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JONES & CARTER INC. FLEXIBLE BENEFIT ACCOUNT PLAN 401k Plan overview

Plan NameJONES & CARTER INC. FLEXIBLE BENEFIT ACCOUNT PLAN
Plan identification number 501

JONES & CARTER INC. FLEXIBLE BENEFIT ACCOUNT PLAN Benefits

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

401k Sponsoring company profile

QUIDDITY-1, INC. has sponsored the creation of one or more 401k plans.

Company Name:QUIDDITY-1, INC.
Employer identification number (EIN):741848244
NAIC Classification:541330
NAIC Description:Engineering Services

Additional information about QUIDDITY-1, INC.

Jurisdiction of Incorporation: Texas Secretary of State
Incorporation Date: 1976-01-06
Company Identification Number: 0037303700
Legal Registered Office Address: 6330 WEST LOOP S STE 150

BELLAIRE
United States of America (USA)
77401

More information about QUIDDITY-1, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan JONES & CARTER INC. FLEXIBLE BENEFIT ACCOUNT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012021-01-01SHARON BOWERS2022-12-22
5012020-01-01SCOTT KNAPP2021-07-27 SCOTT KNAPP2021-07-27
5012020-01-01SHARON BOWERS2022-12-22
5012019-01-01SCOTT KNAPP2020-07-22 SCOTT KNAPP2020-07-22
5012018-01-01
5012018-01-01SHARON BOWERS2022-12-22
5012017-01-01
5012017-01-01SHARON BOWERS2022-12-22
5012016-01-01
5012016-01-01SHARON BOWERS2022-12-22
5012015-01-01
5012015-01-01SHARON BOWERS2022-12-22
5012014-01-01
5012014-01-01SHARON BOWERS2022-12-22
5012013-01-01
5012013-01-01SHARON BOWERS2022-12-22
5012012-01-01CARLOS COTTON
5012012-01-01SHARON BOWERS2022-12-22
5012011-01-01CARLOS COTTON
5012011-01-01SHARON BOWERS2022-12-22
5012010-01-01CARLOS COTTON
5012010-01-01SHARON BOWERS2022-12-22
5012009-01-01PATRICK K MOORE CARLOS P. COTTON2010-10-15
5012009-01-01SHARON BOWERS2022-12-22

Plan Statistics for JONES & CARTER INC. FLEXIBLE BENEFIT ACCOUNT PLAN

401k plan membership statisitcs for JONES & CARTER INC. FLEXIBLE BENEFIT ACCOUNT PLAN

