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CONTAINER STORE, INC. CAFETERIA PLAN 401k Plan overview

Plan NameCONTAINER STORE, INC. CAFETERIA PLAN
Plan identification number 501

CONTAINER STORE, INC. CAFETERIA PLAN Benefits

401k Plan TypeWelfare 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)
  • Other welfare benefit cover

401k Sponsoring company profile

THE CONTAINER STORE INC. has sponsored the creation of one or more 401k plans.

Company Name:THE CONTAINER STORE INC.
Employer identification number (EIN):751596981
NAIC Classification:442299
NAIC Description:All Other Home Furnishings Stores

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CONTAINER STORE, INC. CAFETERIA PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012021-07-01JUSTIN PADILLA2023-01-26
5012020-07-01JUSTIN PADILLA2021-12-02
5012019-07-01STACY G JUETTEN2021-01-21
5012018-07-01STACY G JUETTEN2019-12-27
5012017-07-01
5012016-07-01
5012015-07-01STACY JUETTEN
5012014-07-01RENEE MORRIS
5012013-07-01RENEE MORRIS
5012012-07-01RENEE MORRIS RENEE MORRIS2014-01-06
5012011-07-01RENEE MORRIS
5012009-07-01RENEE MORRIS

Plan Statistics for CONTAINER STORE, INC. CAFETERIA PLAN

401k plan membership statisitcs for CONTAINER STORE, INC. CAFETERIA PLAN

Measure Date Value
2021: CONTAINER STORE, INC. CAFETERIA PLAN 2021 401k membership
Total participants, beginning-of-year2021-07-013,097
Total number of active participants reported on line 7a of the Form 55002021-07-01901
Number of retired or separated participants receiving benefits2021-07-0139
Number of other retired or separated participants entitled to future benefits2021-07-010
Total of all active and inactive participants2021-07-01940
Number of employers contributing to the scheme2021-07-010
2020: CONTAINER STORE, INC. CAFETERIA PLAN 2020 401k membership
Total participants, beginning-of-year2020-07-012,889
Total number of active participants reported on line 7a of the Form 55002020-07-012,974
Number of retired or separated participants receiving benefits2020-07-01123
Number of other retired or separated participants entitled to future benefits2020-07-010
Total of all active and inactive participants2020-07-013,097
Number of employers contributing to the scheme2020-07-010
2019: CONTAINER STORE, INC. CAFETERIA PLAN 2019 401k membership
Total participants, beginning-of-year2019-07-013,207
Total number of active participants reported on line 7a of the Form 55002019-07-012,695
Number of retired or separated participants receiving benefits2019-07-01194
Number of other retired or separated participants entitled to future benefits2019-07-010
Total of all active and inactive participants2019-07-012,889
Number of employers contributing to the scheme2019-07-010
2018: CONTAINER STORE, INC. CAFETERIA PLAN 2018 401k membership
Total participants, beginning-of-year2018-07-013,076
Total number of active participants reported on line 7a of the Form 55002018-07-013,165
Number of retired or separated participants receiving benefits2018-07-0142
Number of other retired or separated participants entitled to future benefits2018-07-010
Total of all active and inactive participants2018-07-013,207
Number of employers contributing to the scheme2018-07-010
2017: CONTAINER STORE, INC. CAFETERIA PLAN 2017 401k membership
Total participants, beginning-of-year2017-07-013,076
Total number of active participants reported on line 7a of the Form 55002017-07-013,076
Number of retired or separated participants receiving benefits2017-07-010
Number of other retired or separated participants entitled to future benefits2017-07-010
Total of all active and inactive participants2017-07-013,076
Number of employers contributing to the scheme2017-07-010
2016: CONTAINER STORE, INC. CAFETERIA PLAN 2016 401k membership
Total participants, beginning-of-year2016-07-012,067
Total number of active participants reported on line 7a of the Form 55002016-07-011,814
Number of retired or separated participants receiving benefits2016-07-0126
Number of other retired or separated participants entitled to future benefits2016-07-010
Total of all active and inactive participants2016-07-011,840
2015: CONTAINER STORE, INC. CAFETERIA PLAN 2015 401k membership
Total participants, beginning-of-year2015-07-011,305
Total number of active participants reported on line 7a of the Form 55002015-07-011,490
Number of retired or separated participants receiving benefits2015-07-010
Number of other retired or separated participants entitled to future benefits2015-07-010
Total of all active and inactive participants2015-07-011,490
2014: CONTAINER STORE, INC. CAFETERIA PLAN 2014 401k membership
Total participants, beginning-of-year2014-07-011,797
Total number of active participants reported on line 7a of the Form 55002014-07-011,876
Number of retired or separated participants receiving benefits2014-07-0138
Number of other retired or separated participants entitled to future benefits2014-07-010
Total of all active and inactive participants2014-07-011,914
2013: CONTAINER STORE, INC. CAFETERIA PLAN 2013 401k membership
Total participants, beginning-of-year2013-07-011,725
Total number of active participants reported on line 7a of the Form 55002013-07-011,804
Number of retired or separated participants receiving benefits2013-07-0119
Number of other retired or separated participants entitled to future benefits2013-07-010
Total of all active and inactive participants2013-07-011,823
2012: CONTAINER STORE, INC. CAFETERIA PLAN 2012 401k membership
Total participants, beginning-of-year2012-07-011,421
Total number of active participants reported on line 7a of the Form 55002012-07-011,519
Number of retired or separated participants receiving benefits2012-07-0125
Number of other retired or separated participants entitled to future benefits2012-07-010
Total of all active and inactive participants2012-07-011,544
2011: CONTAINER STORE, INC. CAFETERIA PLAN 2011 401k membership
Total participants, beginning-of-year2011-07-011,315
Total number of active participants reported on line 7a of the Form 55002011-07-011,421
Number of retired or separated participants receiving benefits2011-07-0116
Number of other retired or separated participants entitled to future benefits2011-07-010
Total of all active and inactive participants2011-07-011,437
2009: CONTAINER STORE, INC. CAFETERIA PLAN 2009 401k membership
Total participants, beginning-of-year2009-07-01906
Total number of active participants reported on line 7a of the Form 55002009-07-01896
Number of retired or separated participants receiving benefits2009-07-0115
Number of other retired or separated participants entitled to future benefits2009-07-010
Total of all active and inactive participants2009-07-01911

