BIG M TRANSPORTATION INC has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan BIG M TRANSPORATION, INC. 6341 B HIGHWAY 15 BLUE MOUNTAIN, MS 38610
401k plan membership statisitcs for BIG M TRANSPORATION, INC. 6341 B HIGHWAY 15 BLUE MOUNTAIN, MS 38610
| Measure | Date | Value |
|---|
| 2021: BIG M TRANSPORATION, INC. 6341 B HIGHWAY 15 BLUE MOUNTAIN, MS 38610 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-10-01 | 222 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-10-01 | 271 |
| Number of retired or separated participants receiving benefits | 2021-10-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2021-10-01 | 0 |
| Total of all active and inactive participants | 2021-10-01 | 271 |
| 2020: BIG M TRANSPORATION, INC. 6341 B HIGHWAY 15 BLUE MOUNTAIN, MS 38610 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-10-01 | 193 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-10-01 | 222 |
| Number of retired or separated participants receiving benefits | 2020-10-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2020-10-01 | 0 |
| Total of all active and inactive participants | 2020-10-01 | 222 |
| 2019: BIG M TRANSPORATION, INC. 6341 B HIGHWAY 15 BLUE MOUNTAIN, MS 38610 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-10-01 | 230 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-10-01 | 193 |
| Number of retired or separated participants receiving benefits | 2019-10-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2019-10-01 | 0 |
| Total of all active and inactive participants | 2019-10-01 | 193 |
| 2018: BIG M TRANSPORATION, INC. 6341 B HIGHWAY 15 BLUE MOUNTAIN, MS 38610 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-10-01 | 209 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-10-01 | 230 |
| Number of retired or separated participants receiving benefits | 2018-10-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2018-10-01 | 0 |
| Total of all active and inactive participants | 2018-10-01 | 230 |
| 2017: BIG M TRANSPORATION, INC. 6341 B HIGHWAY 15 BLUE MOUNTAIN, MS 38610 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-10-01 | 219 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-10-01 | 209 |
| Number of retired or separated participants receiving benefits | 2017-10-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2017-10-01 | 0 |
| Total of all active and inactive participants | 2017-10-01 | 209 |
| 2016: BIG M TRANSPORATION, INC. 6341 B HIGHWAY 15 BLUE MOUNTAIN, MS 38610 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-10-01 | 213 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-10-01 | 219 |
| Number of retired or separated participants receiving benefits | 2016-10-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2016-10-01 | 0 |
| Total of all active and inactive participants | 2016-10-01 | 219 |
| 2015: BIG M TRANSPORATION, INC. 6341 B HIGHWAY 15 BLUE MOUNTAIN, MS 38610 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-10-01 | 161 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-10-01 | 213 |
| Number of retired or separated participants receiving benefits | 2015-10-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2015-10-01 | 0 |
| Total of all active and inactive participants | 2015-10-01 | 213 |
| 2014: BIG M TRANSPORATION, INC. 6341 B HIGHWAY 15 BLUE MOUNTAIN, MS 38610 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-10-01 | 175 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-10-01 | 161 |
| Number of retired or separated participants receiving benefits | 2014-10-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2014-10-01 | 0 |
| Total of all active and inactive participants | 2014-10-01 | 161 |
| 2013: BIG M TRANSPORATION, INC. 6341 B HIGHWAY 15 BLUE MOUNTAIN, MS 38610 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-10-01 | 153 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-10-01 | 175 |
| Number of retired or separated participants receiving benefits | 2013-10-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2013-10-01 | 0 |
| Total of all active and inactive participants | 2013-10-01 | 175 |
| 2012: BIG M TRANSPORATION, INC. 6341 B HIGHWAY 15 BLUE MOUNTAIN, MS 38610 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-10-01 | 175 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-10-01 | 153 |
| Number of retired or separated participants receiving benefits | 2012-10-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2012-10-01 | 0 |