Measure Date Value
2021: JONES & CARTER INC. FLEXIBLE BENEFIT ACCOUNT PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01483
Total number of active participants reported on line 7a of the Form 55002021-01-01483
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-01483
Number of employers contributing to the scheme2021-01-010
2020: JONES & CARTER INC. FLEXIBLE BENEFIT ACCOUNT PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-011,008
Total number of active participants reported on line 7a of the Form 55002020-01-01936
Total of all active and inactive participants2020-01-01936
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Number of employers contributing to the scheme2020-01-010
2019: JONES & CARTER INC. FLEXIBLE BENEFIT ACCOUNT PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01883
Total number of active participants reported on line 7a of the Form 55002019-01-011,008
Total of all active and inactive participants2019-01-011,008
2018: JONES & CARTER INC. FLEXIBLE BENEFIT ACCOUNT PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01822
Total number of active participants reported on line 7a of the Form 55002018-01-01883
Total of all active and inactive participants2018-01-01883
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-010
Number of employers contributing to the scheme2018-01-010
2017: JONES & CARTER INC. FLEXIBLE BENEFIT ACCOUNT PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01832
Total number of active participants reported on line 7a of the Form 55002017-01-01822
Total of all active and inactive participants2017-01-01822
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-010
Number of employers contributing to the scheme2017-01-010
2016: JONES & CARTER INC. FLEXIBLE BENEFIT ACCOUNT PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01745
Total number of active participants reported on line 7a of the Form 55002016-01-01832
Total of all active and inactive participants2016-01-01832
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-010
Number of employers contributing to the scheme2016-01-010
2015: JONES & CARTER INC. FLEXIBLE BENEFIT ACCOUNT PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01778
Total number of active participants reported on line 7a of the Form 55002015-01-01745
Total of all active and inactive participants2015-01-01745
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-010
Number of employers contributing to the scheme2015-01-010
2014: JONES & CARTER INC. FLEXIBLE BENEFIT ACCOUNT PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01665
Total number of active participants reported on line 7a of the Form 55002014-01-01778
Total of all active and inactive participants2014-01-01778
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-010
Number of employers contributing to the scheme2014-01-010
2013: JONES & CARTER INC. FLEXIBLE BENEFIT ACCOUNT PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01546
Total number of active participants reported on line 7a of the Form 55002013-01-01665
Total of all active and inactive participants2013-01-01665
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-010
Number of employers contributing to the scheme2013-01-010
2012: JONES & CARTER INC. FLEXIBLE BENEFIT ACCOUNT PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01546
Total number of active participants reported on line 7a of the Form 55002012-01-01665
Total of all active and inactive participants2012-01-01665
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-010
Number of employers contributing to the scheme2012-01-010
2011: JONES & CARTER INC. FLEXIBLE BENEFIT ACCOUNT PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01592
Total number of active participants reported on line 7a of the Form 55002011-01-01546
Total of all active and inactive participants2011-01-01546
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-010
Number of employers contributing to the scheme2011-01-010
2010: JONES & CARTER INC. FLEXIBLE BENEFIT ACCOUNT PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-01284
Total number of active participants reported on line 7a of the Form 55002010-01-01592
Total of all active and inactive participants2010-01-01592
Number of retired or separated participants receiving benefits2010-01-010
Number of other retired or separated participants entitled to future benefits2010-01-010
Number of employers contributing to the scheme2010-01-010
2009: JONES & CARTER INC. FLEXIBLE BENEFIT ACCOUNT PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01295
Total number of active participants reported on line 7a of the Form 55002009-01-01284
Total of all active and inactive participants2009-01-01284
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-010
Number of employers contributing to the scheme2009-01-010