Form 5500 Responses for CONTAINER STORE, INC. CAFETERIA PLAN

2021: CONTAINER STORE, INC. CAFETERIA PLAN 2021 form 5500 responses
2021-07-01Type of plan entitySingle employer plan
2021-07-01Plan funding arrangement – InsuranceYes
2021-07-01Plan funding arrangement – General assets of the sponsorYes
2021-07-01Plan benefit arrangement – InsuranceYes
2021-07-01Plan benefit arrangement – General assets of the sponsorYes
2020: CONTAINER STORE, INC. CAFETERIA PLAN 2020 form 5500 responses
2020-07-01Type of plan entitySingle employer plan
2020-07-01Plan funding arrangement – InsuranceYes
2020-07-01Plan funding arrangement – General assets of the sponsorYes
2020-07-01Plan benefit arrangement – InsuranceYes
2020-07-01Plan benefit arrangement – General assets of the sponsorYes
2019: CONTAINER STORE, INC. CAFETERIA PLAN 2019 form 5500 responses
2019-07-01Type of plan entitySingle employer plan
2019-07-01Plan funding arrangement – InsuranceYes
2019-07-01Plan funding arrangement – General assets of the sponsorYes
2019-07-01Plan benefit arrangement – InsuranceYes
2019-07-01Plan benefit arrangement – General assets of the sponsorYes
2018: CONTAINER STORE, INC. CAFETERIA PLAN 2018 form 5500 responses
2018-07-01Type of plan entitySingle employer plan
2018-07-01Plan funding arrangement – InsuranceYes
2018-07-01Plan funding arrangement – General assets of the sponsorYes
2018-07-01Plan benefit arrangement – InsuranceYes
2018-07-01Plan benefit arrangement – General assets of the sponsorYes
2017: CONTAINER STORE, INC. CAFETERIA PLAN 2017 form 5500 responses
2017-07-01Type of plan entitySingle employer plan
2017-07-01Plan funding arrangement – InsuranceYes
2017-07-01Plan funding arrangement – General assets of the sponsorYes
2017-07-01Plan benefit arrangement – InsuranceYes
2017-07-01Plan benefit arrangement – General assets of the sponsorYes
2016: CONTAINER STORE, INC. CAFETERIA PLAN 2016 form 5500 responses
2016-07-01Type of plan entitySingle employer plan
2016-07-01Submission has been amendedNo
2016-07-01This submission is the final filingNo
2016-07-01This return/report is a short plan year return/report (less than 12 months)No
2016-07-01Plan is a collectively bargained planNo
2016-07-01Plan funding arrangement – InsuranceYes
2016-07-01Plan funding arrangement – General assets of the sponsorYes
2016-07-01Plan benefit arrangement – InsuranceYes
2016-07-01Plan benefit arrangement – General assets of the sponsorYes
2015: CONTAINER STORE, INC. CAFETERIA PLAN 2015 form 5500 responses
2015-07-01Type of plan entitySingle employer plan
2015-07-01Submission has been amendedNo
2015-07-01This submission is the final filingNo
2015-07-01This return/report is a short plan year return/report (less than 12 months)No
2015-07-01Plan is a collectively bargained planNo
2015-07-01Plan funding arrangement – InsuranceYes
2015-07-01Plan funding arrangement – General assets of the sponsorYes
2015-07-01Plan benefit arrangement – InsuranceYes
2015-07-01Plan benefit arrangement – General assets of the sponsorYes
2014: CONTAINER STORE, INC. CAFETERIA PLAN 2014 form 5500 responses
2014-07-01Type of plan entitySingle employer plan
2014-07-01Submission has been amendedNo
2014-07-01This submission is the final filingNo
2014-07-01This return/report is a short plan year return/report (less than 12 months)No
2014-07-01Plan is a collectively bargained planNo
2014-07-01Plan funding arrangement – InsuranceYes
2014-07-01Plan funding arrangement – General assets of the sponsorYes
2014-07-01Plan benefit arrangement – InsuranceYes
2014-07-01Plan benefit arrangement – General assets of the sponsorYes
2013: CONTAINER STORE, INC. CAFETERIA PLAN 2013 form 5500 responses
2013-07-01Type of plan entitySingle employer plan
2013-07-01Submission has been amendedNo
2013-07-01This submission is the final filingNo
2013-07-01This return/report is a short plan year return/report (less than 12 months)No
2013-07-01Plan is a collectively bargained planNo
2013-07-01Plan funding arrangement – InsuranceYes
2013-07-01Plan funding arrangement – General assets of the sponsorYes
2013-07-01Plan benefit arrangement – InsuranceYes
2013-07-01Plan benefit arrangement – General assets of the sponsorYes
2012: CONTAINER STORE, INC. CAFETERIA PLAN 2012 form 5500 responses
2012-07-01Type of plan entitySingle employer plan
2012-07-01Submission has been amendedNo
2012-07-01This submission is the final filingNo
2012-07-01This return/report is a short plan year return/report (less than 12 months)No
2012-07-01Plan is a collectively bargained planNo
2012-07-01Plan funding arrangement – InsuranceYes
2012-07-01Plan funding arrangement – General assets of the sponsorYes
2012-07-01Plan benefit arrangement – InsuranceYes
2012-07-01Plan benefit arrangement – General assets of the sponsorYes
2011: CONTAINER STORE, INC. CAFETERIA PLAN 2011 form 5500 responses
2011-07-01Type of plan entitySingle employer plan
2011-07-01Submission has been amendedNo
2011-07-01This submission is the final filingNo
2011-07-01This return/report is a short plan year return/report (less than 12 months)No
2011-07-01Plan is a collectively bargained planNo
2011-07-01Plan funding arrangement – InsuranceYes
2011-07-01Plan funding arrangement – General assets of the sponsorYes
2011-07-01Plan benefit arrangement – InsuranceYes