| Total of all active and inactive participants | 2012-10-01 | 153 |
| 2011: BIG M TRANSPORATION, INC. 6341 B HIGHWAY 15 BLUE MOUNTAIN, MS 38610 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-10-01 | 168 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-10-01 | 175 |
| Number of retired or separated participants receiving benefits | 2011-10-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2011-10-01 | 0 |
| Total of all active and inactive participants | 2011-10-01 | 175 |
| 2010: BIG M TRANSPORATION, INC. 6341 B HIGHWAY 15 BLUE MOUNTAIN, MS 38610 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-10-01 | 151 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-10-01 | 168 |
| Number of retired or separated participants receiving benefits | 2010-10-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2010-10-01 | 0 |
| Total of all active and inactive participants | 2010-10-01 | 168 |
| 2021: BIG M TRANSPORATION, INC. 6341 B HIGHWAY 15 BLUE MOUNTAIN, MS 38610 2021 form 5500 responses |
|---|
| 2021-10-01 | Type of plan entity | Single employer plan |
| 2021-10-01 | Plan funding arrangement – Insurance | Yes |
| 2021-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2020: BIG M TRANSPORATION, INC. 6341 B HIGHWAY 15 BLUE MOUNTAIN, MS 38610 2020 form 5500 responses |
|---|
| 2020-10-01 | Type of plan entity | Single employer plan |
| 2020-10-01 | Plan funding arrangement – Insurance | Yes |
| 2020-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2019: BIG M TRANSPORATION, INC. 6341 B HIGHWAY 15 BLUE MOUNTAIN, MS 38610 2019 form 5500 responses |
|---|
| 2019-10-01 | Type of plan entity | Single employer plan |
| 2019-10-01 | Plan funding arrangement – Insurance | Yes |
| 2019-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: BIG M TRANSPORATION, INC. 6341 B HIGHWAY 15 BLUE MOUNTAIN, MS 38610 2018 form 5500 responses |
|---|
| 2018-10-01 | Type of plan entity | Single employer plan |
| 2018-10-01 | Plan funding arrangement – Insurance | Yes |
| 2018-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: BIG M TRANSPORATION, INC. 6341 B HIGHWAY 15 BLUE MOUNTAIN, MS 38610 2017 form 5500 responses |
|---|
| 2017-10-01 | Type of plan entity | Single employer plan |
| 2017-10-01 | Plan funding arrangement – Insurance | Yes |
| 2017-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: BIG M TRANSPORATION, INC. 6341 B HIGHWAY 15 BLUE MOUNTAIN, MS 38610 2016 form 5500 responses |
|---|
| 2016-10-01 | Type of plan entity | Single employer plan |
| 2016-10-01 | Plan funding arrangement – Insurance | Yes |
| 2016-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: BIG M TRANSPORATION, INC. 6341 B HIGHWAY 15 BLUE MOUNTAIN, MS 38610 2015 form 5500 responses |
|---|
| 2015-10-01 | Type of plan entity | Single employer plan |
| 2015-10-01 | Plan funding arrangement – Insurance | Yes |
| 2015-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: BIG M TRANSPORATION, INC. 6341 B HIGHWAY 15 BLUE MOUNTAIN, MS 38610 2014 form 5500 responses |
|---|
| 2014-10-01 | Type of plan entity | Single employer plan |
| 2014-10-01 | Plan funding arrangement – Insurance | Yes |
| 2014-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: BIG M TRANSPORATION, INC. 6341 B HIGHWAY 15 BLUE MOUNTAIN, MS 38610 2013 form 5500 responses |
|---|
| 2013-10-01 | Type of plan entity | Single employer plan |
| 2013-10-01 | Plan funding arrangement – Insurance | Yes |
| 2013-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: BIG M TRANSPORATION, INC. 6341 B HIGHWAY 15 BLUE MOUNTAIN, MS 38610 2012 form 5500 responses |
|---|
| 2012-10-01 | Type of plan entity | Single employer plan |
| 2012-10-01 | Plan funding arrangement – Insurance | Yes |
| 2012-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: BIG M TRANSPORATION, INC. 6341 B HIGHWAY 15 BLUE MOUNTAIN, MS 38610 2011 form 5500 responses |
|---|
| 2011-10-01 | Type of plan entity | Single employer plan |
| 2011-10-01 | Plan funding arrangement – Insurance | Yes |
| 2011-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2010: BIG M TRANSPORATION, INC. 6341 B HIGHWAY 15 BLUE MOUNTAIN, MS 38610 2010 form 5500 responses |
|---|
| 2010-10-01 | Type of plan entity | Single employer plan |
| 2010-10-01 | Plan funding arrangement – Insurance | Yes |
| 2010-10-01 | Plan benefit arrangement – Insurance | Yes |
| PAUL REVERE VARIABLE ANNUITY INS. CO. (National Association of Insurance Commissioners NAIC id number: 67601 ) |