Form 5500 Responses for JONES & CARTER INC. FLEXIBLE BENEFIT ACCOUNT PLAN

2021: JONES & CARTER INC. FLEXIBLE BENEFIT ACCOUNT PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: JONES & CARTER INC. FLEXIBLE BENEFIT ACCOUNT PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedYes
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes
2019: JONES & CARTER INC. FLEXIBLE BENEFIT ACCOUNT PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – General assets of the sponsorYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – General assets of the sponsorYes
2018: JONES & CARTER INC. FLEXIBLE BENEFIT ACCOUNT PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedYes
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – General assets of the sponsorYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – General assets of the sponsorYes
2017: JONES & CARTER INC. FLEXIBLE BENEFIT ACCOUNT PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedYes
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – General assets of the sponsorYes
2016: JONES & CARTER INC. FLEXIBLE BENEFIT ACCOUNT PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedYes
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – General assets of the sponsorYes
2015: JONES & CARTER INC. FLEXIBLE BENEFIT ACCOUNT PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedYes
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – General assets of the sponsorYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – General assets of the sponsorYes
2014: JONES & CARTER INC. FLEXIBLE BENEFIT ACCOUNT PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedYes
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – General assets of the sponsorYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – General assets of the sponsorYes
2013: JONES & CARTER INC. FLEXIBLE BENEFIT ACCOUNT PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedYes
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – General assets of the sponsorYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – General assets of the sponsorYes
2012: JONES & CARTER INC. FLEXIBLE BENEFIT ACCOUNT PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedYes
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – General assets of the sponsorYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – General assets of the sponsorYes
2011: JONES & CARTER INC. FLEXIBLE BENEFIT ACCOUNT PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedYes
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – General assets of the sponsorYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – General assets of the sponsorYes
2010: JONES & CARTER INC. FLEXIBLE BENEFIT ACCOUNT PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedYes
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan funding arrangement – General assets of the sponsorYes
2010-01-01Plan benefit arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – General assets of the sponsorYes
2009: JONES & CARTER INC. FLEXIBLE BENEFIT ACCOUNT PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedYes
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – General assets of the sponsorYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0200091
Policy instance 4
Insurance contract or identification number0200091
Number of Individuals Covered260
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $25,693
Total amount of fees paid to insurance companyUSD $3,586
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $53,571
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $20,365
Insurance broker organization code?3
Amount paid for insurance broker fees3416
Additional information about fees paid to insurance brokerADMIN FEES
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5944389
Policy instance 3
Insurance contract or identification number5944389
Number of Individuals Covered840
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $145,638
Total amount of fees paid to insurance companyUSD $34,351
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $623,872
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $109,360
Insurance broker organization code?3
Amount paid for insurance broker fees7251
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3331604
Policy instance 2
Insurance contract or identification number3331604
Number of Individuals Covered936
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $678,374
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HYATT LEGAL PLANS (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number9902607
Policy instance 1
Insurance contract or identification number9902607
Number of Individuals Covered69
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $1,759
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedLEGAL
Welfare Benefit Premiums Paid to CarrierUSD $17,531
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,759
Insurance broker organization code?3
HYATT LEGAL PLANS (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number9902607
Policy instance 1
Insurance contract or identification number9902607
Number of Individuals Covered67
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $784
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedLEGAL
Welfare Benefit Premiums Paid to CarrierUSD $6,533
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $784
Insurance broker organization code?3
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3331604
Policy instance 2
Insurance contract or identification number3331604
Number of Individuals Covered1008
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $76
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $575,505
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $76
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5944389
Policy instance 3
Insurance contract or identification number5944389
Number of Individuals Covered859
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $107,323
Total amount of fees paid to insurance companyUSD $24,979
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $598,667
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $80,786
Insurance broker organization code?3
Amount paid for insurance broker fees4932
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0200091
Policy instance 4
Insurance contract or identification number0200091
Number of Individuals Covered190
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $22,296
Total amount of fees paid to insurance companyUSD $4,715
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $65,252
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,644
