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LOCKHEED MARTIN INDUSTRIAL DEFENDER, INC. HEALTH AND WELFARE PLAN 401k Plan overview

Plan NameLOCKHEED MARTIN INDUSTRIAL DEFENDER, INC. HEALTH AND WELFARE PLAN
Plan identification number 501

LOCKHEED MARTIN INDUSTRIAL DEFENDER, INC. HEALTH AND WELFARE PLAN Benefits

401k Plan Type
Plan Features/Benefits

    401k Sponsoring company profile

    INDUSTRIAL DEFENDER, INC. has sponsored the creation of one or more 401k plans.

    Company Name:INDUSTRIAL DEFENDER, INC.
    Employer identification number (EIN):770438054
    NAIC Classification:541519
    NAIC Description:Other Computer Related Services

    Form 5500 Filing Information

    Submission information for form 5500 for 401k plan LOCKHEED MARTIN INDUSTRIAL DEFENDER, INC. HEALTH AND WELFARE PLAN

    Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
    5012018-04-01
    5012017-04-01KIM COFFEY
    5012016-04-01KIM COFFEY
    5012015-04-01LORI FITZPATRICK

    Plan Statistics for LOCKHEED MARTIN INDUSTRIAL DEFENDER, INC. HEALTH AND WELFARE PLAN

    401k plan membership statisitcs for LOCKHEED MARTIN INDUSTRIAL DEFENDER, INC. HEALTH AND WELFARE PLAN

    Measure Date Value
    2018: LOCKHEED MARTIN INDUSTRIAL DEFENDER, INC. HEALTH AND WELFARE PLAN 2018 401k membership
    Total participants, beginning-of-year2018-04-01431
    Total number of active participants reported on line 7a of the Form 55002018-04-010
    Total of all active and inactive participants2018-04-010
    2017: LOCKHEED MARTIN INDUSTRIAL DEFENDER, INC. HEALTH AND WELFARE PLAN 2017 401k membership
    Total participants, beginning-of-year2017-04-01343
    Total number of active participants reported on line 7a of the Form 55002017-04-01427
    Number of retired or separated participants receiving benefits2017-04-014
    Total of all active and inactive participants2017-04-01431
    2016: LOCKHEED MARTIN INDUSTRIAL DEFENDER, INC. HEALTH AND WELFARE PLAN 2016 401k membership
    Total participants, beginning-of-year2016-04-01343
    Total number of active participants reported on line 7a of the Form 55002016-04-01322
    Number of retired or separated participants receiving benefits2016-04-016
    Total of all active and inactive participants2016-04-01328
    2015: LOCKHEED MARTIN INDUSTRIAL DEFENDER, INC. HEALTH AND WELFARE PLAN 2015 401k membership
    Total participants, beginning-of-year2015-04-01139
    Total number of active participants reported on line 7a of the Form 55002015-04-01338
    Number of retired or separated participants receiving benefits2015-04-015
    Number of other retired or separated participants entitled to future benefits2015-04-010
    Total of all active and inactive participants2015-04-01343

    Form 5500 Responses for LOCKHEED MARTIN INDUSTRIAL DEFENDER, INC. HEALTH AND WELFARE PLAN

    2018: LOCKHEED MARTIN INDUSTRIAL DEFENDER, INC. HEALTH AND WELFARE PLAN 2018 form 5500 responses
    2018-04-01Type of plan entitySingle employer plan
    2018-04-01Submission has been amendedNo
    2018-04-01This submission is the final filingYes
    2018-04-01This return/report is a short plan year return/report (less than 12 months)No
    2018-04-01Plan is a collectively bargained planNo
    2018-04-01Plan funding arrangement – InsuranceYes
    2018-04-01Plan funding arrangement – General assets of the sponsorYes
    2018-04-01Plan benefit arrangement – InsuranceYes
    2018-04-01Plan benefit arrangement – General assets of the sponsorYes
    2017: LOCKHEED MARTIN INDUSTRIAL DEFENDER, INC. HEALTH AND WELFARE PLAN 2017 form 5500 responses
    2017-04-01Type of plan entitySingle employer plan
    2017-04-01Submission has been amendedNo
    2017-04-01This submission is the final filingNo
    2017-04-01This return/report is a short plan year return/report (less than 12 months)No
    2017-04-01Plan is a collectively bargained planNo
    2017-04-01Plan funding arrangement – InsuranceYes
    2017-04-01Plan funding arrangement – General assets of the sponsorYes
    2017-04-01Plan benefit arrangement – InsuranceYes
    2017-04-01Plan benefit arrangement – General assets of the sponsorYes
    2016: LOCKHEED MARTIN INDUSTRIAL DEFENDER, INC. HEALTH AND WELFARE PLAN 2016 form 5500 responses
    2016-04-01Type of plan entitySingle employer plan
    2016-04-01Submission has been amendedNo
    2016-04-01This submission is the final filingNo
    2016-04-01This return/report is a short plan year return/report (less than 12 months)No
    2016-04-01Plan is a collectively bargained planNo
    2016-04-01Plan funding arrangement – InsuranceYes
    2016-04-01Plan funding arrangement – General assets of the sponsorYes
    2016-04-01Plan benefit arrangement – InsuranceYes
    2016-04-01Plan benefit arrangement – General assets of the sponsorYes
    2015: LOCKHEED MARTIN INDUSTRIAL DEFENDER, INC. HEALTH AND WELFARE PLAN 2015 form 5500 responses
    2015-04-01Type of plan entitySingle employer plan
    2015-04-01First time form 5500 has been submittedYes
    2015-04-01Submission has been amendedNo
    2015-04-01This submission is the final filingNo
    2015-04-01This return/report is a short plan year return/report (less than 12 months)No
    2015-04-01Plan is a collectively bargained planNo
    2015-04-01Plan funding arrangement – InsuranceYes
    2015-04-01Plan funding arrangement – General assets of the sponsorYes
    2015-04-01Plan benefit arrangement – InsuranceYes
    2015-04-01Plan benefit arrangement – General assets of the sponsorYes