| Policy contract number | 478615 |
| Policy instance | 8 |
| Insurance contract or identification number | 478615 | | Number of Individuals Covered | 86 | | Insurance policy start date | 2021-10-01 | | Insurance policy end date | 2022-09-30 | | Total amount of commissions paid to insurance broker | USD $11,778 | | Total amount of fees paid to insurance company | USD $1,073 | | Other welfare benefits provided | GRP ACCIDENT | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $11,778 | | Amount paid for insurance broker fees | 1073 | | Additional information about fees paid to insurance broker | AGENT COMMISSIONS/CONSULTING | | Insurance broker organization code? | 3 |
|
| BLUE CROSS BLUE SHIELD OF MS, INC. (National Association of Insurance Commissioners NAIC id number: 60111 ) |
| Policy contract number | 064404 |
| Policy instance | 1 |
| Insurance contract or identification number | 064404 | | Number of Individuals Covered | 271 | | Insurance policy start date | 2021-10-01 | | Insurance policy end date | 2022-09-30 | | Total amount of commissions paid to insurance broker | USD $66,000 | | 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 $66,000 | | Additional information about fees paid to insurance broker | AGENT COMMISSIONS/CONSULTING | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 219262 |
| Policy instance | 2 |
| Insurance contract or identification number | 219262 | | Number of Individuals Covered | 127 | | Insurance policy start date | 2021-10-01 | | Insurance policy end date | 2022-09-30 | | Total amount of commissions paid to insurance broker | USD $15,001 | | Total amount of fees paid to insurance company | USD $1,122 | | Temporary Disability 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 $15,001 | | Amount paid for insurance broker fees | 1122 | | Additional information about fees paid to insurance broker | AGENT COMMISSIONS/CONSULTING | | Insurance broker organization code? | 3 |
|
| PAUL REVERE VARIABLE ANNUITY INS. CO. (National Association of Insurance Commissioners NAIC id number: 67601 ) |
| Policy contract number | 478616 |
| Policy instance | 3 |
| Insurance contract or identification number | 478616 | | Number of Individuals Covered | 56 | | Insurance policy start date | 2021-10-01 | | Insurance policy end date | 2022-09-30 | | Total amount of commissions paid to insurance broker | USD $5,755 | | Total amount of fees paid to insurance company | USD $1,439 | | Other welfare benefits provided | ATTAINED AGE CRITICAL ILLNESS | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,755 | | Amount paid for insurance broker fees | 1439 | | Additional information about fees paid to insurance broker | AGENT COMMISSIONS/CONSULTING | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 497419 |
| Policy instance | 4 |
| Insurance contract or identification number | 497419 | | Number of Individuals Covered | 14 | | Insurance policy start date | 2021-10-01 | | Insurance policy end date | 2022-09-30 | | Total amount of commissions paid to insurance broker | USD $1,947 | | Total amount of fees paid to insurance company | USD $582 | | Long Term Disability 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 $1,947 | | Amount paid for insurance broker fees | 582 | | Additional information about fees paid to insurance broker | AGENT COMMISSIONS/CONSULTING | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 497420 |
| Policy instance | 5 |
| Insurance contract or identification number | 497420 | | Number of Individuals Covered | 73 | | Insurance policy start date | 2021-10-01 | | Insurance policy end date | 2022-09-30 | | Total amount of commissions paid to insurance broker | USD $5,738 | | Total amount of fees paid to insurance company | USD $1,845 | | Other welfare benefits provided | SELECT LONG TERM DISABILITY | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,738 | | Amount paid for insurance broker fees | 1845 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 478613 |
| Policy instance | 6 |
| Insurance contract or identification number | 478613 | | Number of Individuals Covered | 216 | | Insurance policy start date | 2021-10-01 | | Insurance policy end date | 2022-09-30 | | Total amount of commissions paid to insurance broker | USD $14,280 | | Total amount of fees paid to insurance company | USD $4,693 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | LIFESTYLE ADD | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $14,280 | | Amount paid for insurance broker fees | 4693 | | Additional information about fees paid to insurance broker | AGENT COMMISSIONS/CONSULTING | | Insurance broker organization code? | 3 |
