401k Plan data: PROGRESSIVE EMPLOYER MANAGEMENT COMPANY WELFARE BENEFIT PLAN plan

PROGRESSIVE EMPLOYER MANAGEMENT COMPANY WELFARE BENEFIT PLAN 401k Plan overview

Plan Name	PROGRESSIVE EMPLOYER MANAGEMENT COMPANY WELFARE BENEFIT PLAN
Plan identification number	501

PROGRESSIVE EMPLOYER MANAGEMENT COMPANY WELFARE BENEFIT PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Temporary disability (accident and sickness) Long-term disability cover Other welfare benefit cover

401k Sponsoring company profile

PROGRESSIVE EMPLOYER MANAGEMENT COMPANY, INC. has sponsored the creation of one or more 401k plans.

Company Name: PROGRESSIVE EMPLOYER MANAGEMENT COMPANY, INC.

Employer identification number (EIN): 651060160

NAIC Classification: 561300

Additional information about PROGRESSIVE EMPLOYER MANAGEMENT COMPANY, INC.

Jurisdiction of Incorporation: Florida Department of State Division of Corporations

Incorporation Date: 2000-12-11

Company Identification Number: P00000114631

Legal Registered Office Address: 1200 S PINE ISLAND RD

PLANTATION

33324

More information about PROGRESSIVE EMPLOYER MANAGEMENT COMPANY, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PROGRESSIVE EMPLOYER MANAGEMENT COMPANY WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2015-01-01 PETER GRABOWSKI PETER GRABOWSKI 2016-10-06
501 2014-01-01 PETER GRABOWSKI PETER GRABOWSKI 2015-10-08
501 2013-01-01
501 2012-01-01 KAT BUSH
501 2011-01-01 KAT BUSH
501 2010-01-01 KAT BUSH

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
501	2015-01-01	PETER GRABOWSKI	PETER GRABOWSKI	2016-10-06
501	2014-01-01	PETER GRABOWSKI	PETER GRABOWSKI	2015-10-08
501	2013-01-01
501	2012-01-01	KAT BUSH
501	2011-01-01	KAT BUSH
501	2010-01-01	KAT BUSH

Plan Statistics for PROGRESSIVE EMPLOYER MANAGEMENT COMPANY WELFARE BENEFIT PLAN

401k plan membership statisitcs for PROGRESSIVE EMPLOYER MANAGEMENT COMPANY WELFARE BENEFIT PLAN

Measure Date Value
2015: PROGRESSIVE EMPLOYER MANAGEMENT COMPANY WELFARE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 0
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 0
Total of all active and inactive participants 2015-01-01 0
Total participants 2015-01-01 0
2014: PROGRESSIVE EMPLOYER MANAGEMENT COMPANY WELFARE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 2,117
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 0
Total of all active and inactive participants 2014-01-01 0
Total participants 2014-01-01 0
2013: PROGRESSIVE EMPLOYER MANAGEMENT COMPANY WELFARE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 1,964
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 2,117
Total of all active and inactive participants 2013-01-01 2,117
Total participants 2013-01-01 2,117
2012: PROGRESSIVE EMPLOYER MANAGEMENT COMPANY WELFARE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 1,893
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 1,964
Total of all active and inactive participants 2012-01-01 1,964
Total participants 2012-01-01 1,964
2011: PROGRESSIVE EMPLOYER MANAGEMENT COMPANY WELFARE BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 2,324
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 1,893
Total of all active and inactive participants 2011-01-01 1,893
Total participants 2011-01-01 1,893
2010: PROGRESSIVE EMPLOYER MANAGEMENT COMPANY WELFARE BENEFIT PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 2,041
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 2,324
Total of all active and inactive participants 2010-01-01 2,324
Total participants 2010-01-01 2,324

