WATKINS & SHEPARD TRUCKING, INC. has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan GROUP TERM LIFE, ACCIDENTAL DEATH & DISMEMBERMENT, DEPENDENT LIFE
401k plan membership statisitcs for GROUP TERM LIFE, ACCIDENTAL DEATH & DISMEMBERMENT, DEPENDENT LIFE
Measure | Date | Value |
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2017: GROUP TERM LIFE, ACCIDENTAL DEATH & DISMEMBERMENT, DEPENDENT LIFE 2017 401k membership |
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Total participants, beginning-of-year | 2017-10-01 | 1,092 |
Total number of active participants reported on line 7a of the Form 5500 | 2017-10-01 | 0 |
Number of retired or separated participants receiving benefits | 2017-10-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2017-10-01 | 0 |
Total of all active and inactive participants | 2017-10-01 | 0 |
2016: GROUP TERM LIFE, ACCIDENTAL DEATH & DISMEMBERMENT, DEPENDENT LIFE 2016 401k membership |
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Total participants, beginning-of-year | 2016-10-01 | 1,265 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-10-01 | 1,092 |
Number of retired or separated participants receiving benefits | 2016-10-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2016-10-01 | 0 |
Total of all active and inactive participants | 2016-10-01 | 1,092 |
2015: GROUP TERM LIFE, ACCIDENTAL DEATH & DISMEMBERMENT, DEPENDENT LIFE 2015 401k membership |
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Total participants, beginning-of-year | 2015-10-01 | 1,208 |
Total number of active participants reported on line 7a of the Form 5500 | 2015-10-01 | 1,265 |
Number of retired or separated participants receiving benefits | 2015-10-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2015-10-01 | 0 |
Total of all active and inactive participants | 2015-10-01 | 1,265 |
2014: GROUP TERM LIFE, ACCIDENTAL DEATH & DISMEMBERMENT, DEPENDENT LIFE 2014 401k membership |
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Total participants, beginning-of-year | 2014-10-01 | 696 |
Total number of active participants reported on line 7a of the Form 5500 | 2014-10-01 | 1,208 |
Number of retired or separated participants receiving benefits | 2014-10-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2014-10-01 | 0 |
Total of all active and inactive participants | 2014-10-01 | 1,208 |
2013: GROUP TERM LIFE, ACCIDENTAL DEATH & DISMEMBERMENT, DEPENDENT LIFE 2013 401k membership |
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Total participants, beginning-of-year | 2013-10-01 | 623 |
Total number of active participants reported on line 7a of the Form 5500 | 2013-10-01 | 696 |
Total of all active and inactive participants | 2013-10-01 | 696 |
2012: GROUP TERM LIFE, ACCIDENTAL DEATH & DISMEMBERMENT, DEPENDENT LIFE 2012 401k membership |
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Total participants, beginning-of-year | 2012-10-01 | 615 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-10-01 | 623 |
Total of all active and inactive participants | 2012-10-01 | 623 |
2011: GROUP TERM LIFE, ACCIDENTAL DEATH & DISMEMBERMENT, DEPENDENT LIFE 2011 401k membership |
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Total participants, beginning-of-year | 2011-10-01 | 608 |
Total number of active participants reported on line 7a of the Form 5500 | 2011-10-01 | 615 |
Total of all active and inactive participants | 2011-10-01 | 615 |
2010: GROUP TERM LIFE, ACCIDENTAL DEATH & DISMEMBERMENT, DEPENDENT LIFE 2010 401k membership |
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Total participants, beginning-of-year | 2010-10-01 | 576 |
Total number of active participants reported on line 7a of the Form 5500 | 2010-10-01 | 608 |
Total of all active and inactive participants | 2010-10-01 | 608 |
2009: GROUP TERM LIFE, ACCIDENTAL DEATH & DISMEMBERMENT, DEPENDENT LIFE 2009 401k membership |
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Total participants, beginning-of-year | 2009-10-01 | 460 |
Total number of active participants reported on line 7a of the Form 5500 | 2009-10-01 | 576 |
Total of all active and inactive participants | 2009-10-01 | 576 |
2017: GROUP TERM LIFE, ACCIDENTAL DEATH & DISMEMBERMENT, DEPENDENT LIFE 2017 form 5500 responses |
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2017-10-01 | Type of plan entity | Single employer plan |
2017-10-01 | This submission is the final filing | Yes |
2017-10-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
2017-10-01 | Plan funding arrangement – Insurance | Yes |
2017-10-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2017-10-01 | Plan benefit arrangement – Insurance | Yes |
2017-10-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2016: GROUP TERM LIFE, ACCIDENTAL DEATH & DISMEMBERMENT, DEPENDENT LIFE 2016 form 5500 responses |
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2016-10-01 | Type of plan entity | Single employer plan |
2016-10-01 | Submission has been amended | Yes |
2016-10-01 | Plan funding arrangement – Insurance | Yes |
2016-10-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2016-10-01 | Plan benefit arrangement – Insurance | Yes |
2016-10-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2015: GROUP TERM LIFE, ACCIDENTAL DEATH & DISMEMBERMENT, DEPENDENT LIFE 2015 form 5500 responses |
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2015-10-01 | Type of plan entity | Single employer plan |
2015-10-01 | Plan funding arrangement – Insurance | Yes |
2015-10-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2015-10-01 | Plan benefit arrangement – Insurance | Yes |
2015-10-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2014: GROUP TERM LIFE, ACCIDENTAL DEATH & DISMEMBERMENT, DEPENDENT LIFE 2014 form 5500 responses |