    Insurance Providers Used on plan

    THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
    Policy contract number10228155
    Policy instance 4
    Insurance contract or identification number10228155
    Number of Individuals Covered445
    Insurance policy start date2018-04-01
    Insurance policy end date2019-03-31
    Total amount of commissions paid to insurance brokerUSD $15,324
    Total amount of fees paid to insurance companyUSD $9,777
    Are there contracts with allocated funds for individual policies?0
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
    Are there contracts with unallocated funds for contracts of type guaranteed investment?No
    Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
    Health Insurance Welfare BenefitNo
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitYes
    Temporary Disability Insurance Welfare BenefitYes
    Long Term Disability Insurance Welfare BenefitYes
    Unemployment Insurance Welfare BenefitNo
    Other welfare benefits providedAD&D AND NY DBL
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $245,568
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $15,324
    Amount paid for insurance broker fees9777
    Additional information about fees paid to insurance brokerINCENTIVE BONUS
    Insurance broker organization code?3
    EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
    Policy contract number9876889
    Policy instance 3
    Insurance contract or identification number9876889
    Number of Individuals Covered863
    Insurance policy start date2018-04-01
    Insurance policy end date2019-03-31
    Total amount of commissions paid to insurance brokerUSD $5,410
    Total amount of fees paid to insurance companyUSD $0
    Are there contracts with allocated funds for individual policies?0
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
    Are there contracts with unallocated funds for contracts of type guaranteed investment?No
    Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
    Health Insurance Welfare BenefitNo
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitYes
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $49,743
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $5,410
    Insurance broker organization code?3
    DELTA DENTAL OF MASSACHUSETTS (National Association of Insurance Commissioners NAIC id number: 52060 )
    Policy contract number005906
    Policy instance 2
    Insurance contract or identification number005906
    Number of Individuals Covered936
    Insurance policy start date2018-04-01
    Insurance policy end date2019-03-31
    Total amount of commissions paid to insurance brokerUSD $17,185
    Total amount of fees paid to insurance companyUSD $0
    Are there contracts with allocated funds for individual policies?0
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
    Are there contracts with unallocated funds for contracts of type guaranteed investment?No
    Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
    Health Insurance Welfare BenefitNo
    Dental Insurance Welfare BenefitYes
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $425,580
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $17,185
    Insurance broker organization code?3
    BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 )
    Policy contract number8002794
    Policy instance 1
    Insurance contract or identification number8002794
    Number of Individuals Covered900
    Insurance policy start date2018-04-01
    Insurance policy end date2019-03-31
    Total amount of commissions paid to insurance brokerUSD $81,341
    Total amount of fees paid to insurance companyUSD $31,664
    Are there contracts with allocated funds for individual policies?0
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
    Are there contracts with unallocated funds for contracts of type guaranteed investment?No
    Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
    Health Insurance Welfare BenefitYes
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $81,341
    Amount paid for insurance broker fees31664
    Additional information about fees paid to insurance brokerPERSISTENCY
    Insurance broker organization code?3
    THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
    Policy contract number10228155
    Policy instance 4
    Insurance contract or identification number10228155
    Number of Individuals Covered427
    Insurance policy start date2017-04-01
    Insurance policy end date2018-03-31
    Total amount of commissions paid to insurance brokerUSD $10,543
    Total amount of fees paid to insurance companyUSD $0
    Are there contracts with allocated funds for individual policies?0
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
    Are there contracts with unallocated funds for contracts of type guaranteed investment?No
    Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
    Health Insurance Welfare BenefitNo
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitYes
    Temporary Disability Insurance Welfare BenefitYes
    Long Term Disability Insurance Welfare BenefitYes
    Unemployment Insurance Welfare BenefitNo
    Other welfare benefits providedAD&D
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $174,938
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $10,543
    Insurance broker organization code?3
    Insurance broker nameBROWN & BROWN OF MA
    EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
    Policy contract number9876889
    Policy instance 3
    Insurance contract or identification number9876889
    Number of Individuals Covered883
    Insurance policy start date2017-04-01
    Insurance policy end date2018-03-31
    Total amount of commissions paid to insurance brokerUSD $4,498
    Total amount of fees paid to insurance companyUSD $0
    Are there contracts with allocated funds for individual policies?0
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
    Are there contracts with unallocated funds for contracts of type guaranteed investment?No
    Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
    Health Insurance Welfare BenefitNo
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitYes
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $49,331
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $4,498
    Insurance broker organization code?3
