VICTORY MARKETING, LLC has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan VICTORY MARKETING, LLC BENEFIT WRAP PLAN
| Measure | Date | Value |
|---|
| 2018: VICTORY MARKETING, LLC BENEFIT WRAP PLAN 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-01-01 | 307 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 354 |
| 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 | 354 |
| 2017: VICTORY MARKETING, LLC BENEFIT WRAP PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-01-01 | 578 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 307 |
| Number of retired or separated participants receiving benefits | 2017-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2017-01-01 | 0 |
| Total of all active and inactive participants | 2017-01-01 | 307 |
| 2016: VICTORY MARKETING, LLC BENEFIT WRAP PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-01-01 | 578 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 0 |
| Number of retired or separated participants receiving benefits | 2016-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2016-01-01 | 0 |
| Total of all active and inactive participants | 2016-01-01 | 0 |
| 2015: VICTORY MARKETING, LLC BENEFIT WRAP PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-01-01 | 585 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 578 |
| Number of retired or separated participants receiving benefits | 2015-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2015-01-01 | 0 |
| Total of all active and inactive participants | 2015-01-01 | 578 |
| 2014: VICTORY MARKETING, LLC BENEFIT WRAP PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-01-01 | 545 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 504 |
| Number of retired or separated participants receiving benefits | 2014-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2014-01-01 | 0 |
| Total of all active and inactive participants | 2014-01-01 | 504 |
| 2013: VICTORY MARKETING, LLC BENEFIT WRAP PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-01-01 | 184 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 545 |
| Total of all active and inactive participants | 2013-01-01 | 545 |
| 2012: VICTORY MARKETING, LLC BENEFIT WRAP PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-01-01 | 184 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 184 |
| Total of all active and inactive participants | 2012-01-01 | 184 |
| BLUE CROSS BLUE SHIELD OF MS, INC. (National Association of Insurance Commissioners NAIC id number: 60111 ) |
| Policy contract number | 0015689 |
| Policy instance | 6 |
| Insurance contract or identification number | 0015689 | | Number of Individuals Covered | 107 | | Insurance policy start date | 2018-09-01 | | Insurance policy end date | 2019-08-31 | | Total amount of commissions paid to insurance broker | USD $21,800 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | | Commission paid to Insurance Broker | USD $21,800 |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 500124 |
| Policy instance | 5 |
| Insurance contract or identification number | 500124 | | Number of Individuals Covered | 106 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | GVTL0356J |
| Policy instance | 4 |
| Insurance contract or identification number | GVTL0356J | | Number of Individuals Covered | 45 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $3,394 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $22,626 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,394 | | Additional information about fees paid to insurance broker | AGENT OR BROKER OF RECORD | | Insurance broker organization code? | 3 |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | GLUG0356J |
| Policy instance | 3 |
| Insurance contract or identification number | GLUG0356J | | Number of Individuals Covered | 116 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $2,324 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $15,496 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,324 | | Additional information about fees paid to insurance broker | AGENT OR BROKER OF RECORD | | Insurance broker organization code? | 3 |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | GUC0356J |
| Policy instance | 2 |
| Insurance contract or identification number | GUC0356J | | Number of Individuals Covered | 112 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $1,524 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $10,158 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,524 | | Additional information about fees paid to insurance broker | AGENT OR BROKER OF RECORD | | Insurance broker organization code? | 3 |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | TS05996175 |
| Policy instance | 1 |
| Insurance contract or identification number | TS05996175 | | Number of Individuals Covered | 354 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $16,231 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $109,785 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $16,231 | | Additional information about fees paid to insurance broker | BASE COMMISSIONS | | Insurance broker organization code? | 3 |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | TS05996175 |
| Policy instance | 1 |
