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BBC INTERNATIONAL, LLC WELFARE BENEFIT PLAN 401k Plan overview

Plan NameBBC INTERNATIONAL, LLC WELFARE BENEFIT PLAN
Plan identification number 501

BBC INTERNATIONAL, LLC WELFARE BENEFIT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Other welfare benefit cover

401k Sponsoring company profile

BBC INTERNATIONAL, LLC has sponsored the creation of one or more 401k plans.

Company Name:BBC INTERNATIONAL, LLC
Employer identification number (EIN):651158358
NAIC Classification:541400

Additional information about BBC INTERNATIONAL, LLC

Jurisdiction of Incorporation: Nevada Department of State
Incorporation Date: 2008-06-19
Company Identification Number: 20081383628
Legal Registered Office Address: 3225 MCLEOD DRIVE #110

LAS VEGAS
United States of America (USA)
89121

More information about BBC INTERNATIONAL, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BBC INTERNATIONAL, LLC WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-08-01
5012021-08-01DEAN D. MAROTTA2022-12-05 DEAN D. MAROTTA2022-12-05
5012020-08-01DEAN D. MAROTTA2021-11-02
5012019-08-01DEAN D. MAROTTA2020-10-28
5012018-08-01DEAN D. MAROTTA2019-11-15
5012017-08-01
5012016-08-01
5012015-08-01
5012014-08-01
5012013-08-01
5012012-08-01DEAN MAROTTA
5012011-08-01DEAN MAROTTA

Plan Statistics for BBC INTERNATIONAL, LLC WELFARE BENEFIT PLAN

401k plan membership statisitcs for BBC INTERNATIONAL, LLC WELFARE BENEFIT PLAN

Measure Date Value
2022: BBC INTERNATIONAL, LLC WELFARE BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year2022-08-01152
Total number of active participants reported on line 7a of the Form 55002022-08-01147
Number of retired or separated participants receiving benefits2022-08-014
Number of other retired or separated participants entitled to future benefits2022-08-012
Total of all active and inactive participants2022-08-01153
2021: BBC INTERNATIONAL, LLC WELFARE BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year2021-08-01141
Total number of active participants reported on line 7a of the Form 55002021-08-01148
Number of retired or separated participants receiving benefits2021-08-014
Total of all active and inactive participants2021-08-01152
2020: BBC INTERNATIONAL, LLC WELFARE BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year2020-08-01119
Total number of active participants reported on line 7a of the Form 55002020-08-01135
Number of retired or separated participants receiving benefits2020-08-016
Total of all active and inactive participants2020-08-01141
2019: BBC INTERNATIONAL, LLC WELFARE BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year2019-08-01130
Total number of active participants reported on line 7a of the Form 55002019-08-01119
Number of retired or separated participants receiving benefits2019-08-016
Total of all active and inactive participants2019-08-01125
2018: BBC INTERNATIONAL, LLC WELFARE BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year2018-08-01125
Total number of active participants reported on line 7a of the Form 55002018-08-01130
Number of retired or separated participants receiving benefits2018-08-011
Total of all active and inactive participants2018-08-01131
2017: BBC INTERNATIONAL, LLC WELFARE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year2017-08-01128
Total number of active participants reported on line 7a of the Form 55002017-08-01125
Number of retired or separated participants receiving benefits2017-08-011
Total of all active and inactive participants2017-08-01126
2016: BBC INTERNATIONAL, LLC WELFARE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year2016-08-01131
Total number of active participants reported on line 7a of the Form 55002016-08-01128
Number of retired or separated participants receiving benefits2016-08-012
Total of all active and inactive participants2016-08-01130
2015: BBC INTERNATIONAL, LLC WELFARE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year2015-08-01125
Number of retired or separated participants receiving benefits2015-08-01131
Total of all active and inactive participants2015-08-01131
2014: BBC INTERNATIONAL, LLC WELFARE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year2014-08-01114
Total number of active participants reported on line 7a of the Form 55002014-08-01125
Total of all active and inactive participants2014-08-01125
2013: BBC INTERNATIONAL, LLC WELFARE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year2013-08-01120
Total number of active participants reported on line 7a of the Form 55002013-08-01114
Total of all active and inactive participants2013-08-01114
2012: BBC INTERNATIONAL, LLC WELFARE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year2012-08-01114
Total number of active participants reported on line 7a of the Form 55002012-08-01120
Number of retired or separated participants receiving benefits2012-08-010
Total of all active and inactive participants2012-08-01120
2011: BBC INTERNATIONAL, LLC WELFARE BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year2011-08-0199
Total number of active participants reported on line 7a of the Form 55002011-08-01113
Number of retired or separated participants receiving benefits2011-08-011
Total of all active and inactive participants2011-08-01114