Insurance broker organization code?3
Amount paid for insurance broker fees924
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3331604
Policy instance 2
Insurance contract or identification number3331604
Number of Individuals Covered883
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $38,914
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $400,545
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $20,573
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5944389
Policy instance 3
Insurance contract or identification number5944389
Number of Individuals Covered783
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $121,101
Total amount of fees paid to insurance companyUSD $37,675
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $489,612
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $66,127
Amount paid for insurance broker fees2380
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
Insurance broker organization code?3
HYATT LEGAL PLANS (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number8390001
Policy instance 1
Insurance contract or identification number8390001
Number of Individuals Covered27
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $616
Total amount of fees paid to insurance companyUSD $983
Other welfare benefits providedLEGAL
Welfare Benefit Premiums Paid to CarrierUSD $6,162
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $616
Amount paid for insurance broker fees983
Additional information about fees paid to insurance brokerPLATFORM FEE
Insurance broker organization code?3
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3331604
Policy instance 3
Insurance contract or identification number3331604
Number of Individuals Covered822
Insurance policy start date2017-05-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $22,689
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $251,960
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $22,689
Insurance broker organization code?3
Insurance broker nameCARL CHAPMAN
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1036557
Policy instance 2
Insurance contract or identification number1036557
Number of Individuals Covered627
Insurance policy start date2017-01-01
Insurance policy end date2017-04-30
Total amount of commissions paid to insurance brokerUSD $92,232
Total amount of fees paid to insurance companyUSD $14,202
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedCRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $469,118
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $71,249
Insurance broker organization code?3
Amount paid for insurance broker fees9243
Additional information about fees paid to insurance brokerSERVICE FEE
Insurance broker nameMARK S METTILLE
HYATT LEGAL PLANS (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number8390001
Policy instance 1
Insurance contract or identification number8390001
Number of Individuals Covered24
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $697
Total amount of fees paid to insurance companyUSD $653
Other welfare benefits providedLEGAL
Welfare Benefit Premiums Paid to CarrierUSD $6,968
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $697
Insurance broker organization code?3
Amount paid for insurance broker fees653
Additional information about fees paid to insurance brokerPLATFORM FEE
Insurance broker nameGIS BENEFITS, INC
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5944389
Policy instance 5
Insurance contract or identification number5944389
Number of Individuals Covered666
Insurance policy start date2017-05-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $8,037
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $315,546
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees8037
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
Insurance broker organization code?3
Insurance broker nameGIS BENEFITS INC
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number010043353
Policy instance 4
Insurance contract or identification number010043353
Number of Individuals Covered624
Insurance policy start date2017-01-01
Insurance policy end date2017-04-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $34,571
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HYATT LEGAL PLANS (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number8390001
Policy instance 1
Insurance contract or identification number8390001
Number of Individuals Covered27
Insurance policy start date2015-05-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $354
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedLEGAL
Welfare Benefit Premiums Paid to CarrierUSD $3,936
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $354
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameMERCER HEALTH AND BENEFITS
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1036557
Policy instance 2
Insurance contract or identification number1036557
Number of Individuals Covered745
Insurance policy start date2014-06-01
Insurance policy end date2015-04-30
Total amount of commissions paid to insurance brokerUSD $42,425
Total amount of fees paid to insurance companyUSD $12,784
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $341,724
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $34,637
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerBONUS
Insurance broker nameCHAPMAN INSURANCE SERVICES INC
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberKM05727250
Policy instance 1
Insurance contract or identification numberKM05727250
Number of Individuals Covered778
Insurance policy start date2013-06-01
Insurance policy end date2014-05-31
Total amount of commissions paid to insurance brokerUSD $30,953
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $225,366
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $30,953
Insurance broker organization code?3
Insurance broker nameCHAPMAN INSURANCE SERVICES
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3331604
Policy instance 2
Insurance contract or identification number3331604
Number of Individuals Covered601
Insurance policy start date2013-04-01
Insurance policy end date2014-03-31
Total amount of commissions paid to insurance brokerUSD $30,126
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Welfare Benefit Premiums Paid to CarrierUSD $317,448
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $30,126
Insurance broker organization code?3
Insurance broker nameCARL CHAPMAN
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1036557
Policy instance 3
Insurance contract or identification number1036557
Number of Individuals Covered588
Insurance policy start date2013-07-01