| Insurance contract or identification number | TS05996175 | | Number of Individuals Covered | 307 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $14,716 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $102,084 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $10,038 | | Additional information about fees paid to insurance broker | NON-MONETARY COMPENSATION | | Insurance broker organization code? | 3 | | Insurance broker name | LOCKARD & WILLIAMS INSURANCE SERVIC |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | GUC0356J |
| Policy instance | 2 |
| Insurance contract or identification number | GUC0356J | | Number of Individuals Covered | 83 | | Insurance policy start date | 2016-09-01 | | Insurance policy end date | 2017-09-01 | | Total amount of commissions paid to insurance broker | USD $1,200 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $8,001 | | 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 | | Additional information about fees paid to insurance broker | AGENT OR BROKER RECORD | | Insurance broker organization code? | 3 | | Insurance broker name | GROUP RISK SPECIALISTS, INC. |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | GLUG0356J |
| Policy instance | 3 |
| Insurance contract or identification number | GLUG0356J | | Number of Individuals Covered | 85 | | Insurance policy start date | 2016-09-01 | | Insurance policy end date | 2017-09-01 | | Total amount of commissions paid to insurance broker | USD $2,316 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $15,439 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,781 | | Additional information about fees paid to insurance broker | AGENT OR BROKER OF RECORD | | Insurance broker organization code? | 3 | | Insurance broker name | GROUP RISK SPECIALISTS, INC |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | GVTL0356J |
| Policy instance | 4 |
| Insurance contract or identification number | GVTL0356J | | Number of Individuals Covered | 34 | | Insurance policy start date | 2016-09-01 | | Insurance policy end date | 2017-09-01 | | Total amount of commissions paid to insurance broker | USD $3,328 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $22,185 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,315 | | Additional information about fees paid to insurance broker | AGENT OR BROKER OF RECORD | | Insurance broker organization code? | 3 | | Insurance broker name | GROUP RISK SPECIALISTS, INC |
|
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 500124 |
| Policy instance | 5 |
| Insurance contract or identification number | 500124 | | Number of Individuals Covered | 106 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-04-30 | | Total amount of commissions paid to insurance broker | USD $9,689 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $187,603 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $9,689 | | Insurance broker organization code? | 3 | | Insurance broker name | CLYDE P BALLARD |
|
| UNITED HEALTH CARE (National Association of Insurance Commissioners NAIC id number: 79413 ) |
| Policy contract number | 493685/500124 |
| Policy instance | 6 |
| Insurance contract or identification number | 493685/500124 | | Number of Individuals Covered | 105 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $26,419 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $521,237 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $26,419 | | Insurance broker organization code? | 3 | | Insurance broker name | CLYDE P BALLARD |
|
| COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 ) |
| Policy contract number | MVP01654 |
| Policy instance | 5 |
| Insurance contract or identification number | MVP01654 | | Number of Individuals Covered | 117 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $8,088 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000356J |
| Policy instance | 4 |
| Insurance contract or identification number | G000356J | | Number of Individuals Covered | 32 | | Insurance policy start date | 2014-09-01 | | Insurance policy end date | 2015-09-01 | | Total amount of commissions paid to insurance broker | USD $3,531 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $23,539 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,531 | | Additional information about fees paid to insurance broker | AGENT OR BROKER OF RECORD | | Insurance broker organization code? | 3 | | Insurance broker name | |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000356J |
| Policy instance | 3 |
| Insurance contract or identification number | G000356J | | Number of Individuals Covered | 148 | | Insurance policy start date | 2014-09-01 | | Insurance policy end date | 2015-09-01 | | Total amount of commissions paid to insurance broker | USD $3,229 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $21,529 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,229 | | Additional information about fees paid to insurance broker | AGENT OR BROKER OF RECORD | | Insurance broker organization code? | 3 | | Insurance broker name | LOCKARD & WILLIAMS INSURANCE SVS PA |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000356J |
| Policy instance | 2 |