2011-07-01Plan benefit arrangement – General assets of the sponsorYes
2009: CONTAINER STORE, INC. CAFETERIA PLAN 2009 form 5500 responses
2009-07-01Type of plan entitySingle employer plan
2009-07-01Submission has been amendedNo
2009-07-01This submission is the final filingNo
2009-07-01This return/report is a short plan year return/report (less than 12 months)No
2009-07-01Plan is a collectively bargained planNo
2009-07-01Plan funding arrangement – InsuranceYes
2009-07-01Plan funding arrangement – General assets of the sponsorYes
2009-07-01Plan benefit arrangement – InsuranceYes
2009-07-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX966645
Policy instance 5
Insurance contract or identification numberFLX966645
Number of Individuals Covered910
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $866,648
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number99139891001
Policy instance 4
Insurance contract or identification number99139891001
Number of Individuals Covered2138
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $37,794
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Welfare Benefit Premiums Paid to CarrierUSD $159,205
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $37,794
Amount paid for insurance broker fees0
Insurance broker organization code?3
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number11077000
Policy instance 3
Insurance contract or identification number11077000
Number of Individuals Covered945
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $10,157
Total amount of fees paid to insurance companyUSD $7,684
Other welfare benefits providedHOSPITAL
Welfare Benefit Premiums Paid to CarrierUSD $203,139
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,157
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerGROUP MARKETING SUPPORT FEE
CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 )
Policy contract number20552
Policy instance 2
Insurance contract or identification number20552
Number of Individuals Covered901
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $100,228
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $238,374
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $41,757
Amount paid for insurance broker fees0
Insurance broker organization code?3
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number847844
Policy instance 1
Insurance contract or identification number847844
Number of Individuals Covered283
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $17
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $47,007
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees17
Additional information about fees paid to insurance brokerINDIRECT COMPENSATION
Insurance broker organization code?3
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number847844
Policy instance 1
Insurance contract or identification number847844
Number of Individuals Covered309
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $44,221
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 )
Policy contract number20552
Policy instance 2
Insurance contract or identification number20552
Number of Individuals Covered2974
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $36,221
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $184,001
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,123
Amount paid for insurance broker fees0
Insurance broker organization code?3
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number11077000
Policy instance 3
Insurance contract or identification number11077000
Number of Individuals Covered968
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $10,489
Total amount of fees paid to insurance companyUSD $6,318
Other welfare benefits providedHOSPITAL
Welfare Benefit Premiums Paid to CarrierUSD $236,523
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,489
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerGROUP MARKETING SUPPORT FEE
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number99139891001
Policy instance 4
Insurance contract or identification number99139891001
Number of Individuals Covered2874
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $16,029
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Welfare Benefit Premiums Paid to CarrierUSD $147,004
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,029
Amount paid for insurance broker fees0
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX966645
Policy instance 5
Insurance contract or identification numberFLX966645
Number of Individuals Covered2974
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $479
Total amount of fees paid to insurance companyUSD $14,837
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $405,843
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $479
Amount paid for insurance broker fees14837
Additional information about fees paid to insurance brokerOVERRIDE
Insurance broker organization code?3
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number847844
Policy instance 1
Insurance contract or identification number847844
Number of Individuals Covered367
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $3,903
Total amount of fees paid to insurance companyUSD $103
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $58,471
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,903