Form 5500 Responses for BBC INTERNATIONAL, LLC WELFARE BENEFIT PLAN

2022: BBC INTERNATIONAL, LLC WELFARE BENEFIT PLAN 2022 form 5500 responses
2022-08-01Type of plan entitySingle employer plan
2022-08-01Submission has been amendedNo
2022-08-01This submission is the final filingNo
2022-08-01This return/report is a short plan year return/report (less than 12 months)No
2022-08-01Plan is a collectively bargained planNo
2022-08-01Plan funding arrangement – InsuranceYes
2022-08-01Plan benefit arrangement – InsuranceYes
2021: BBC INTERNATIONAL, LLC WELFARE BENEFIT PLAN 2021 form 5500 responses
2021-08-01Type of plan entitySingle employer plan
2021-08-01Plan funding arrangement – InsuranceYes
2021-08-01Plan benefit arrangement – InsuranceYes
2020: BBC INTERNATIONAL, LLC WELFARE BENEFIT PLAN 2020 form 5500 responses
2020-08-01Type of plan entitySingle employer plan
2020-08-01Plan funding arrangement – InsuranceYes
2020-08-01Plan benefit arrangement – InsuranceYes
2019: BBC INTERNATIONAL, LLC WELFARE BENEFIT PLAN 2019 form 5500 responses
2019-08-01Type of plan entitySingle employer plan
2019-08-01Plan funding arrangement – InsuranceYes
2019-08-01Plan benefit arrangement – InsuranceYes
2018: BBC INTERNATIONAL, LLC WELFARE BENEFIT PLAN 2018 form 5500 responses
2018-08-01Type of plan entitySingle employer plan
2018-08-01Plan funding arrangement – InsuranceYes
2018-08-01Plan benefit arrangement – InsuranceYes
2017: BBC INTERNATIONAL, LLC WELFARE BENEFIT PLAN 2017 form 5500 responses
2017-08-01Type of plan entitySingle employer plan
2017-08-01Submission has been amendedYes
2017-08-01Plan funding arrangement – InsuranceYes
2017-08-01Plan benefit arrangement – InsuranceYes
2016: BBC INTERNATIONAL, LLC WELFARE BENEFIT PLAN 2016 form 5500 responses
2016-08-01Type of plan entitySingle employer plan
2016-08-01Plan funding arrangement – InsuranceYes
2016-08-01Plan benefit arrangement – InsuranceYes
2015: BBC INTERNATIONAL, LLC WELFARE BENEFIT PLAN 2015 form 5500 responses
2015-08-01Type of plan entitySingle employer plan
2015-08-01Plan funding arrangement – InsuranceYes
2015-08-01Plan benefit arrangement – InsuranceYes
2014: BBC INTERNATIONAL, LLC WELFARE BENEFIT PLAN 2014 form 5500 responses
2014-08-01Type of plan entitySingle employer plan
2014-08-01Plan funding arrangement – InsuranceYes
2014-08-01Plan benefit arrangement – InsuranceYes
2013: BBC INTERNATIONAL, LLC WELFARE BENEFIT PLAN 2013 form 5500 responses
2013-08-01Type of plan entitySingle employer plan
2013-08-01Plan funding arrangement – InsuranceYes
2013-08-01Plan benefit arrangement – InsuranceYes
2012: BBC INTERNATIONAL, LLC WELFARE BENEFIT PLAN 2012 form 5500 responses
2012-08-01Type of plan entitySingle employer plan
2012-08-01Plan funding arrangement – InsuranceYes
2012-08-01Plan benefit arrangement – InsuranceYes
2011: BBC INTERNATIONAL, LLC WELFARE BENEFIT PLAN 2011 form 5500 responses
2011-08-01Type of plan entitySingle employer plan
2011-08-01First time form 5500 has been submittedYes
2011-08-01Plan funding arrangement – InsuranceYes
2011-08-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSOK0609350
Policy instance 3
Insurance contract or identification numberSOK0609350
Number of Individuals Covered136
Insurance policy start date2022-08-01
Insurance policy end date2023-07-31
Total amount of commissions paid to insurance brokerUSD $124
Total amount of fees paid to insurance companyUSD $36
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedADD
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,065
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $107
Insurance broker organization code?3
Amount paid for insurance broker fees36
Additional information about fees paid to insurance brokerGENERAL AGENCY FEES
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSGM0612366
Policy instance 2
Insurance contract or identification numberSGM0612366
Number of Individuals Covered136
Insurance policy start date2022-08-01
Insurance policy end date2023-07-31
Total amount of commissions paid to insurance brokerUSD $823
Total amount of fees paid to insurance companyUSD $243
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $7,102
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $710
Insurance broker organization code?3
Amount paid for insurance broker fees243
Additional information about fees paid to insurance brokerGENERAL AGENCY FEES
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number00636852
Policy instance 1
Insurance contract or identification number00636852
Number of Individuals Covered188
Insurance policy start date2022-08-01
Insurance policy end date2023-07-31
Total amount of commissions paid to insurance brokerUSD $12,215
Total amount of fees paid to insurance companyUSD $119,371
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,668,797
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,215
Amount paid for insurance broker fees77331
Additional information about fees paid to insurance brokerBENEFIT ADVISOR FEES
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 )
Policy contract numberD0700
Policy instance 4
Insurance contract or identification numberD0700
Number of Individuals Covered157
Insurance policy start date2021-08-01
Insurance policy end date2022-07-31
Total amount of commissions paid to insurance brokerUSD $1,421
