401k Plan data: TRUMAN ARNOLD COMPANIES CAFETERIA PLAN plan

TRUMAN ARNOLD COMPANIES CAFETERIA PLAN 401k Plan overview

Plan Name	TRUMAN ARNOLD COMPANIES CAFETERIA PLAN
Plan identification number	501

TRUMAN ARNOLD COMPANIES CAFETERIA 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 Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

TRUMAN ARNOLD COMPANIES has sponsored the creation of one or more 401k plans.

Company Name: TRUMAN ARNOLD COMPANIES

Employer identification number (EIN): 751289172

NAIC Classification: 424700

Additional information about TRUMAN ARNOLD COMPANIES

Jurisdiction of Incorporation: State of Delaware Division of Corporations

Incorporation Date:

Company Identification Number: 3467763

More information about TRUMAN ARNOLD COMPANIES

Form 5500 Filing Information

Submission information for form 5500 for 401k plan TRUMAN ARNOLD COMPANIES CAFETERIA PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2021-01-01 JAMES HENRY RUSSELL 2022-10-04
501 2020-01-01 JAMES HENRY RUSSELL 2021-06-22
501 2019-01-01 STEVE MCMILLEN 2020-10-08
501 2019-01-01 JAMES HENRY RUSSELL 2021-08-06
501 2018-01-01 STEVE MCMILLEN 2019-07-30
501 2018-01-01 STEVE MCMILLEN 2019-08-12
501 2017-01-01
501 2017-01-01 STEVE MCMILLEN 2019-07-30
501 2016-01-01 STEVE MCMILLEN
501 2015-01-01 STEVE MCMILLEN JIM DAY 2016-06-14
501 2014-01-01 STEVE MCMILLEN JIM DAY 2015-07-07
501 2013-01-01 STEVE MCMILLEN JIM DAY 2014-07-08
501 2012-01-01 STEVE MCMILLEN JIM DAY 2013-07-01
501 2011-01-01 STEVE MCMILLEN JIM DAY 2012-07-16

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2021-01-01	JAMES HENRY RUSSELL	2022-10-04
501	2020-01-01	JAMES HENRY RUSSELL	2021-06-22
501	2019-01-01	STEVE MCMILLEN	2020-10-08
501	2019-01-01	JAMES HENRY RUSSELL	2021-08-06
501	2018-01-01	STEVE MCMILLEN	2019-07-30
501	2018-01-01	STEVE MCMILLEN	2019-08-12
501	2017-01-01
501	2017-01-01	STEVE MCMILLEN	2019-07-30
501	2016-01-01	STEVE MCMILLEN
501	2015-01-01	STEVE MCMILLEN		JIM DAY	2016-06-14
501	2014-01-01	STEVE MCMILLEN		JIM DAY	2015-07-07
501	2013-01-01	STEVE MCMILLEN		JIM DAY	2014-07-08
501	2012-01-01	STEVE MCMILLEN		JIM DAY	2013-07-01
501	2011-01-01	STEVE MCMILLEN		JIM DAY	2012-07-16