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2014-10-01 | Type of plan entity | Single employer plan |
2014-10-01 | Plan funding arrangement – Insurance | Yes |
2014-10-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2014-10-01 | Plan benefit arrangement – Insurance | Yes |
2014-10-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2013: GROUP TERM LIFE, ACCIDENTAL DEATH & DISMEMBERMENT, DEPENDENT LIFE 2013 form 5500 responses |
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2013-10-01 | Type of plan entity | Single employer plan |
2013-10-01 | Plan funding arrangement – Insurance | Yes |
2013-10-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2013-10-01 | Plan benefit arrangement – Insurance | Yes |
2013-10-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2012: GROUP TERM LIFE, ACCIDENTAL DEATH & DISMEMBERMENT, DEPENDENT LIFE 2012 form 5500 responses |
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2012-10-01 | Type of plan entity | Single employer plan |
2012-10-01 | Plan funding arrangement – Insurance | Yes |
2012-10-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2012-10-01 | Plan benefit arrangement – Insurance | Yes |
2012-10-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2011: GROUP TERM LIFE, ACCIDENTAL DEATH & DISMEMBERMENT, DEPENDENT LIFE 2011 form 5500 responses |
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2011-10-01 | Type of plan entity | Single employer plan |
2011-10-01 | Plan funding arrangement – Insurance | Yes |
2011-10-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2011-10-01 | Plan benefit arrangement – Insurance | Yes |
2011-10-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2010: GROUP TERM LIFE, ACCIDENTAL DEATH & DISMEMBERMENT, DEPENDENT LIFE 2010 form 5500 responses |
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2010-10-01 | Type of plan entity | Single employer plan |
2010-10-01 | Plan funding arrangement – Insurance | Yes |
2010-10-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2010-10-01 | Plan benefit arrangement – Insurance | Yes |
2010-10-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2009: GROUP TERM LIFE, ACCIDENTAL DEATH & DISMEMBERMENT, DEPENDENT LIFE 2009 form 5500 responses |
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2009-10-01 | Type of plan entity | Single employer plan |
2009-10-01 | Plan funding arrangement – Insurance | Yes |
2009-10-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2009-10-01 | Plan benefit arrangement – Insurance | Yes |
2009-10-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
MAGELLAN HEALTH SERVICES (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | HCSC0-073 |
Policy instance | 7 |
Insurance contract or identification number | HCSC0-073 | Number of Individuals Covered | 659 | Insurance policy start date | 2017-10-01 | Insurance policy end date | 2017-12-31 | Other welfare benefits provided | EAP | Welfare Benefit Premiums Paid to Carrier | USD $989 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
Policy contract number | 1036339 |
Policy instance | 1 |
Insurance contract or identification number | 1036339 | Number of Individuals Covered | 1092 | Insurance policy start date | 2017-10-01 | Insurance policy end date | 2017-12-31 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $9,405 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 852142G |
Policy instance | 2 |
Insurance contract or identification number | 852142G | Number of Individuals Covered | 348 | Insurance policy start date | 2017-10-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $10,106 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $40,426 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,053 | Insurance broker organization code? | 3 | Insurance broker name | BCINSOURCING, LLC |
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PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) |
Policy contract number | 0007714517 |
Policy instance | 3 |
Insurance contract or identification number | 0007714517 | Number of Individuals Covered | 610 | Insurance policy start date | 2017-10-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $8,652 | Total amount of fees paid to insurance company | USD $859 | Other welfare benefits provided | CRITICAL ILLNESS, ACCIDENT | Welfare Benefit Premiums Paid to Carrier | USD $47,440 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,326 | Amount paid for insurance broker fees | 456 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | BCINSOURCING, LLC |
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DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
Policy contract number | MX41188 |
Policy instance | 4 |
Insurance contract or identification number | MX41188 | Number of Individuals Covered | 1 | Insurance policy start date | 2017-10-01 | Insurance policy end date | 2017-12-31 | Total amount of fees paid to insurance company | USD $25 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $84 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 25 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | PEAK1 ADMINISTRATION LLC |
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NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 ) |
Policy contract number | 33891 |
Policy instance | 5 |
Insurance contract or identification number | 33891 | Number of Individuals Covered | 707 | Insurance policy start date | 2017-10-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $1,673 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $12,554 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,673 | Insurance broker organization code? | 3 | Insurance broker name | LOCKTON COMPANIES, LLC |