Insurance policy end date2014-05-31
Total amount of commissions paid to insurance brokerUSD $9,793
Total amount of fees paid to insurance companyUSD $110
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
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $79,538
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,793
Amount paid for insurance broker fees110
Insurance broker organization code?3
Insurance broker nameCARL CHAPMAN
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberKM05727250
Policy instance 1
Insurance contract or identification numberKM05727250
Number of Individuals Covered665
Insurance policy start date2012-06-01
Insurance policy end date2013-05-31
Total amount of commissions paid to insurance brokerUSD $30,716
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $258,101
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $30,716
Insurance broker organization code?3
Insurance broker nameCHAPMAN INSURANCE SERVICES
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3331604
Policy instance 2
Insurance contract or identification number3331604
Number of Individuals Covered510
Insurance policy start date2012-04-01
Insurance policy end date2013-03-31
Total amount of commissions paid to insurance brokerUSD $24,175
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Welfare Benefit Premiums Paid to CarrierUSD $216,738
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $24,175
Insurance broker organization code?3
Insurance broker nameCARL CHAPMAN
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberKM05727250
Policy instance 1
Insurance contract or identification numberKM05727250
Number of Individuals Covered665
Insurance policy start date2012-06-01
Insurance policy end date2013-05-31
Total amount of commissions paid to insurance brokerUSD $30,716
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $258,101
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $30,716
Insurance broker organization code?3
Insurance broker nameCHAPMAN INSURANCE SERVICES
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3331604
Policy instance 2
Insurance contract or identification number3331604
Number of Individuals Covered510
Insurance policy start date2012-04-01
Insurance policy end date2013-03-31
Total amount of commissions paid to insurance brokerUSD $24,175
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Welfare Benefit Premiums Paid to CarrierUSD $216,738
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $24,175
Insurance broker organization code?3
Insurance broker nameCARL CHAPMAN
CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 )
Policy contract number3331604
Policy instance 4
Insurance contract or identification number3331604
Number of Individuals Covered445
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
Total amount of commissions paid to insurance brokerUSD $22,177
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Welfare Benefit Premiums Paid to CarrierUSD $182,220
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberKM05727250
Policy instance 1
Insurance contract or identification numberKM05727250
Number of Individuals Covered546
Insurance policy start date2011-06-01
Insurance policy end date2012-05-31
Total amount of commissions paid to insurance brokerUSD $12,789
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $128,509
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLI960064
Policy instance 2
Insurance contract or identification numberFLI960064
Number of Individuals Covered246
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
Total amount of commissions paid to insurance brokerUSD $3,291
Total amount of fees paid to insurance companyUSD $0
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 $21,939
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberOK 961320
Policy instance 3
Insurance contract or identification numberOK 961320
Number of Individuals Covered246
Insurance policy start date2011-04-01
Insurance policy end date2012-04-01
Total amount of commissions paid to insurance brokerUSD $788
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Other welfare benefits providedACCIDENTAL DEATH
Welfare Benefit Premiums Paid to CarrierUSD $5,253
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberOK 961320
Policy instance 3
Insurance contract or identification numberOK 961320
Number of Individuals Covered28
Insurance policy start date2009-04-01
Insurance policy end date2010-04-01
Total amount of commissions paid to insurance brokerUSD $861
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Other welfare benefits providedACCIDENTAL DEATH
Welfare Benefit Premiums Paid to CarrierUSD $5,741
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $861
Additional information about fees paid to insurance brokerSALES & SERVICE
Insurance broker organization code?3
Insurance broker nameCARL G CHAPMAN
CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 )
Policy contract number3331604
Policy instance 4
Insurance contract or identification number3331604
Number of Individuals Covered255
Insurance policy start date2009-04-01
Insurance policy end date2010-03-31
Total amount of commissions paid to insurance brokerUSD $24,824
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Welfare Benefit Premiums Paid to CarrierUSD $164,149
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $24,824
Insurance broker organization code?3
Insurance broker nameCARGL CHAPMAN
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberKM05727250
Policy instance 1
Insurance contract or identification numberKM05727250
Number of Individuals Covered592
Insurance policy start date2009-06-01
Insurance policy end date2010-05-31
Total amount of commissions paid to insurance brokerUSD $12,271
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $121,661
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,271
Insurance broker organization code?3
Insurance broker nameCHAPMAN INSURANCE SERVICES
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLI960064
Policy instance 2
Insurance contract or identification numberFLI960064
Number of Individuals Covered248
Insurance policy start date2009-04-01
Insurance policy end date2010-04-01
Total amount of commissions paid to insurance brokerUSD $4,836
Total amount of fees paid to insurance companyUSD $0
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 $32,243
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,836
Additional information about fees paid to insurance brokerSALES & SERVICE
Insurance broker organization code?3
Insurance broker nameCARL G CHAPMAN

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