Plan Statistics for TRUMAN ARNOLD COMPANIES CAFETERIA PLAN

401k plan membership statisitcs for TRUMAN ARNOLD COMPANIES CAFETERIA PLAN

Measure Date Value
2021: TRUMAN ARNOLD COMPANIES CAFETERIA PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 741
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 747
Number of retired or separated participants receiving benefits 2021-01-01 0
Number of other retired or separated participants entitled to future benefits 2021-01-01 0
Total of all active and inactive participants 2021-01-01 747
Number of employers contributing to the scheme 2021-01-01 0
2020: TRUMAN ARNOLD COMPANIES CAFETERIA PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 647
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 741
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 0
Total of all active and inactive participants 2020-01-01 741
Number of employers contributing to the scheme 2020-01-01 0
2019: TRUMAN ARNOLD COMPANIES CAFETERIA PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 647
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 647
Number of retired or separated participants receiving benefits 2019-01-01 5
Number of other retired or separated participants entitled to future benefits 2019-01-01 0
Total of all active and inactive participants 2019-01-01 652
Number of employers contributing to the scheme 2019-01-01 0
2018: TRUMAN ARNOLD COMPANIES CAFETERIA PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 647
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 674
Number of retired or separated participants receiving benefits 2018-01-01 5
Number of other retired or separated participants entitled to future benefits 2018-01-01 0
Total of all active and inactive participants 2018-01-01 679
Number of employers contributing to the scheme 2018-01-01 0
2017: TRUMAN ARNOLD COMPANIES CAFETERIA PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 618
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 617
Number of retired or separated participants receiving benefits 2017-01-01 1
Number of other retired or separated participants entitled to future benefits 2017-01-01 0
Total of all active and inactive participants 2017-01-01 618
Number of employers contributing to the scheme 2017-01-01 0
2016: TRUMAN ARNOLD COMPANIES CAFETERIA PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 296
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 504
Number of retired or separated participants receiving benefits 2016-01-01 5
Number of other retired or separated participants entitled to future benefits 2016-01-01 0
Total of all active and inactive participants 2016-01-01 509
2015: TRUMAN ARNOLD COMPANIES CAFETERIA PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 479
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 583
Total of all active and inactive participants 2015-01-01 583
Total participants 2015-01-01 0
2014: TRUMAN ARNOLD COMPANIES CAFETERIA PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 288
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 479
Total of all active and inactive participants 2014-01-01 479
Total participants 2014-01-01 0
2013: TRUMAN ARNOLD COMPANIES CAFETERIA PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 319
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 288
Total of all active and inactive participants 2013-01-01 288
Total participants 2013-01-01 0
2012: TRUMAN ARNOLD COMPANIES CAFETERIA PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 314
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 319
Total of all active and inactive participants 2012-01-01 319
Total participants 2012-01-01 0
2011: TRUMAN ARNOLD COMPANIES CAFETERIA PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 299
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 314
Total of all active and inactive participants 2011-01-01 314
Total participants 2011-01-01 314

Measure	Date	Value
2021: TRUMAN ARNOLD COMPANIES CAFETERIA PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	741
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	747
Number of retired or separated participants receiving benefits	2021-01-01	0
Number of other retired or separated participants entitled to future benefits	2021-01-01	0
Total of all active and inactive participants	2021-01-01	747
Number of employers contributing to the scheme	2021-01-01	0
2020: TRUMAN ARNOLD COMPANIES CAFETERIA PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	647
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	741
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	0
Total of all active and inactive participants	2020-01-01	741
Number of employers contributing to the scheme	2020-01-01	0
2019: TRUMAN ARNOLD COMPANIES CAFETERIA PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	647
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	647
Number of retired or separated participants receiving benefits	2019-01-01	5
Number of other retired or separated participants entitled to future benefits	2019-01-01	0
Total of all active and inactive participants	2019-01-01	652
Number of employers contributing to the scheme	2019-01-01	0
2018: TRUMAN ARNOLD COMPANIES CAFETERIA PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	647
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	674
Number of retired or separated participants receiving benefits	2018-01-01	5
Number of other retired or separated participants entitled to future benefits	2018-01-01	0
Total of all active and inactive participants	2018-01-01	679
Number of employers contributing to the scheme	2018-01-01	0
2017: TRUMAN ARNOLD COMPANIES CAFETERIA PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	618
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	617
Number of retired or separated participants receiving benefits	2017-01-01	1
Number of other retired or separated participants entitled to future benefits	2017-01-01	0
Total of all active and inactive participants	2017-01-01	618
Number of employers contributing to the scheme	2017-01-01	0
2016: TRUMAN ARNOLD COMPANIES CAFETERIA PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	296
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	504
Number of retired or separated participants receiving benefits	2016-01-01	5
Number of other retired or separated participants entitled to future benefits	2016-01-01	0
Total of all active and inactive participants	2016-01-01	509
2015: TRUMAN ARNOLD COMPANIES CAFETERIA PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	479
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	583
Total of all active and inactive participants	2015-01-01	583
Total participants	2015-01-01	0
2014: TRUMAN ARNOLD COMPANIES CAFETERIA PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	288
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	479
Total of all active and inactive participants	2014-01-01	479
Total participants	2014-01-01	0
2013: TRUMAN ARNOLD COMPANIES CAFETERIA PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	319
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	288
Total of all active and inactive participants	2013-01-01	288
Total participants	2013-01-01	0
2012: TRUMAN ARNOLD COMPANIES CAFETERIA PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	314
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	319
Total of all active and inactive participants	2012-01-01	319
Total participants	2012-01-01	0
2011: TRUMAN ARNOLD COMPANIES CAFETERIA PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	299
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	314
Total of all active and inactive participants	2011-01-01	314
Total participants	2011-01-01	314