    Insurance broker nameBROWN & BROWN OF MASSACHUSETTS
    DELTA DENTAL OF MASSACHUSETTS (National Association of Insurance Commissioners NAIC id number: 52060 )
    Policy contract number005906
    Policy instance 2
    Insurance contract or identification number005906
    Number of Individuals Covered946
    Insurance policy start date2017-04-01
    Insurance policy end date2018-03-31
    Total amount of commissions paid to insurance brokerUSD $9,184
    Total amount of fees paid to insurance companyUSD $0
    Are there contracts with allocated funds for individual policies?0
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
    Are there contracts with unallocated funds for contracts of type guaranteed investment?No
    Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
    Health Insurance Welfare BenefitNo
    Dental Insurance Welfare BenefitYes
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $347,330
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $9,184
    Insurance broker organization code?3
    Insurance broker nameBROWN & BROWN OF MASSACHUSETTS
    BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 )
    Policy contract number8002794
    Policy instance 1
    Insurance contract or identification number8002794
    Number of Individuals Covered867
    Insurance policy start date2017-04-01
    Insurance policy end date2018-03-31
    Total amount of commissions paid to insurance brokerUSD $56,981
    Total amount of fees paid to insurance companyUSD $23,760
    Are there contracts with allocated funds for individual policies?0
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
    Are there contracts with unallocated funds for contracts of type guaranteed investment?No
    Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
    Health Insurance Welfare BenefitYes
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $56,981
    Amount paid for insurance broker fees23760
    Additional information about fees paid to insurance brokerPERSISTENCY
    Insurance broker organization code?3
    Insurance broker nameBROWN & BROWN OF MASSACHUSETTS
    SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
    Policy contract number0101601200
    Policy instance 4
    Insurance contract or identification number0101601200
    Number of Individuals Covered338
    Insurance policy start date2015-04-01
    Insurance policy end date2016-03-31
    Total amount of commissions paid to insurance brokerUSD $13,923
    Total amount of fees paid to insurance companyUSD $0
    Are there contracts with allocated funds for individual policies?No
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
    Are there contracts with unallocated funds for contracts of type guaranteed investment?No
    Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
    Health Insurance Welfare BenefitNo
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitYes
    Temporary Disability Insurance Welfare BenefitYes
    Long Term Disability Insurance Welfare BenefitYes
    Unemployment Insurance Welfare BenefitNo
    Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $139,881
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $13,923
    Insurance broker organization code?3
    Insurance broker nameBROWN & BROWN OF MASSACHUSETTS
    EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
    Policy contract number9876889
    Policy instance 3
    Insurance contract or identification number9876889
    Number of Individuals Covered741
    Insurance policy start date2015-04-01
    Insurance policy end date2016-03-31
    Total amount of commissions paid to insurance brokerUSD $1,967
    Total amount of fees paid to insurance companyUSD $0
    Are there contracts with allocated funds for individual policies?No
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
    Are there contracts with unallocated funds for contracts of type guaranteed investment?No
    Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
    Health Insurance Welfare BenefitNo
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitYes
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $2,708,952
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $1,967
    Insurance broker organization code?3
    Insurance broker nameBROWN & BROWN OF MASSACHUSETTS
    DELTA DENTAL OF MASSACHUSETTS (National Association of Insurance Commissioners NAIC id number: 52060 )
    Policy contract number005906
    Policy instance 2
    Insurance contract or identification number005906
    Number of Individuals Covered833
    Insurance policy start date2015-04-01
    Insurance policy end date2016-03-31
    Total amount of commissions paid to insurance brokerUSD $4,941
    Total amount of fees paid to insurance companyUSD $0
    Are there contracts with allocated funds for individual policies?No
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
    Are there contracts with unallocated funds for contracts of type guaranteed investment?No
    Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
    Health Insurance Welfare BenefitNo
    Dental Insurance Welfare BenefitYes
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $222,640
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $4,941
    Insurance broker organization code?3
    Insurance broker nameBROWN & BROWN OF MASSACHUSETTS
    BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 )
    Policy contract number8002794
    Policy instance 1
    Insurance contract or identification number8002794
    Number of Individuals Covered760
    Insurance policy start date2015-04-01
    Insurance policy end date2016-03-31
    Total amount of commissions paid to insurance brokerUSD $41,727
    Total amount of fees paid to insurance companyUSD $11,790
    Are there contracts with allocated funds for individual policies?No
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
    Are there contracts with unallocated funds for contracts of type guaranteed investment?No
    Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
    Health Insurance Welfare BenefitYes
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $41,727
    Amount paid for insurance broker fees11790
    Additional information about fees paid to insurance brokerPERSISTENCY
    Insurance broker organization code?3
    Insurance broker nameBROWN & BROWN OF MASSACHUSETTS

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