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $17,758
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,421
Insurance broker organization code?3
USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 )
Policy contract number50036166
Policy instance 3
Insurance contract or identification number50036166
Number of Individuals Covered156
Insurance policy start date2021-08-01
Insurance policy end date2022-07-31
Total amount of commissions paid to insurance brokerUSD $728
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACC DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $5,655
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $674
Amount paid for insurance broker fees0
Insurance broker organization code?3
FLORIDA COMBINED LIFE INSURANCE COMPANY, INC. (National Association of Insurance Commissioners NAIC id number: 76031 )
Policy contract numberX5680 - 9F634T
Policy instance 2
Insurance contract or identification numberX5680 - 9F634T
Number of Individuals Covered155
Insurance policy start date2021-08-01
Insurance policy end date2022-07-31
Total amount of commissions paid to insurance brokerUSD $5,485
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $129,832
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,485
Amount paid for insurance broker fees0
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 )
Policy contract numberD0700
Policy instance 1
Insurance contract or identification numberD0700
Number of Individuals Covered148
Insurance policy start date2021-08-01
Insurance policy end date2022-07-31
Total amount of commissions paid to insurance brokerUSD $34,362
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $34,362
Amount paid for insurance broker fees0
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 )
Policy contract numberD0700
Policy instance 1
Insurance contract or identification numberD0700
Number of Individuals Covered134
Insurance policy start date2020-08-01
Insurance policy end date2021-07-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees0
Insurance broker organization code?3
FLORIDA COMBINED LIFE INSURANCE COMPANY, INC. (National Association of Insurance Commissioners NAIC id number: 76031 )
Policy contract numberX5680 - 9F634T
Policy instance 2
Insurance contract or identification numberX5680 - 9F634T
Number of Individuals Covered139
Insurance policy start date2020-08-01
Insurance policy end date2021-07-31
Total amount of commissions paid to insurance brokerUSD $4,246
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $109,667
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,246
Amount paid for insurance broker fees0
Insurance broker organization code?3
USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 )
Policy contract number50036166
Policy instance 3
Insurance contract or identification number50036166
Number of Individuals Covered145
Insurance policy start date2020-08-01
Insurance policy end date2021-07-31
Total amount of commissions paid to insurance brokerUSD $589
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACC DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $5,098
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $558
Amount paid for insurance broker fees0
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 )
Policy contract numberD0700
Policy instance 4
Insurance contract or identification numberD0700
Number of Individuals Covered136
Insurance policy start date2020-08-01
Insurance policy end date2021-07-31
Total amount of commissions paid to insurance brokerUSD $1,395
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $17,438
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,395
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 )
Policy contract numberD0700
Policy instance 4
Insurance contract or identification numberD0700
Number of Individuals Covered127
Insurance policy start date2019-08-01
Insurance policy end date2020-07-31
Total amount of commissions paid to insurance brokerUSD $1,060
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $17,669
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,060
Amount paid for insurance broker fees0
Insurance broker organization code?3
USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 )
Policy contract number50036166
Policy instance 3
Insurance contract or identification number50036166
Number of Individuals Covered132
Insurance policy start date2019-08-01
Insurance policy end date2020-07-31
Total amount of commissions paid to insurance brokerUSD $3,622
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACC DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $5,590
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,622
Amount paid for insurance broker fees0
Insurance broker organization code?3
FLORIDA COMBINED LIFE INSURANCE COMPANY, INC. (National Association of Insurance Commissioners NAIC id number: 76031 )
Policy contract numberX5680 - 9F634T
Policy instance 2
Insurance contract or identification numberX5680 - 9F634T
Number of Individuals Covered128
Insurance policy start date2019-08-01
Insurance policy end date2020-07-31
Total amount of commissions paid to insurance brokerUSD $8,715
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $113,903
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,400
Amount paid for insurance broker fees0