Form 5500 Responses for TRUMAN ARNOLD COMPANIES CAFETERIA PLAN

2021: TRUMAN ARNOLD COMPANIES CAFETERIA PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2020: TRUMAN ARNOLD COMPANIES CAFETERIA PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2019: TRUMAN ARNOLD COMPANIES CAFETERIA PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	Yes
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2018: TRUMAN ARNOLD COMPANIES CAFETERIA PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	Yes
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2017: TRUMAN ARNOLD COMPANIES CAFETERIA PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	Yes
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2016: TRUMAN ARNOLD COMPANIES CAFETERIA PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2015: TRUMAN ARNOLD COMPANIES CAFETERIA PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2014: TRUMAN ARNOLD COMPANIES CAFETERIA PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2013: TRUMAN ARNOLD COMPANIES CAFETERIA PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2012: TRUMAN ARNOLD COMPANIES CAFETERIA PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2011: TRUMAN ARNOLD COMPANIES CAFETERIA PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

759703

Policy instance

Insurance contract or identification number	759703
Number of Individuals Covered	708
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $15,118
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	9000
Additional information about fees paid to insurance broker	MARKETING
Insurance broker organization code?	3

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )

Policy contract number

3340138

Policy instance

Insurance contract or identification number	3340138
Number of Individuals Covered	541
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $17,250
Total amount of fees paid to insurance company	USD $0
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $349,341
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $17,321
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )

Policy contract number

191301

Policy instance

Insurance contract or identification number	191301
Number of Individuals Covered	1021
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $116,119
Total amount of fees paid to insurance company	USD $6,144
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $5,100,883
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes
Commission paid to Insurance Broker	USD $116,119
Amount paid for insurance broker fees	6144
Additional information about fees paid to insurance broker	SPECIAL PROGRAMS
Insurance broker organization code?	3

NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 )

Policy contract number

37849

Policy instance

Insurance contract or identification number	37849
Number of Individuals Covered	452
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $6,590
Total amount of fees paid to insurance company	USD $0
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $65,899
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $6,590
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 )

Policy contract number

37849

Policy instance

Insurance contract or identification number	37849
Number of Individuals Covered	412
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $5,387
Total amount of fees paid to insurance company	USD $0
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $53,868
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes
Commission paid to Insurance Broker	USD $5,387
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )

Policy contract number

191301

Policy instance

Insurance contract or identification number	191301
Number of Individuals Covered	947
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $105,790
Total amount of fees paid to insurance company	USD $5,724
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $4,445,413
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes
Commission paid to Insurance Broker	USD $105,790
Amount paid for insurance broker fees	5724
Additional information about fees paid to insurance broker	SPECIAL PROGRAMS
Insurance broker organization code?	3

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )

Policy contract number

3340138

Policy instance

Insurance contract or identification number	3340138
Number of Individuals Covered	486
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $14,960
Total amount of fees paid to insurance company	USD $1,393
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $302,773
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $13,558
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Additional information about fees paid to insurance broker	GENERAL AGENT PAYMENTS

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

Policy contract number

217699

Policy instance

Insurance contract or identification number	217699
Number of Individuals Covered	741
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $28,674
Total amount of fees paid to insurance company	USD $5,735
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $282,116
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $28,674
Amount paid for insurance broker fees	5735
Additional information about fees paid to insurance broker	ADDITIONAL COMPENSATION
Insurance broker organization code?	3

BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )

Policy contract number

191301

Policy instance

Insurance contract or identification number	191301
Number of Individuals Covered	886
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $94,246
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $4,157,322
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes
Commission paid to Insurance Broker	USD $94,246
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )

Policy contract number

3340138

Policy instance

Insurance contract or identification number	3340138
Number of Individuals Covered	442
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $14,721
Total amount of fees paid to insurance company	USD $0
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $297,961
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $14,721
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

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

Policy contract number

217699

Policy instance

Insurance contract or identification number	217699
Number of Individuals Covered	1035
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $26,319
Total amount of fees paid to insurance company	USD $5,264
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $258,459
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $26,319
Amount paid for insurance broker fees	5264
Additional information about fees paid to insurance broker	ADDITIONAL COMPENSATION
Insurance broker organization code?	3

NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 )

Policy contract number

37849

Policy instance

Insurance contract or identification number	37849
Number of Individuals Covered	343
Insurance policy start date	2018-11-01
Insurance policy end date	2019-10-31
Total amount of commissions paid to insurance broker	USD $4,617
Total amount of fees paid to insurance company	USD $0
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $46,174
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes
Commission paid to Insurance Broker	USD $4,617
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 )

Policy contract number

37849

Policy instance

Insurance contract or identification number	37849
Number of Individuals Covered	381
Insurance policy start date	2019-11-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $953
Total amount of fees paid to insurance company	USD $0
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $4,767
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes
Commission paid to Insurance Broker	USD $953
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

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

Policy contract number

217699

Policy instance

Insurance contract or identification number	217699
Number of Individuals Covered	1035
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $26,319
Total amount of fees paid to insurance company	USD $5,264
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $258,459
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $26,319
Amount paid for insurance broker fees	5264
Additional information about fees paid to insurance broker	ADDITIONAL COMPENSATION
Insurance broker organization code?	3

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )

Policy contract number

3340138

Policy instance

Insurance contract or identification number	3340138
Number of Individuals Covered	394
Insurance policy start date	2016-11-01
Insurance policy end date	2017-10-31
Total amount of commissions paid to insurance broker	USD $11,384
Total amount of fees paid to insurance company	USD $0
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $230,808
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $11,384
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Insurance broker name	LOCKTON COMPANIES, LLC

BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )

Policy contract number

19272

Policy instance

Insurance contract or identification number	19272
Number of Individuals Covered	761
Insurance policy start date	2016-11-01
Insurance policy end date	2017-10-31
Total amount of commissions paid to insurance broker	USD $96,519
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $3,876,002
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes
Commission paid to Insurance Broker	USD $96,519
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Insurance broker name	LOCKTON COMPANIES, LLC

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

Policy contract number

10076951

Policy instance

Insurance contract or identification number	10076951
Number of Individuals Covered	582
Insurance policy start date	2016-11-01
Insurance policy end date	2017-10-31
Total amount of commissions paid to insurance broker	USD $3,321
Total amount of fees paid to insurance company	USD $0
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $36,516
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,321
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Insurance broker name	LOCKTON COMPANIES, LLC

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

Policy contract number

217700

Policy instance

Insurance contract or identification number	217700
Number of Individuals Covered	166
Insurance policy start date	2016-05-01
Insurance policy end date	2017-04-30
Total amount of commissions paid to insurance broker	USD $9,397
Total amount of fees paid to insurance company	USD $1,075
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $53,725
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