| Insurance contract or identification number | G000356J | | Number of Individuals Covered | 86 | | Insurance policy start date | 2014-09-01 | | Insurance policy end date | 2015-09-01 | | Total amount of commissions paid to insurance broker | USD $1,198 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $7,988 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,198 | | Additional information about fees paid to insurance broker | AGENT OR BROKER RECORD | | Insurance broker organization code? | 3 | | Insurance broker name | LOCKARD & WILLIAMS INSURANCE SVS PA |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | TS05996175 |
| Policy instance | 1 |
| Insurance contract or identification number | TS05996175 | | Number of Individuals Covered | 497 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $19,160 | | Total amount of fees paid to insurance company | USD $3,265 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $128,555 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $12,773 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 16 | | Additional information about fees paid to insurance broker | NON-MONETARY COMPENSATION | | Insurance broker name | GROUP RISK SPECIALISTS INC |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | TS05996175 |
| Policy instance | 4 |
| Insurance contract or identification number | TS05996175 | | Number of Individuals Covered | 504 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $17,859 | | Total amount of fees paid to insurance company | USD $2,174 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $121,385 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $11,906 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 2174 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | | Insurance broker name | GROUP RISK SPECIALISTS INC |
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| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000356J |
| Policy instance | 3 |
| Insurance contract or identification number | G000356J | | Number of Individuals Covered | 37 | | Insurance policy start date | 2013-09-01 | | Insurance policy end date | 2014-09-01 | | Total amount of commissions paid to insurance broker | USD $3,307 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $22,049 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,307 | | Insurance broker organization code? | 3 | | Insurance broker name | LOCKARD & WILLIAMS INSURANCE |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000356J |
| Policy instance | 1 |
| Insurance contract or identification number | G000356J | | Number of Individuals Covered | 81 | | Insurance policy start date | 2013-09-01 | | Insurance policy end date | 2014-09-01 | | Total amount of commissions paid to insurance broker | USD $1,268 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $8,451 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,268 | | Insurance broker organization code? | 3 | | Insurance broker name | LOCKARD & WILLIAMS INSURANCE |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G00356J |
| Policy instance | 2 |
| Insurance contract or identification number | G00356J | | Number of Individuals Covered | 136 | | Insurance policy start date | 2013-09-01 | | Insurance policy end date | 2014-09-01 | | Total amount of commissions paid to insurance broker | USD $3,257 | | Other welfare benefits provided | LIFE & AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $21,714 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,257 | | Insurance broker organization code? | 3 | | Insurance broker name | LOCKARD & WILLIAMS INSURANCE |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000356J |
| Policy instance | 1 |
| Insurance contract or identification number | G000356J | | Insurance contract or identification number | G000356J | | Number of Individuals Covered | 149 | | Number of Individuals Covered | 149 | | Insurance policy start date | 2012-09-01 | | Insurance policy end date | 2013-09-01 | | Insurance policy start date | 2012-09-01 | | Total amount of commissions paid to insurance broker | USD $3,258 | | Total amount of commissions paid to insurance broker | USD $3,258 | | Life Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $19,548 | | Welfare Benefit Premiums Paid to Carrier | USD $19,548 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000356J |
| Policy instance | 1 |
| Insurance contract or identification number | G000356J | | Insurance contract or identification number | G000356J | | Number of Individuals Covered | 149 | | Number of Individuals Covered | 149 | | Insurance policy start date | 2012-09-01 | | Insurance policy end date | 2013-09-01 | | Insurance policy start date | 2012-09-01 | | Total amount of commissions paid to insurance broker | USD $3,258 | | Total amount of commissions paid to insurance broker | USD $3,258 | | Life Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $19,548 | | Welfare Benefit Premiums Paid to Carrier | USD $19,548 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G00356J |
| Policy instance | 2 |
| Insurance contract or identification number | G00356J | | Insurance contract or identification number | G00356J | | Number of Individuals Covered | 88 | | Number of Individuals Covered | 88 | | Insurance policy start date | 2012-09-01 | | Insurance policy start date | 2012-09-01 | | Insurance policy end date | 2013-09-01 | | Insurance policy end date | 2013-09-01 | | Total amount of commissions paid to insurance broker | USD $1,427 | | Total amount of commissions paid to insurance broker | USD $1,427 | | Temporary Disability Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $9,510 | | Welfare Benefit Premiums Paid to Carrier | USD $9,510 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G00356J |
