contract or identification number5479028
Number of Individuals Covered414
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $4,417
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedGROUP TERM LIFE AD&D
Welfare Benefit Premiums Paid to CarrierUSD $44,167
Commission paid to Insurance BrokerUSD $4,417
Additional information about fees paid to insurance brokerCOMMISSION
Insurance broker organization code?3
Insurance broker nameGROUP ASSOCIATES LLC
ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 )
Policy contract numberGTU-5091792-05
Policy instance 1
Insurance contract or identification numberGTU-5091792-05
Number of Individuals Covered106
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $2,950
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $19,669
Commission paid to Insurance BrokerUSD $2,950
Additional information about fees paid to insurance brokerCOMMISSION
Insurance broker organization code?3
Insurance broker nameSAM D. MAKAMSON
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number010-376348
Policy instance 5
Insurance contract or identification number010-376348
Number of Individuals Covered433
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $1,959
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $87,874
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,959
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerCOMMISSION
Insurance broker organization code?3
Insurance broker nameSAM D. MAKAMSON
ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 )
Policy contract numberGTU-5091792-05
Policy instance 1
Insurance contract or identification numberGTU-5091792-05
Number of Individuals Covered106
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $2,908
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $19,388
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,908
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerCOMMISSION
Insurance broker organization code?3
Insurance broker nameSAM D. MAKAMSON
BLUE CROSS BLUE SHIELD OF MS, INC. (National Association of Insurance Commissioners NAIC id number: 60111 )
Policy contract number0007919
Policy instance 2
Insurance contract or identification number0007919
Number of Individuals Covered593
Insurance policy start date2015-01-01
Insurance policy end date2015-07-31
Total amount of commissions paid to insurance brokerUSD $8,293
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,293
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerCOMMISSION
Insurance broker organization code?3
Insurance broker nameSAM D. MAKAMSON
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00475092
Policy instance 3
Insurance contract or identification number00475092
Number of Individuals Covered430
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $5,732
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,732
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerCOMMISSION
Insurance broker organization code?3
Insurance broker nameGROUP ASSOCIATES, LLC
GREENWICH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 22322 )
Policy contract numberSXTG1003-15
Policy instance 4
Insurance contract or identification numberSXTG1003-15
Number of Individuals Covered448
Insurance policy start date2015-08-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $12,383
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $123,832
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,192
Additional information about fees paid to insurance brokerCOMMISSION
Insurance broker organization code?3
Insurance broker nameKENNETH MCINTOSH
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number010-376348
Policy instance 4
Insurance contract or identification number010-376348
Number of Individuals Covered444
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $4,177
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $129,888
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,177
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerCOMMISSION
Insurance broker organization code?3
Insurance broker nameSAM D. MAKAMSON
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00475092
Policy instance 3
Insurance contract or identification number00475092
Number of Individuals Covered429
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $6,049
Total amount of fees paid to insurance companyUSD $1,072
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,049
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerCOMMISSION
Insurance broker organization code?3
Insurance broker nameGROUP ASSOCIATES, LLC
BLUE CROSS BLUE SHIELD OF MS, INC. (National Association of Insurance Commissioners NAIC id number: 60111 )
Policy contract number07919, 29981
Policy instance 2
Insurance contract or identification number07919, 29981
Number of Individuals Covered596
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $12,611
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,611
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerCOMMISSION
Insurance broker organization code?3
Insurance broker nameSAM D. MAKAMSON
ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 )
Policy contract numberGTU-5091792-04
Policy instance 1
Insurance contract or identification numberGTU-5091792-04
Number of Individuals Covered429
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $3,094
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $20,630
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,094
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerCOMMISSION
Insurance broker organization code?3
Insurance broker nameSAM D. MAKAMSON
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number010-376348
Policy instance 4
Insurance contract or identification number010-376348
Number of Individuals Covered383
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $3,808
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $99,649
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,808
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerCOMMISSION
Insurance broker organization code?3
Insurance broker nameSAM D. MAKAMSON
ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 )
Policy contract numberGTU-5091792-03
Policy instance 1
Insurance contract or identification numberGTU-5091792-03
Number of Individuals Covered368
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $2,739
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $18,262
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,739
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerCOMMISSION
Insurance broker organization code?3