217699

Policy instance

Insurance contract or identification number	217699
Number of Individuals Covered	905
Insurance policy start date	2016-04-01
Insurance policy end date	2017-03-31
Total amount of commissions paid to insurance broker	USD $35,071
Total amount of fees paid to insurance company	USD $3,890
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $194,621
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $35,047
Amount paid for insurance broker fees	3890
Additional information about fees paid to insurance broker	ADDITIONAL COMPENSATION, ADDITIONAL COMPENSATION
Insurance broker organization code?	3
Insurance broker name	DAMON M YOUNG JR

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

Policy contract number

217699

Policy instance

Insurance contract or identification number	217699
Number of Individuals Covered	905
Insurance policy start date	2016-04-01
Insurance policy end date	2017-03-31
Total amount of commissions paid to insurance broker	USD $25,674
Total amount of fees paid to insurance company	USD $2,815
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $140,896
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )

Policy contract number

19272

Policy instance

Insurance contract or identification number	19272
Number of Individuals Covered	761
Insurance policy start date	2016-11-01
Insurance policy end date	2017-10-31
Total amount of commissions paid to insurance broker	USD $96,519
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $3,876,002
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )

Policy contract number

3340138

Policy instance

Insurance contract or identification number	3340138
Number of Individuals Covered	394
Insurance policy start date	2016-11-01
Insurance policy end date	2017-10-31
Total amount of commissions paid to insurance broker	USD $11,384
Total amount of fees paid to insurance company	USD $0
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $230,808
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: 39616 )

Policy contract number

30054645

Policy instance

Insurance contract or identification number	30054645
Number of Individuals Covered	172
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $3,909
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $26,058
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,964
Insurance broker organization code?	3
Additional information about fees paid to insurance broker	MARKETING
Insurance broker name	DAMON YOUNG

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

Policy contract number

217700

Policy instance

Insurance contract or identification number	217700
Number of Individuals Covered	109
Insurance policy start date	2014-04-01
Insurance policy end date	2015-04-01
Total amount of commissions paid to insurance broker	USD $10,352
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $41,407
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $10,352
Insurance broker organization code?	3
Insurance broker name	DAMON M YOUNG JR

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

Policy contract number

217699

Policy instance

Insurance contract or identification number	217699
Number of Individuals Covered	583
Insurance policy start date	2014-04-01
Insurance policy end date	2015-04-01
Total amount of commissions paid to insurance broker	USD $27,951
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 $111,802
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $27,951
Additional information about fees paid to insurance broker	MARKETING
Insurance broker organization code?	3
Insurance broker name	DAMON YOUNG JR

ARKANSAS BLUE CROSS BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 83470 )

Policy contract number

027073

Policy instance

Insurance contract or identification number	027073
Number of Individuals Covered	239
Insurance policy start date	2014-11-01
Insurance policy end date	2015-10-31
Dental Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

ARKANSAS BLUE CROSS BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 83470 )

Policy contract number

019272

Policy instance

Insurance contract or identification number	019272
Number of Individuals Covered	219
Insurance policy start date	2014-11-01
Insurance policy end date	2015-10-31
Health Insurance Welfare Benefit	Yes
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

237830/E925

Policy instance

Insurance contract or identification number	237830/E925
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $304
Total amount of fees paid to insurance company	USD $101
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $241
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $304
Additional information about fees paid to insurance broker	MARKETING
Insurance broker organization code?	3
Amount paid for insurance broker fees	101
Insurance broker name	TRANSAMERICA

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

Policy contract number

217699

Policy instance

Insurance contract or identification number	217699
Number of Individuals Covered	479
Insurance policy start date	2013-04-01
Insurance policy end date	2014-04-01
Total amount of commissions paid to insurance broker	USD $29,176
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 $116,704
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $29,176
Additional information about fees paid to insurance broker	MARKETING
Insurance broker organization code?	3
Insurance broker name	DAMON YOUNG