| Policy instance | 2 |
| Insurance contract or identification number | G00356J | | Insurance contract or identification number | G00356J | | Number of Individuals Covered | 88 | | Number of Individuals Covered | 88 | | Insurance policy start date | 2012-09-01 | | Insurance policy start date | 2012-09-01 | | Insurance policy end date | 2013-09-01 | | Insurance policy end date | 2013-09-01 | | Total amount of commissions paid to insurance broker | USD $1,427 | | Total amount of commissions paid to insurance broker | USD $1,427 | | Temporary Disability Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $9,510 | | Welfare Benefit Premiums Paid to Carrier | USD $9,510 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000356J |
| Policy instance | 3 |
| Insurance contract or identification number | G000356J | | Insurance contract or identification number | G000356J | | Number of Individuals Covered | 41 | | Number of Individuals Covered | 41 | | Insurance policy start date | 2012-09-01 | | Insurance policy start date | 2012-09-01 | | Insurance policy end date | 2013-09-01 | | Total amount of commissions paid to insurance broker | USD $2,932 | | Insurance policy end date | 2013-09-01 | | Life Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $19,548 | | Welfare Benefit Premiums Paid to Carrier | USD $19,548 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000356J |
| Policy instance | 3 |
| Insurance contract or identification number | G000356J | | Insurance contract or identification number | G000356J | | Number of Individuals Covered | 41 | | Number of Individuals Covered | 41 | | Insurance policy start date | 2012-09-01 | | Insurance policy start date | 2012-09-01 | | Insurance policy end date | 2013-09-01 | | Total amount of commissions paid to insurance broker | USD $2,932 | | Insurance policy end date | 2013-09-01 | | Life Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $19,548 | | Welfare Benefit Premiums Paid to Carrier | USD $19,548 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | TS05996175 |
| Policy instance | 4 |
| Insurance contract or identification number | TS05996175 | | Insurance contract or identification number | TS05996175 | | Number of Individuals Covered | 545 | | Number of Individuals Covered | 545 | | Insurance policy start date | 2013-01-01 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $18,297 | | Total amount of commissions paid to insurance broker | USD $18,297 | | Dental Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $128,648 | | Welfare Benefit Premiums Paid to Carrier | USD $128,648 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | TS05996175 |
| Policy instance | 4 |
| Insurance contract or identification number | TS05996175 | | Insurance contract or identification number | TS05996175 | | Number of Individuals Covered | 545 | | Number of Individuals Covered | 545 | | Insurance policy start date | 2013-01-01 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $18,297 | | Total amount of commissions paid to insurance broker | USD $18,297 | | Dental Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $128,648 | | Welfare Benefit Premiums Paid to Carrier | USD $128,648 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000356J |
| Policy instance | 3 |
| Insurance contract or identification number | G000356J | | Number of Individuals Covered | 46 | | Insurance policy start date | 2011-09-01 | | Insurance policy end date | 2012-09-01 | | Total amount of commissions paid to insurance broker | USD $3,048 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $20,321 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,048 | | Insurance broker organization code? | 3 | | Insurance broker name | LOCKARD & WILLIAMS INSURANCE |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000356J |
| Policy instance | 1 |
| Insurance contract or identification number | G000356J | | Number of Individuals Covered | 184 | | Insurance policy start date | 2011-09-01 | | Insurance policy end date | 2012-09-01 | | Total amount of commissions paid to insurance broker | USD $3,032 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $20,313 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,032 | | Insurance broker organization code? | 3 | | Insurance broker name | LOCKARD & WILLIAMS INSURANCE |
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| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G00356J |
| Policy instance | 2 |
| Insurance contract or identification number | G00356J | | Number of Individuals Covered | 92 | | Insurance policy start date | 2011-09-01 | | Insurance policy end date | 2012-09-01 | | Total amount of commissions paid to insurance broker | USD $1,418 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $9,453 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,418 | | Insurance broker organization code? | 3 | | Insurance broker name | LOCKARD & WILLIAMS INSURANCE |
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