Insurance broker nameSAM D. MAKAMSON
BLUE CROSS BLUE SHIELD OF MS, INC. (National Association of Insurance Commissioners NAIC id number: 60111 )
Policy contract number07919, 29981
Policy instance 2
Insurance contract or identification number07919, 29981
Number of Individuals Covered481
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $10,228
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,228
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerCOMMISSION
Insurance broker organization code?3
Insurance broker nameSAM D. MAKAMSON
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00475092
Policy instance 3
Insurance contract or identification number00475092
Number of Individuals Covered368
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $4,067
Total amount of fees paid to insurance companyUSD $1,243
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,067
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerCOMMISSION
Insurance broker organization code?3
Insurance broker nameGROUP ASSOCIATES, LLC
BLUE CROSS BLUE SHIELD OF MS, INC. (National Association of Insurance Commissioners NAIC id number: 60111 )
Policy contract number0007919 ET AL
Policy instance 1
Insurance contract or identification number0007919 ET AL
Number of Individuals Covered489
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $10,378
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,378
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerSERVICE FEE
Insurance broker organization code?3
Insurance broker nameSAM D. MAKAMSON
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number010-376348
Policy instance 2
Insurance contract or identification number010-376348
Number of Individuals Covered370
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $3,485
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,485
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerSERVICE FEE
Insurance broker organization code?3
Insurance broker nameSAM D. MAKAMSON
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number010-376348
Policy instance 2
Insurance contract or identification number010-376348
Number of Individuals Covered370
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $3,233
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
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 number0007919 ET AL
Policy instance 1
Insurance contract or identification number0007919 ET AL
Number of Individuals Covered524
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $9,791
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number010-376348
Policy instance 2
Insurance contract or identification number010-376348
Number of Individuals Covered440
Insurance policy start date2010-08-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $3,686
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
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 number07919,29981,401
Policy instance 1
Insurance contract or identification number07919,29981,401
Number of Individuals Covered567
Insurance policy start date2010-08-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $12,027
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number010-376348
Policy instance 1
Insurance contract or identification number010-376348
Number of Individuals Covered439
Insurance policy start date2008-08-01
Insurance policy end date2009-07-31
Total amount of commissions paid to insurance brokerUSD $3,531
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,531
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerSERVICE FEE
Insurance broker organization code?3
Insurance broker nameSAM D. MAKAMSON
BLUE CROSS BLUE SHIELD OF MS, INC. (National Association of Insurance Commissioners NAIC id number: 60111 )
Policy contract number07919,29981,401
Policy instance 2
Insurance contract or identification number07919,29981,401
Number of Individuals Covered509
Insurance policy start date2008-08-01
Insurance policy end date2009-07-31
Total amount of commissions paid to insurance brokerUSD $10,108
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,108
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerSERVICE FEE
Insurance broker organization code?3
Insurance broker nameSAM D. MAKAMSON
BLUE CROSS BLUE SHIELD OF MS, INC. (National Association of Insurance Commissioners NAIC id number: 60111 )
Policy contract number07919,29981,401
Policy instance 2
Insurance contract or identification number07919,29981,401
Number of Individuals Covered466
Insurance policy start date2007-08-01
Insurance policy end date2008-07-31
Total amount of commissions paid to insurance brokerUSD $8,885
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,885
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerSERVICE FEE
Insurance broker organization code?3
Insurance broker nameSAM D. MAKAMSON
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number010-376348
Policy instance 1
Insurance contract or identification number010-376348
Number of Individuals Covered390
Insurance policy start date2007-08-01
Insurance policy end date2008-07-31
Total amount of commissions paid to insurance brokerUSD $3,440
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,440
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerSERVICE FEE
Insurance broker organization code?3
Insurance broker nameSAM D. MAKAMSON
BLUE CROSS BLUE SHIELD OF MS, INC. (National Association of Insurance Commissioners NAIC id number: 60111 )
Policy contract number07919,29981,401
Policy instance 2
Insurance contract or identification number07919,29981,401
Number of Individuals Covered414
Insurance policy start date2006-08-01
Insurance policy end date2007-07-31
Total amount of commissions paid to insurance brokerUSD $7,740
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,740
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerSERVICE FEE
Insurance broker organization code?3
Insurance broker nameSAM D. MAKAMSON
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number010-376348
Policy instance 1
Insurance contract or identification number010-376348
Number of Individuals Covered373
Insurance policy start date2006-08-01
Insurance policy end date2007-07-31
Total amount of commissions paid to insurance brokerUSD $3,391
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,391
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerSERVICE FEE
Insurance broker organization code?3
Insurance broker nameSAM D. MAKAMSON
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number010-376348
Policy instance 2
Insurance contract or identification number010-376348