Measure	Date	Value
2015: PROGRESSIVE EMPLOYER MANAGEMENT COMPANY WELFARE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	0
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	0
Total of all active and inactive participants	2015-01-01	0
Total participants	2015-01-01	0
2014: PROGRESSIVE EMPLOYER MANAGEMENT COMPANY WELFARE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	2,117
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	0
Total of all active and inactive participants	2014-01-01	0
Total participants	2014-01-01	0
2013: PROGRESSIVE EMPLOYER MANAGEMENT COMPANY WELFARE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	1,964
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	2,117
Total of all active and inactive participants	2013-01-01	2,117
Total participants	2013-01-01	2,117
2012: PROGRESSIVE EMPLOYER MANAGEMENT COMPANY WELFARE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	1,893
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	1,964
Total of all active and inactive participants	2012-01-01	1,964
Total participants	2012-01-01	1,964
2011: PROGRESSIVE EMPLOYER MANAGEMENT COMPANY WELFARE BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	2,324
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	1,893
Total of all active and inactive participants	2011-01-01	1,893
Total participants	2011-01-01	1,893
2010: PROGRESSIVE EMPLOYER MANAGEMENT COMPANY WELFARE BENEFIT PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	2,041
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	2,324
Total of all active and inactive participants	2010-01-01	2,324
Total participants	2010-01-01	2,324

Form 5500 Responses for PROGRESSIVE EMPLOYER MANAGEMENT COMPANY WELFARE BENEFIT PLAN

2015: PROGRESSIVE EMPLOYER MANAGEMENT COMPANY WELFARE BENEFIT PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Mulitple employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2014: PROGRESSIVE EMPLOYER MANAGEMENT COMPANY WELFARE BENEFIT PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Mulitple employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2013: PROGRESSIVE EMPLOYER MANAGEMENT COMPANY WELFARE BENEFIT PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Mulitple employer plan
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2012: PROGRESSIVE EMPLOYER MANAGEMENT COMPANY WELFARE BENEFIT PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Mulitple employer plan
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2011: PROGRESSIVE EMPLOYER MANAGEMENT COMPANY WELFARE BENEFIT PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Mulitple employer plan
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2010: PROGRESSIVE EMPLOYER MANAGEMENT COMPANY WELFARE BENEFIT PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Mulitple employer plan
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )

Policy contract number

E7684632

Policy instance

Insurance contract or identification number	E7684632
Number of Individuals Covered	33
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $2,013
Total amount of fees paid to insurance company	USD $358
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENT
Welfare Benefit Premiums Paid to Carrier	USD $35,262
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $796
Amount paid for insurance broker fees	266
Additional information about fees paid to insurance broker	INSURANCE FEE
Insurance broker organization code?	3
Insurance broker name	WILLIAM A HINSON

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

Policy contract number

066679

Policy instance

Insurance contract or identification number	066679
Number of Individuals Covered	240
Insurance policy start date	2013-01-01
Insurance policy end date	2014-01-01
Other welfare benefits provided	LIFESTYLE ADD, LIFESTYLE LIFE
Welfare Benefit Premiums Paid to Carrier	USD $97,770
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

599258

Policy instance

Insurance contract or identification number	599258
Number of Individuals Covered	108
Insurance policy start date	2013-01-01
Insurance policy end date	2014-01-01
Total amount of commissions paid to insurance broker	USD $471
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	ADD
Welfare Benefit Premiums Paid to Carrier	USD $6,399
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $471
Insurance broker organization code?	3
Insurance broker name	PROGRESSIVE EMPLOYER INSURANCE

EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )

Policy contract number

90890-1036

Policy instance

Insurance contract or identification number	90890-1036
Number of Individuals Covered	567
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $3,556
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $35,561
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,556
Insurance broker organization code?	3
Insurance broker name	PROGRESSIVE EMPLOYER INSURANCE

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

752093

Policy instance

Insurance contract or identification number	752093
Number of Individuals Covered	224
Insurance policy start date	2012-08-01
Insurance policy end date	2013-07-31
Total amount of commissions paid to insurance broker	USD $23,526
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $413,192
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $23,526
Insurance broker organization code?	3
Insurance broker name	EMPLOYER BENEFITS CONSULTING LLC

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )

Policy contract number

801829

Policy instance

Insurance contract or identification number	801829
Number of Individuals Covered	21
Insurance policy start date	2013-09-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $1,600
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	SHORT TERM DISABILITY
Welfare Benefit Premiums Paid to Carrier	USD $15,684
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,600
Insurance broker organization code?	3
Insurance broker name	WORKLIFE INSURANCE AGENCY INC

AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )

Policy contract number

04637

Policy instance

Insurance contract or identification number	04637
Number of Individuals Covered	1
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $63
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $448
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $63
Insurance broker organization code?	3
Insurance broker name	JAMES H. SANTORA

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )

Policy contract number

801829

Policy instance

Insurance contract or identification number	801829
Number of Individuals Covered	23
Insurance policy start date	2012-09-01
Insurance policy end date	2013-08-31
Total amount of commissions paid to insurance broker	USD $1,448
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	SHORT TERM DISABILITY
Welfare Benefit Premiums Paid to Carrier	USD $49,620
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,448
Insurance broker organization code?	3
Insurance broker name	WORKLIFE INSURANCE AGENCY INC

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )

Policy contract number

801900

Policy instance

Insurance contract or identification number	801900
Number of Individuals Covered	29
Insurance policy start date	2012-09-01
Insurance policy end date	2013-08-31
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	SHORT TERM DISABILITY
Welfare Benefit Premiums Paid to Carrier	USD $16,530
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

00407425

Policy instance

Insurance contract or identification number	00407425
Number of Individuals Covered	756
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $11,487
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $502,157
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $11,487
Insurance broker organization code?	3
Insurance broker name	PROGRESSIVE EMPLOYER INSURANCE

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

000010118025

Policy instance

Insurance contract or identification number	000010118025
Number of Individuals Covered	115
Insurance policy start date	2012-08-01
Insurance policy end date	2013-07-31
Total amount of commissions paid to insurance broker	USD $1,887
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $11,769
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,887
Insurance broker organization code?	3
Insurance broker name	SOUTH FLORIDA GROUP BENEFITS

AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )

Policy contract number

V0572

Policy instance

Insurance contract or identification number	V0572
Number of Individuals Covered	21
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $1,336
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $6,733
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,336
Insurance broker organization code?	3
Insurance broker name	PROGRESSIVE EMPL INS AGCY INC

COMPBENEFITS (National Association of Insurance Commissioners NAIC id number: 60984 )

Policy contract number

CD0887

Policy instance

Insurance contract or identification number	CD0887
Number of Individuals Covered	0
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $2,329
Welfare Benefit Premiums Paid to Carrier	USD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $38
Insurance broker organization code?	3
Insurance broker name	WORKLIFE INSURANCE AGENCY INC

SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )

Policy contract number

10528

Policy instance

Insurance contract or identification number	10528
Number of Individuals Covered	12
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $2,092
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $20,922
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,092
Insurance broker organization code?	3
Insurance broker name	SOUTHERN EAGLE UNDERWRITING MGMT CO

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

1000896

Policy instance

Insurance contract or identification number	1000896
Number of Individuals Covered	28
Insurance policy start date	2012-01-01
Insurance policy end date	2012-04-30
Total amount of commissions paid to insurance broker	USD $650
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $4,550
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $264
Insurance broker organization code?	3
Insurance broker name	WORKLIFE INS AGENCY INC

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

Policy contract number

TM05760435

Policy instance

Insurance contract or identification number	TM05760435
Number of Individuals Covered	54
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $788
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )

Policy contract number

V0572

Policy instance

Insurance contract or identification number	V0572
Number of Individuals Covered	19
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $1,423
Health Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $10,475
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,423
Insurance broker organization code?	3
Insurance broker name	WORKLIFE INS AGENCY INC

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

Policy contract number

066679

Policy instance

Insurance contract or identification number	066679
Number of Individuals Covered	200
Insurance policy start date	2012-01-01
Insurance policy end date	2013-01-01
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	LIFESTYLE ADD
Welfare Benefit Premiums Paid to Carrier	USD $76,092
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

599258

Policy instance

Insurance contract or identification number	599258
Number of Individuals Covered	101
Insurance policy start date	2012-01-01
Insurance policy end date	2013-01-01
Total amount of commissions paid to insurance broker	USD $505
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	ADD
Welfare Benefit Premiums Paid to Carrier	USD $5,768
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $505
Insurance broker organization code?	3
Insurance broker name	WORKLIFE INSURANCE AGENCY INC

COMPBENEFITS COMPANY (National Association of Insurance Commissioners NAIC id number: 52015 )

Policy contract number

VS6852

Policy instance

Insurance contract or identification number	VS6852
Number of Individuals Covered	89
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $1,111
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $11,130
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $182
Insurance broker organization code?	3
Insurance broker name	WORKLIFE INSURANCE AGENCY INC

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 32395 )

Policy contract number

12268981

Policy instance

Insurance contract or identification number	12268981
Number of Individuals Covered	265
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $1,708
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 $1,708
Insurance broker organization code?	3
Insurance broker name	WORKLIFE INSURANCE AGENCY, INC.