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 )
Policy contract numberD0700
Policy instance 1
Insurance contract or identification numberD0700
Number of Individuals Covered125
Insurance policy start date2019-08-01
Insurance policy end date2020-07-31
Total amount of commissions paid to insurance brokerUSD $76,384
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $76,384
Amount paid for insurance broker fees0
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSGM602608
Policy instance 3
Insurance contract or identification numberSGM602608
Number of Individuals Covered130
Insurance policy start date2018-08-01
Insurance policy end date2019-07-31
Total amount of commissions paid to insurance brokerUSD $698
Total amount of fees paid to insurance companyUSD $349
Life Insurance Welfare BenefitYes
Other welfare benefits providedACC DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $6,982
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $698
Amount paid for insurance broker fees349
Additional information about fees paid to insurance brokerSALES & SERVICE
Insurance broker organization code?3
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3335050
Policy instance 1
Insurance contract or identification number3335050
Number of Individuals Covered130
Insurance policy start date2018-08-01
Insurance policy end date2019-07-31
Total amount of commissions paid to insurance brokerUSD $13,636
Total amount of fees paid to insurance companyUSD $4,902
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $137,475
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,636
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerGENERAL AGENT PAYMENTS
BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 )
Policy contract numberD0700
Policy instance 2
Insurance contract or identification numberD0700
Number of Individuals Covered122
Insurance policy start date2018-08-01
Insurance policy end date2019-07-31
Total amount of commissions paid to insurance brokerUSD $72,251
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $72,251
Amount paid for insurance broker fees0
Insurance broker organization code?3
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number00606881
Policy instance 1
Insurance contract or identification number00606881
Number of Individuals Covered0
Insurance policy start date2017-08-01
Insurance policy end date2017-11-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $34,984
Life Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees34984
Additional information about fees paid to insurance brokerTERMINATION FEES
Insurance broker organization code?3
Insurance broker nameCIGNA HEALTH & LIFE INS COMPANY
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSGM602608
Policy instance 4
Insurance contract or identification numberSGM602608
Number of Individuals Covered140
Insurance policy start date2017-08-01
Insurance policy end date2018-08-01
Total amount of commissions paid to insurance brokerUSD $561
Total amount of fees paid to insurance companyUSD $281
Life Insurance Welfare BenefitYes
Other welfare benefits providedACC DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $5,612
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $561
Amount paid for insurance broker fees281
Additional information about fees paid to insurance brokerSALES & SERVICE
Insurance broker organization code?3
Insurance broker nameBENEFITMALL
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3335050
Policy instance 2
Insurance contract or identification number3335050
Number of Individuals Covered129
Insurance policy start date2017-08-01
Insurance policy end date2018-07-31
Total amount of commissions paid to insurance brokerUSD $12,549
Total amount of fees paid to insurance companyUSD $4,494
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,549
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerSERVICE & GENERAL AGENT PAYMENTS
Insurance broker nameROGERS BENEFIT GROUP INC
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number00616644
Policy instance 3
Insurance contract or identification number00616644
Number of Individuals Covered125
Insurance policy start date2017-08-01
Insurance policy end date2018-07-31
Total amount of commissions paid to insurance brokerUSD $52,157
Total amount of fees paid to insurance companyUSD $71,436
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,190,678
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $52,157
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerADMINISTRATION FEES
Insurance broker nameROGERS BENEFIT GROUP INC
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3335050
Policy instance 2
Insurance contract or identification number3335050
Number of Individuals Covered136
Insurance policy start date2015-08-01
Insurance policy end date2016-07-31
Total amount of commissions paid to insurance brokerUSD $10,740
Total amount of fees paid to insurance companyUSD $4,775
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $108,405
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,740
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerGENERAL AGENT PAYMENTS
Insurance broker nameCENTERSTONE INS (NJ) DBA BENEFITMAL
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number00606881
Policy instance 1
Insurance contract or identification number00606881
Number of Individuals Covered129