Number of Individuals Covered393
Insurance policy start date2005-08-01
Insurance policy end date2006-07-31
Total amount of commissions paid to insurance brokerUSD $2,809
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,809
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerSERVICE FEE
Insurance broker organization code?3
Insurance broker nameSAM D. MAKAMSON
BLUE CROSS BLUE SHIELD OF MS, INC. (National Association of Insurance Commissioners NAIC id number: 60111 )
Policy contract number07919,29981,401
Policy instance 1
Insurance contract or identification number07919,29981,401
Number of Individuals Covered366
Insurance policy start date2005-08-01
Insurance policy end date2006-07-31
Total amount of commissions paid to insurance brokerUSD $7,666
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,666
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerSERVICE FEE
Insurance broker organization code?3
Insurance broker nameSAM D. MAKAMSON
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number010-376348
Policy instance 2
Insurance contract or identification number010-376348
Number of Individuals Covered370
Insurance policy start date2004-08-01
Insurance policy end date2005-07-31
Total amount of commissions paid to insurance brokerUSD $3,879
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,879
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerSERVICE FEE
Insurance broker organization code?3
Insurance broker nameSAM D. MAKAMSON
BLUE CROSS BLUE SHIELD OF MS, INC. (National Association of Insurance Commissioners NAIC id number: 60111 )
Policy contract number07919,29981,401
Policy instance 1
Insurance contract or identification number07919,29981,401
Number of Individuals Covered323
Insurance policy start date2004-08-01
Insurance policy end date2005-07-31
Total amount of commissions paid to insurance brokerUSD $7,089
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,089
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerSERVICE FEE
Insurance broker organization code?3
Insurance broker nameSAM D. MAKAMSON
BLUE CROSS BLUE SHIELD OF MS, INC. (National Association of Insurance Commissioners NAIC id number: 60111 )
Policy contract number07919,29981,401
Policy instance 1
Insurance contract or identification number07919,29981,401
Number of Individuals Covered295
Insurance policy start date2003-08-01
Insurance policy end date2004-07-31
Total amount of commissions paid to insurance brokerUSD $6,213
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,213
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerSERVICE FEE
Insurance broker organization code?3
Insurance broker nameSAM D. MAKAMSON
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number010-376348
Policy instance 2
Insurance contract or identification number010-376348
Number of Individuals Covered393
Insurance policy start date2003-08-01
Insurance policy end date2004-07-31
Total amount of commissions paid to insurance brokerUSD $3,402
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,402
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerSERVICE FEE
Insurance broker organization code?3
Insurance broker nameSAM D. MAKAMSON
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number010-376348
Policy instance 2
Insurance contract or identification number010-376348
Number of Individuals Covered396
Insurance policy start date2002-08-01
Insurance policy end date2003-07-31
Total amount of commissions paid to insurance brokerUSD $2,700
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,700
Additional information about fees paid to insurance brokerSERVICE FEE
Insurance broker organization code?3
Insurance broker nameSAM D. MAKAMSON
BLUE CROSS BLUE SHIELD OF MS, INC. (National Association of Insurance Commissioners NAIC id number: 60111 )
Policy contract number07919,29981,401
Policy instance 1
Insurance contract or identification number07919,29981,401
Number of Individuals Covered263
Insurance policy start date2002-08-01
Insurance policy end date2003-07-31
Total amount of commissions paid to insurance brokerUSD $5,640
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,640
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerSERVICE FEE
Insurance broker organization code?3
Insurance broker nameSAM D. MAKAMSON
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number010-376348
Policy instance 2
Insurance contract or identification number010-376348
Number of Individuals Covered285
Insurance policy start date2001-08-01
Insurance policy end date2002-07-31
Total amount of commissions paid to insurance brokerUSD $2,963
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,963
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerSERVICE FEE
Insurance broker organization code?3
Insurance broker nameSAM D. MAKAMSON
BLUE CROSS BLUE SHIELD OF MS, INC. (National Association of Insurance Commissioners NAIC id number: 60111 )
Policy contract number07919,29981,401
Policy instance 1
Insurance contract or identification number07919,29981,401
Number of Individuals Covered269
Insurance policy start date2001-08-01
Insurance policy end date2002-07-31
Total amount of commissions paid to insurance brokerUSD $6,471
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,471
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerSERVICE FEE
Insurance broker organization code?3
Insurance broker nameSAM D. MAKAMSON
BLUE CROSS BLUE SHIELD OF MS, INC. (National Association of Insurance Commissioners NAIC id number: 60111 )
Policy contract number0007919 ET AL
Policy instance 2
Insurance contract or identification number0007919 ET AL
Insurance policy start date2000-08-01
Insurance policy end date2001-07-31
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Number of Individuals Covered269
Total amount of commissions paid to insurance brokerUSD $4,523
Commission paid to Insurance BrokerUSD $4,523
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerSERVICE FEE
Insurance broker organization code?3
Insurance broker nameSAM D. MAKAMSON
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number010-376348
Policy instance 1
Insurance contract or identification number010-376348
Number of Individuals Covered342
Insurance policy start date2000-08-01
Insurance policy end date2001-07-31
Total amount of commissions paid to insurance brokerUSD $4,006
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,006
Additional information about fees paid to insurance brokerSERVICE FEE
Insurance broker organization code?3
Insurance broker nameSAM D. MAKAMSON

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