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )

Policy contract number

800694

Policy instance

Insurance contract or identification number	800694
Number of Individuals Covered	10
Insurance policy start date	2012-07-02
Insurance policy end date	2012-09-02
Total amount of commissions paid to insurance broker	USD $596
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	SHORT TERM DISABILITY
Welfare Benefit Premiums Paid to Carrier	USD $4,923
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $596
Insurance broker organization code?	3
Insurance broker name	WORKLIFE INSURANCE AGENCY, INC.

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

Policy contract number

00407425

Policy instance

Insurance contract or identification number	00407425
Number of Individuals Covered	662
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $6,330
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $413,875
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $6,330
Insurance broker organization code?	3
Insurance broker name	WORKLIFE INSURANCE AGENCY, INC.

COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )

Policy contract number

E7684632

Policy instance

Insurance contract or identification number	E7684632
Number of Individuals Covered	37
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $2,246
Total amount of fees paid to insurance company	USD $361
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENT
Welfare Benefit Premiums Paid to Carrier	USD $42,781
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $942
Amount paid for insurance broker fees	241
Insurance broker organization code?	3
Insurance broker name	SHEALY BENEFITS SERVICES INC

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

000010118025

Policy instance

Insurance contract or identification number	000010118025
Number of Individuals Covered	151
Insurance policy start date	2011-08-01
Insurance policy end date	2012-07-31
Total amount of commissions paid to insurance broker	USD $3,311
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $20,814
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,311
Insurance broker organization code?	3
Insurance broker name	SOUTH FLORIDA GROUP BENEFITS

AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )

Policy contract number

04637

Policy instance

Insurance contract or identification number	04637
Number of Individuals Covered	1
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $84
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $660
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $84
Insurance broker organization code?	3
Insurance broker name	JAMES H. SANTORA

CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 )

Policy contract number

3334744

Policy instance

Insurance contract or identification number	3334744
Number of Individuals Covered	56
Insurance policy start date	2011-05-01
Insurance policy end date	2012-04-30
Total amount of commissions paid to insurance broker	USD $30,795
Total amount of fees paid to insurance company	USD $8,010
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $552,126
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	8010
Insurance broker organization code?	3
Commission paid to Insurance Broker	USD $5,546
Insurance broker name	SOUTHERN EAGLE UNDERWRITING MGMT

KANAWHA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65110 )

Policy contract number

7206818000

Policy instance

Insurance contract or identification number	7206818000
Number of Individuals Covered	36
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $3,649
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $9,256
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $469
Insurance broker organization code?	3
Insurance broker name	ERICKSON RICHARD P

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

491975

Policy instance

Insurance contract or identification number	491975
Number of Individuals Covered	222
Insurance policy start date	2011-08-01
Insurance policy end date	2012-07-31
Total amount of commissions paid to insurance broker	USD $56,002
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $809,315
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $56,002
Insurance broker organization code?	3
Insurance broker name	EMPLOYER BENEFITS CONSULTING LLC

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )

Policy contract number

801829

Policy instance

Insurance contract or identification number	801829
Number of Individuals Covered	9
Insurance policy start date	2011-09-01
Insurance policy end date	2012-08-31
Total amount of commissions paid to insurance broker	USD $6,043
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	SHORT TERM DISABILITY
Welfare Benefit Premiums Paid to Carrier	USD $52,428
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,980
Insurance broker organization code?	3
Insurance broker name	WORKLIFE INSURANCE AGENCY INC

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )

Policy contract number

800694

Policy instance

Insurance contract or identification number	800694
Number of Individuals Covered	12
Insurance policy start date	2011-07-02
Insurance policy end date	2012-07-01
Total amount of commissions paid to insurance broker	USD $6,006
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	SHORT TERM DISABILITY
Welfare Benefit Premiums Paid to Carrier	USD $60,072
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,554
Insurance broker organization code?	3
Insurance broker name	WORKLIFE INSURANCE AGENCY, INC