|
| STARMOUNT LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68985 ) |
| Policy contract number | 478614 |
| Policy instance | 7 |
| Insurance contract or identification number | 478614 | | Number of Individuals Covered | 252 | | Insurance policy start date | 2021-10-01 | | Insurance policy end date | 2022-09-30 | | Total amount of commissions paid to insurance broker | USD $11,846 | | Total amount of fees paid to insurance company | USD $5,295 | | Dental Insurance Welfare Benefit | Yes | | Vision 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 $11,846 | | Amount paid for insurance broker fees | 5295 | | Additional information about fees paid to insurance broker | AGENT COMMISSIONS/CONSULTING | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 219262 |
| Policy instance | 3 |
| Insurance contract or identification number | 219262 | | Number of Individuals Covered | 81 | | Insurance policy start date | 2020-10-01 | | Insurance policy end date | 2021-09-30 | | Total amount of commissions paid to insurance broker | USD $8,348 | | Total amount of fees paid to insurance company | USD $313 | | Temporary Disability 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 $8,348 | | Amount paid for insurance broker fees | 313 | | Additional information about fees paid to insurance broker | AGENT COMMISSIONS/CONSULTING | | Insurance broker organization code? | 3 |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00428259 |
| Policy instance | 2 |
| Insurance contract or identification number | 00428259 | | Number of Individuals Covered | 204 | | Insurance policy start date | 2020-10-01 | | Insurance policy end date | 2021-09-30 | | Total amount of commissions paid to insurance broker | USD $19,678 | | Total amount of fees paid to insurance company | USD $2,136 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | CRITICAL ILLNESS | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $19,678 | | Amount paid for insurance broker fees | 1480 | | Additional information about fees paid to insurance broker | AGENT COMMISSIONS/CONSULTING | | Insurance broker organization code? | 3 |
|
| BLUE CROSS BLUE SHIELD OF MS, INC. (National Association of Insurance Commissioners NAIC id number: 60111 ) |
| Policy contract number | 064404 |
| Policy instance | 1 |
| Insurance contract or identification number | 064404 | | Number of Individuals Covered | 222 | | Insurance policy start date | 2020-10-01 | | Insurance policy end date | 2021-09-30 | | Total amount of commissions paid to insurance broker | USD $56,950 | | 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 $56,950 | | Additional information about fees paid to insurance broker | AGENT COMMISSIONS/CONSULTING | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 219262 |
| Policy instance | 4 |
| Insurance contract or identification number | 219262 | | Number of Individuals Covered | 69 | | Insurance policy start date | 2019-10-01 | | Insurance policy end date | 2020-09-30 | | Total amount of commissions paid to insurance broker | USD $9,666 | | Temporary Disability 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 $5,631 | | Additional information about fees paid to insurance broker | AGENT COMMISSIONS/CONSULTING | | Insurance broker organization code? | 3 |
|
| GULF GUARANTY EMPLOYEE BENEFIT SERVICES, INC (National Association of Insurance Commissioners NAIC id number: 77976 ) |
| Policy contract number | 00800 |
| Policy instance | 3 |
| Insurance contract or identification number | 00800 | | Number of Individuals Covered | 157 | | Insurance policy start date | 2019-10-01 | | Insurance policy end date | 2020-09-30 | | Total amount of commissions paid to insurance broker | USD $35,358 | | Other welfare benefits provided | FULLY INSURED GAP PLAN | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $31,964 | | Additional information about fees paid to insurance broker | AGENT COMMISSIONS/CONSULTING | | Insurance broker organization code? | 3 |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00428259 |
| Policy instance | 2 |