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

Policy contract number

217700

Policy instance

Insurance contract or identification number	217700
Number of Individuals Covered	102
Insurance policy start date	2013-04-01
Insurance policy end date	2014-04-01
Total amount of commissions paid to insurance broker	USD $10,572
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $42,288
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $10,572
Additional information about fees paid to insurance broker	MARKETING
Insurance broker organization code?	3
Insurance broker name	DAMON YOUNG

ARKANSAS BLUE CROSS BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 83470 )

Policy contract number

019272

Policy instance

Insurance contract or identification number	019272
Number of Individuals Covered	208
Insurance policy start date	2013-11-01
Insurance policy end date	2014-10-31
Health Insurance Welfare Benefit	Yes
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

237830/E925

Policy instance

Insurance contract or identification number	237830/E925
Number of Individuals Covered	144
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $3,334
Total amount of fees paid to insurance company	USD $1,124
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $22,226
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,334
Additional information about fees paid to insurance broker	MARKETING
Insurance broker organization code?	3
Amount paid for insurance broker fees	1124
Insurance broker name	TRANSAMERICA

ARKANSAS BLUE CROSS BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 83470 )

Policy contract number

027073

Policy instance

Insurance contract or identification number	027073
Number of Individuals Covered	222
Insurance policy start date	2013-11-01
Insurance policy end date	2014-10-31
Dental Insurance Welfare Benefit	Yes
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

217699

Policy instance

Insurance contract or identification number	217699
Number of Individuals Covered	551
Insurance policy start date	2012-04-01
Insurance policy end date	2013-04-01
Total amount of commissions paid to insurance broker	USD $30,608
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 $122,431
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $30,608
Additional information about fees paid to insurance broker	MARKETING
Insurance broker organization code?	3
Insurance broker name	DAMON YOUNG

ARKANSAS BLUE CROSS BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 83470 )

Policy contract number

027073

Policy instance

Insurance contract or identification number	027073
Number of Individuals Covered	240
Insurance policy start date	2012-11-01
Insurance policy end date	2013-10-31
Dental Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

ARKANSAS BLUE CROSS BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 83470 )

Policy contract number

019272

Policy instance

Insurance contract or identification number	019272
Number of Individuals Covered	229
Insurance policy start date	2012-11-01
Insurance policy end date	2013-10-31
Health Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )

Policy contract number

704711G

Policy instance

Insurance contract or identification number	704711G
Number of Individuals Covered	288
Insurance policy start date	2012-02-01
Insurance policy end date	2013-01-31
Total amount of commissions paid to insurance broker	USD $5,941
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $29,705
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,941
Additional information about fees paid to insurance broker	MARKETING
Insurance broker organization code?	3
Insurance broker name	DAMON YOUNG

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

Policy contract number

237830

Policy instance

Insurance contract or identification number	237830
Number of Individuals Covered	152
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $3,733
Total amount of fees paid to insurance company	USD $1,244
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $24,885
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,733
Additional information about fees paid to insurance broker	MARKETING
Insurance broker organization code?	3
Amount paid for insurance broker fees	1244
Insurance broker name	TRANSAMERICA

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

Policy contract number

217700

Policy instance

Insurance contract or identification number	217700
Number of Individuals Covered	110
Insurance policy start date	2012-04-01
Insurance policy end date	2013-04-01
Total amount of commissions paid to insurance broker	USD $10,438
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $41,752
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $10,438
Additional information about fees paid to insurance broker	MARKETING
Insurance broker organization code?	3
Insurance broker name	DAMON YOUNG

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

Policy contract number

237830

Policy instance

Insurance contract or identification number	237830
Number of Individuals Covered	160
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $4,277
Total amount of fees paid to insurance company	USD $1,426
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $28,513
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	1426
Additional information about fees paid to insurance broker	MARKETING
Insurance broker organization code?	3
Commission paid to Insurance Broker	USD $4,277
Insurance broker name	D. MIKE YOUNG, JR.