AETNA HEALTH INC (National Association of Insurance Commissioners NAIC id number: 95088 )

Policy contract number

US 193682

Policy instance

Insurance contract or identification number	US 193682
Number of Individuals Covered	42
Insurance policy start date	2010-07-01
Insurance policy end date	2011-06-30
Total amount of commissions paid to insurance broker	USD $26,660
Welfare Benefit Premiums Paid to Carrier	USD $298,204
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

00407425

Policy instance

Insurance contract or identification number	00407425
Number of Individuals Covered	692
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $11,618
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $515,964
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )

Policy contract number

E7684632

Policy instance

Insurance contract or identification number	E7684632
Number of Individuals Covered	47
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $2,822
Total amount of fees paid to insurance company	USD $828
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENT
Welfare Benefit Premiums Paid to Carrier	USD $52,344
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

COMPBENEFITS COMPANY (National Association of Insurance Commissioners NAIC id number: 52015 )

Policy contract number

VS1386

Policy instance

Insurance contract or identification number	VS1386
Number of Individuals Covered	4
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $427
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

000010118025

Policy instance

Insurance contract or identification number	000010118025
Number of Individuals Covered	206
Insurance policy start date	2010-08-01
Insurance policy end date	2011-07-31
Total amount of commissions paid to insurance broker	USD $4,042
Total amount of fees paid to insurance company	USD $509
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $23,395
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

000010118024

Policy instance

Insurance contract or identification number	000010118024
Number of Individuals Covered	228
Insurance policy start date	2010-08-01
Insurance policy end date	2011-07-31
Total amount of commissions paid to insurance broker	USD $1,875
Total amount of fees paid to insurance company	USD $262
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $12,500
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

491975

Policy instance

Insurance contract or identification number	491975
Number of Individuals Covered	104
Insurance policy start date	2010-08-01
Insurance policy end date	2011-07-31
Total amount of commissions paid to insurance broker	USD $58,605
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $963,343
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

000010118026

Policy instance

Insurance contract or identification number	000010118026
Number of Individuals Covered	29
Insurance policy start date	2010-08-01
Insurance policy end date	2011-07-31
Total amount of commissions paid to insurance broker	USD $1,420
Total amount of fees paid to insurance company	USD $227
Other welfare benefits provided	WEEKLY INCOME
Welfare Benefit Premiums Paid to Carrier	USD $9,469
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

000400128173

Policy instance

Insurance contract or identification number	000400128173
Number of Individuals Covered	41
Insurance policy start date	2010-08-01
Insurance policy end date	2011-07-31
Total amount of commissions paid to insurance broker	USD $2,136
Total amount of fees paid to insurance company	USD $307
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $14,237
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )

Policy contract number

04637

Policy instance

Insurance contract or identification number	04637
Number of Individuals Covered	4
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $282
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $2,286
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )

Policy contract number

V0572

Policy instance

Insurance contract or identification number	V0572
Number of Individuals Covered	44
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $8,013
Health Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $21,062
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 32395 )

Policy contract number

12268981

Policy instance

Insurance contract or identification number	12268981
Number of Individuals Covered	259
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $1,931
Vision Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

COMPBENEFITS COMPANY (National Association of Insurance Commissioners NAIC id number: 52015 )

Policy contract number

17843

Policy instance

Insurance contract or identification number	17843
Number of Individuals Covered	16
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $420
Other welfare benefits provided	PREPAID PLAN
Welfare Benefit Premiums Paid to Carrier	USD $4,413
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

599258

Policy instance

Insurance contract or identification number	599258
Number of Individuals Covered	129
Insurance policy start date	2011-01-01
Insurance policy end date	2012-01-01
Total amount of commissions paid to insurance broker	USD $563
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $8,576
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )

Policy contract number

801829

Policy instance

Insurance contract or identification number	801829
Number of Individuals Covered	33
Insurance policy start date	2010-09-01
Insurance policy end date	2011-08-31
Total amount of commissions paid to insurance broker	USD $3,276
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	SHORT TERM DISABILITY
Welfare Benefit Premiums Paid to Carrier	USD $42,174
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

066679

Policy instance

Insurance contract or identification number	066679
Number of Individuals Covered	15
Insurance policy start date	2011-01-01
Insurance policy end date	2012-01-01
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $19,757
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

599258

Policy instance

Insurance contract or identification number	599258
Number of Individuals Covered	105
Insurance policy start date	2010-01-01
Insurance policy end date	2011-01-01
Total amount of commissions paid to insurance broker	USD $442
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $7,353
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $442
Insurance broker organization code?	3
Insurance broker name	ELITE INSURANCE SERVICES, INC.