| Insurance contract or identification number | 00428259 | | Number of Individuals Covered | 193 | | Insurance policy start date | 2019-10-01 | | Insurance policy end date | 2020-09-30 | | Total amount of commissions paid to insurance broker | USD $19,537 | | Total amount of fees paid to insurance company | USD $8,515 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | CRITICAL ILLNESS | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $16,516 | | Amount paid for insurance broker fees | 8515 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE COSTS | | Insurance broker organization code? | 3 |
|
| GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 ) |
| Policy contract number | GLIUME001995 |
| Policy instance | 1 |
| Insurance contract or identification number | GLIUME001995 | | Number of Individuals Covered | 156 | | Insurance policy start date | 2019-10-01 | | Insurance policy end date | 2020-09-30 | | Total amount of commissions paid to insurance broker | USD $81,140 | | Total amount of fees paid to insurance company | USD $111,002 | | Welfare Benefit Premiums Paid to Carrier | USD $274,940 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 90510 | | Additional information about fees paid to insurance broker | TPA FEES/WELLNESS PROGRAM | | Insurance broker organization code? | 5 | | Commission paid to Insurance Broker | USD $61,480 |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00428259 |
| Policy instance | 2 |
| Insurance contract or identification number | 00428259 | | Number of Individuals Covered | 196 | | Insurance policy start date | 2018-10-01 | | Insurance policy end date | 2019-09-30 | | Total amount of commissions paid to insurance broker | USD $19,439 | | Total amount of fees paid to insurance company | USD $8,097 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | CRITICAL ILLNESS | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $19,439 | | Amount paid for insurance broker fees | 8097 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE COSTS | | Insurance broker organization code? | 3 |
|
| GULF GUARANTY EMPLOYEE BENEFIT SERVICES, INC (National Association of Insurance Commissioners NAIC id number: 77976 ) |
| Policy contract number | 00800 |
| Policy instance | 3 |
| Insurance contract or identification number | 00800 | | Number of Individuals Covered | 230 | | Insurance policy start date | 2018-10-01 | | Insurance policy end date | 2019-09-30 | | Total amount of commissions paid to insurance broker | USD $42,936 | | Other welfare benefits provided | FULLY INSURED GAP PLAN | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $42,936 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE COSTS | | Insurance broker organization code? | 3 |
|
| GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 ) |
| Policy contract number | GLIUME001995 |
| Policy instance | 1 |
| Insurance contract or identification number | GLIUME001995 | | Number of Individuals Covered | 179 | | Insurance policy start date | 2018-10-01 | | Insurance policy end date | 2019-09-30 | | Total amount of commissions paid to insurance broker | USD $89,040 | | Total amount of fees paid to insurance company | USD $124,481 | | Welfare Benefit Premiums Paid to Carrier | USD $263,597 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $69,006 | | Additional information about fees paid to insurance broker | AGENT COMMISSIONS/CONSULTING | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 101449 |
|
| BLUE CROSS BLUE SHIELD OF MS, INC. (National Association of Insurance Commissioners NAIC id number: 60111 ) |
| Policy contract number | 0042566 ET AL |
| Policy instance | 1 |
| Insurance contract or identification number | 0042566 ET AL | | Number of Individuals Covered | 219 | | Insurance policy start date | 2017-10-01 | | Insurance policy end date | 2018-09-30 | | Total amount of commissions paid to insurance broker | USD $33,033 | | Health Insurance Welfare Benefit | Yes | | 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 | 00428259 |
| Policy instance | 2 |
| Insurance contract or identification number | 00428259 | | Number of Individuals Covered | 203 | | Insurance policy start date | 2017-10-01 | | Insurance policy end date | 2018-09-30 | | Total amount of commissions paid to insurance broker | USD $20,784 | | Total amount of fees paid to insurance company | USD $7,925 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | CRITICAL ILLNESS | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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