ARKANSAS BLUE CROSS BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 83470 )

Policy contract number

027073

Policy instance

Insurance contract or identification number	027073
Number of Individuals Covered	251
Insurance policy start date	2011-11-01
Insurance policy end date	2012-10-31
Dental Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )

Policy contract number

704711G

Policy instance

Insurance contract or identification number	704711G
Number of Individuals Covered	319
Insurance policy start date	2011-02-01
Insurance policy end date	2012-01-31
Total amount of commissions paid to insurance broker	USD $37,641
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $188,204
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $37,641
Insurance broker name	DAMON YOUNG

ARKANSAS BLUE CROSS BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 83470 )

Policy contract number

019272

Policy instance

Insurance contract or identification number	019272
Number of Individuals Covered	247
Insurance policy start date	2011-11-01
Insurance policy end date	2012-10-31
Health Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

ARKANSAS BLUE CROSS BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 83470 )

Policy contract number

027073

Policy instance

Insurance contract or identification number	027073
Number of Individuals Covered	271
Insurance policy start date	2010-11-01
Insurance policy end date	2011-10-31
Dental Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

ARKANSAS BLUE CROSS BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 83470 )

Policy contract number

019272

Policy instance

Insurance contract or identification number	019272
Number of Individuals Covered	273
Insurance policy start date	2010-11-01
Insurance policy end date	2011-10-31
Health Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )

Policy contract number

704711G

Policy instance

Insurance contract or identification number	704711G
Number of Individuals Covered	314
Insurance policy start date	2010-02-01
Insurance policy end date	2011-01-31
Total amount of commissions paid to insurance broker	USD $36,181
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $195,701
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

237830

Policy instance

Insurance contract or identification number	237830
Number of Individuals Covered	180
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $4,841
Total amount of fees paid to insurance company	USD $1,614
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $32,275
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )

Policy contract number

704711G

Policy instance

Insurance contract or identification number	704711G
Number of Individuals Covered	299
Insurance policy start date	2009-02-01
Insurance policy end date	2010-01-31
Total amount of commissions paid to insurance broker	USD $34,359
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $157,000
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $34,359
Insurance broker name	DAMON YOUNG

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

Policy contract number

237830

Policy instance

Insurance contract or identification number	237830
Number of Individuals Covered	191
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $4,722
Total amount of fees paid to insurance company	USD $1,574
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $31,483
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	1574
Additional information about fees paid to insurance broker	MARKETING
Insurance broker organization code?	3
Commission paid to Insurance Broker	USD $4,722
Insurance broker name	D. MIKE YOUNG, JR.

ARKANSAS BLUE CROSS BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 83470 )

Policy contract number

027073

Policy instance

Insurance contract or identification number	027073
Number of Individuals Covered	282
Insurance policy start date	2009-11-01
Insurance policy end date	2010-10-31
Dental Insurance Welfare Benefit	Yes
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 number

KM05735475

Policy instance

Insurance contract or identification number	KM05735475
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $182
Total amount of fees paid to insurance company	USD $207
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $22
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
Amount paid for insurance broker fees	207
Additional information about fees paid to insurance broker	SUPPLEMENTAL COMPENSATION
Insurance broker organization code?	3
Insurance broker name	DAMON YOUNG

ARKANSAS BLUE CROSS BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 83470 )

Policy contract number

019272

Policy instance

Insurance contract or identification number	019272
Number of Individuals Covered	285
Insurance policy start date	2009-11-01
Insurance policy end date	2010-10-31
Health Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	TRUMAN ARNOLD COMPANIES
Employer identification number (EIN):	751289172
NAIC Classification:	424700

Jurisdiction of Incorporation:	State of Delaware Division of Corporations
Incorporation Date:
Company Identification Number:	3467763