Insurance policy start date2015-08-01
Insurance policy end date2016-07-31
Total amount of commissions paid to insurance brokerUSD $66,927
Total amount of fees paid to insurance companyUSD $57,535
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $441,695
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $66,927
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerADMINISTRATION FEES
Insurance broker nameCIGNA HEALTH & LIFE INS COMPANY
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number00606881
Policy instance 1
Insurance contract or identification number00606881
Number of Individuals Covered117
Insurance policy start date2014-08-01
Insurance policy end date2015-07-31
Total amount of commissions paid to insurance brokerUSD $21,848
Total amount of fees paid to insurance companyUSD $59,303
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $364,211
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees59303
Additional information about fees paid to insurance brokerADMINISTRATION FEES
Insurance broker organization code?0
Insurance broker nameBLODGETT & ASSOCIATES INC.
CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 )
Policy contract number3335050
Policy instance 2
Insurance contract or identification number3335050
Number of Individuals Covered127
Insurance policy start date2014-08-01
Insurance policy end date2015-07-31
Total amount of commissions paid to insurance brokerUSD $11,026
Total amount of fees paid to insurance companyUSD $4,879
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $111,448
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,026
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerGENERAL AGENT PAYMENTS
Insurance broker nameCENTERSTONE INS (NJ) DBA BENEFITMAL
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number00606881
Policy instance 1
Insurance contract or identification number00606881
Number of Individuals Covered112
Insurance policy start date2013-08-01
Insurance policy end date2014-07-31
Total amount of commissions paid to insurance brokerUSD $21,286
Total amount of fees paid to insurance companyUSD $55,393
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $313,086
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees55393
Additional information about fees paid to insurance brokerADMINISTRATION FEES
Insurance broker organization code?0
Insurance broker nameBLODGETT & ASSOCIATES INC.
CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 )
Policy contract number3335050
Policy instance 2
Insurance contract or identification number3335050
Number of Individuals Covered119
Insurance policy start date2013-08-01
Insurance policy end date2014-07-31
Total amount of commissions paid to insurance brokerUSD $9,935
Total amount of fees paid to insurance companyUSD $4,386
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $100,491
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,935
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerGENERAL AGENT PAYMENTS
Insurance broker nameCENTERSTONE INS (NJ) DBA BENEFITMAL
CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 )
Policy contract number3335050
Policy instance 2
Insurance contract or identification number3335050
Number of Individuals Covered124
Insurance policy start date2012-08-01
Insurance policy end date2013-07-31
Total amount of commissions paid to insurance brokerUSD $9,178
Total amount of fees paid to insurance companyUSD $4,004
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $92,787
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,178
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerGENERAL AGENT PAYMENTS
Insurance broker nameCENTERSTONE INS (NJ) DBA BENEFITMAL
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number00606881
Policy instance 1
Insurance contract or identification number00606881
Number of Individuals Covered117
Insurance policy start date2012-08-01
Insurance policy end date2013-07-31
Total amount of commissions paid to insurance brokerUSD $21,509
Total amount of fees paid to insurance companyUSD $52,537
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $261,662
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees52537
Additional information about fees paid to insurance brokerADMINISTRATION FEES
Insurance broker organization code?0
Insurance broker nameBLODGETT & ASSOCIATES INC.
CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 )
Policy contract number3335050
Policy instance 2
Insurance contract or identification number3335050
Number of Individuals Covered113
Insurance policy start date2011-08-01
Insurance policy end date2012-07-31
Total amount of commissions paid to insurance brokerUSD $7,722
Total amount of fees paid to insurance companyUSD $3,381
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $78,098
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number00606881
Policy instance 1
Insurance contract or identification number00606881
Number of Individuals Covered109
Insurance policy start date2011-08-01
Insurance policy end date2012-07-31
Total amount of commissions paid to insurance brokerUSD $19,532
Total amount of fees paid to insurance companyUSD $39,836
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $229,644
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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