Amount paid for insurance broker fees103
Additional information about fees paid to insurance brokerINDIRECT COMPENSATION
Insurance broker organization code?3
CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 )
Policy contract number20552
Policy instance 2
Insurance contract or identification number20552
Number of Individuals Covered2695
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $62,299
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $229,238
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $23,502
Amount paid for insurance broker fees0
Insurance broker organization code?3
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number11077
Policy instance 3
Insurance contract or identification number11077
Number of Individuals Covered1076
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $11,050
Other welfare benefits providedHOSPITAL
Welfare Benefit Premiums Paid to CarrierUSD $278,407
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees5556
Additional information about fees paid to insurance brokerGROUP MARKETING SUPPORT FEE
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number99139891001
Policy instance 4
Insurance contract or identification number99139891001
Number of Individuals Covered2367
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $15,152
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Welfare Benefit Premiums Paid to CarrierUSD $151,340
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,152
Amount paid for insurance broker fees0
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX966645
Policy instance 5
Insurance contract or identification numberFLX966645
Number of Individuals Covered2695
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $13,298
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $858,538
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees13298
Additional information about fees paid to insurance brokerOVERRIDE
Insurance broker organization code?3
CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 )
Policy contract number20552
Policy instance 2
Insurance contract or identification number20552
Number of Individuals Covered2598
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $58,368
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $231,285
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $21,915
Amount paid for insurance broker fees0
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number99139891001
Policy instance 5
Insurance contract or identification number99139891001
Number of Individuals Covered3207
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $17,191
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Welfare Benefit Premiums Paid to CarrierUSD $161,544
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17,191
Amount paid for insurance broker fees0
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX966645
Policy instance 4
Insurance contract or identification numberFLX966645
Number of Individuals Covered1287
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $759,429
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number11077
Policy instance 3
Insurance contract or identification number11077
Number of Individuals Covered659
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $29,769
Total amount of fees paid to insurance companyUSD $20,178
Other welfare benefits providedHOSPITAL
Welfare Benefit Premiums Paid to CarrierUSD $575,282
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $29,769
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerGROUP MARKETING SUPPORT FEE
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number847844
Policy instance 1
Insurance contract or identification number847844
Number of Individuals Covered424
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $32
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $68,311
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees32
Additional information about fees paid to insurance brokerINDIRECT COMPENSATION
Insurance broker organization code?3
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number847844
Policy instance 2
Insurance contract or identification number847844
Number of Individuals Covered418
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $66,085
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 numberFLX966645
Policy instance 4
Insurance contract or identification numberFLX966645
Number of Individuals Covered3076
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $26,196
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $783,269
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number99139891001
Policy instance 1
Insurance contract or identification number99139891001
Number of Individuals Covered3076
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $2,130
Total amount of fees paid to insurance companyUSD $18,765
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $144,312
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 )
Policy contract number20552
Policy instance 3
Insurance contract or identification number20552
Number of Individuals Covered2278
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $66,446
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $230,535
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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