COMPBENEFITS COMPANY (National Association of Insurance Commissioners NAIC id number: 52015 )

Policy contract number

17843

Policy instance

Insurance contract or identification number	17843
Number of Individuals Covered	20
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $764
Other welfare benefits provided	PREPAID PLAN
Welfare Benefit Premiums Paid to Carrier	USD $7,098
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $764
Insurance broker organization code?	3
Insurance broker name	ANDREA K HART SOBOCINSKI

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 32395 )

Policy contract number

12268981

Policy instance

Insurance contract or identification number	12268981
Number of Individuals Covered	375
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $2,627
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 $2,627
Insurance broker organization code?	3
Insurance broker name	ELITE INSURANCE SERVICES,INC.

AETNA HEALTH INC (National Association of Insurance Commissioners NAIC id number: 95088 )

Policy contract number

US 193682

Policy instance

Insurance contract or identification number	US 193682
Number of Individuals Covered	202
Insurance policy start date	2009-07-01
Insurance policy end date	2010-06-30
Total amount of commissions paid to insurance broker	USD $48,598
Welfare Benefit Premiums Paid to Carrier	USD $614,432
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,991
Insurance broker organization code?	3
Insurance broker name	ELITE INSURANCE SERVICES DBA PES

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

Policy contract number

00407425

Policy instance

Insurance contract or identification number	00407425
Number of Individuals Covered	849
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $10,574
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $607,367
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $10,574
Insurance broker organization code?	3
Insurance broker name	ELITE INSURANCE SERVICES INC

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

Policy contract number

066679

Policy instance

Insurance contract or identification number	066679
Number of Individuals Covered	254
Insurance policy start date	2010-01-01
Insurance policy end date	2011-01-01
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $96,270
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )

Policy contract number

E7684632

Policy instance

Insurance contract or identification number	E7684632
Number of Individuals Covered	31
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $7,906
Total amount of fees paid to insurance company	USD $3,395
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	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 $2,645
Amount paid for insurance broker fees	2454
Insurance broker organization code?	3
Insurance broker name	FRANK FEREZ

COMPBENEFITS COMPANY (National Association of Insurance Commissioners NAIC id number: 52015 )

Policy contract number

VS1386

Policy instance

Insurance contract or identification number	VS1386
Number of Individuals Covered	7
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,176
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

000010118025

Policy instance

Insurance contract or identification number	000010118025
Number of Individuals Covered	240
Insurance policy start date	2009-08-01
Insurance policy end date	2010-07-31
Total amount of commissions paid to insurance broker	USD $4,504
Total amount of fees paid to insurance company	USD $174
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $23,958
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,504
Amount paid for insurance broker fees	174
Insurance broker organization code?	3
Insurance broker name	SOUTH FLORIDA GROUP BENEFITS

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

000010118024

Policy instance

Insurance contract or identification number	000010118024
Number of Individuals Covered	241
Insurance policy start date	2009-08-01
Insurance policy end date	2010-07-31
Total amount of commissions paid to insurance broker	USD $1,900
Total amount of fees paid to insurance company	USD $95
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $12,668
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,900
Amount paid for insurance broker fees	95
Insurance broker organization code?	3
Insurance broker name	SOUTH FLORIDA GROUP BEBEFITS

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Company Name:	PROGRESSIVE EMPLOYER MANAGEMENT COMPANY, INC.
Employer identification number (EIN):	651060160
NAIC Classification:	561300

Jurisdiction of Incorporation:	Florida Department of State Division of Corporations
Incorporation Date:	2000-12-11
Company Identification Number:	P00000114631
Legal Registered Office Address:	1200 S PINE ISLAND RD PLANTATION 33324