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BCS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 38245 ) |
Policy contract number | EXL-30326 |
Policy instance | 6 |
Insurance contract or identification number | EXL-30326 | Number of Individuals Covered | 661 | Insurance policy start date | 2017-10-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $7,199 | Welfare Benefit Premiums Paid to Carrier | USD $143,971 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $7,199 | Insurance broker organization code? | 3 | Insurance broker name | LOCKTON COMPANIES, LLC |
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PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
Policy contract number | 1036339 |
Policy instance | 2 |
Insurance contract or identification number | 1036339 | Number of Individuals Covered | 926 | Insurance policy start date | 2015-10-01 | Insurance policy end date | 2016-09-30 | Total amount of fees paid to insurance company | USD $536 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $19,023 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 536 | Additional information about fees paid to insurance broker | BONUS | Insurance broker organization code? | 3 | Insurance broker name | LOCKTON COMPANIES, LLC |
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HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 852142G |
Policy instance | 3 |
Insurance contract or identification number | 852142G | Number of Individuals Covered | 434 | Insurance policy start date | 2015-10-01 | Insurance policy end date | 2016-09-30 | Total amount of commissions paid to insurance broker | USD $27,691 | Total amount of fees paid to insurance company | USD $1,925 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $110,766 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $21,341 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 1925 | Additional information about fees paid to insurance broker | BONUS | Insurance broker name | LOCKTON COMPANIES, LLC |
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DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
Policy contract number | MM041188 |
Policy instance | 4 |
Insurance contract or identification number | MM041188 | Number of Individuals Covered | 33 | Insurance policy start date | 2015-10-01 | Insurance policy end date | 2016-09-30 | Total amount of fees paid to insurance company | USD $6,767 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | VOLUNTARY AD&D | Welfare Benefit Premiums Paid to Carrier | USD $18,916 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 5675 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | LOCKTON COMPANIES, LLC |
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PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) |
Policy contract number | 0007714517 |
Policy instance | 5 |
Insurance contract or identification number | 0007714517 | Number of Individuals Covered | 1073 | Insurance policy start date | 2015-10-01 | Insurance policy end date | 2016-09-30 | Total amount of commissions paid to insurance broker | USD $62,064 | Total amount of fees paid to insurance company | USD $10,490 | Other welfare benefits provided | CRITICAL ILLNESS, ACCIDENT | Welfare Benefit Premiums Paid to Carrier | USD $251,382 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $31,032 | Amount paid for insurance broker fees | 5245 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | HEALTH & BENEFIT SYSTEMS, INC. |
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DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
Policy contract number | MX41188 |
Policy instance | 6 |
Insurance contract or identification number | MX41188 | Number of Individuals Covered | 2 | Insurance policy start date | 2015-10-01 | Insurance policy end date | 2016-09-30 | Total amount of fees paid to insurance company | USD $426 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,280 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 384 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | LOCKTON COMPANIES, LLC |
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FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
Policy contract number | 0007714517 |
Policy instance | 7 |
Insurance contract or identification number | 0007714517 | Number of Individuals Covered | 8 | Insurance policy start date | 2015-10-01 | Insurance policy end date | 2016-09-30 | Total amount of commissions paid to insurance broker | USD $438 | Total amount of fees paid to insurance company | USD $64 | Other welfare benefits provided | ACCIDENT | Welfare Benefit Premiums Paid to Carrier | USD $1,030 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $219 | Amount paid for insurance broker fees | 32 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | HEALTH & BENEFIT SYSTEMS, INC. |
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NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 ) |
Policy contract number | 33891 |
Policy instance | 8 |
Insurance contract or identification number | 33891 | Number of Individuals Covered | 569 | Insurance policy start date | 2015-10-01 | Insurance policy end date | 2016-09-30 | Total amount of commissions paid to insurance broker | USD $1,446 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $29,299 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,446 | Insurance broker organization code? | 3 | Insurance broker name | ALLTRUST INSURANCE INC. |
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BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | X46702 |
Policy instance | 1 |
Insurance contract or identification number | X46702 | Number of Individuals Covered | 1254 | Insurance policy start date | 2015-10-01 | Insurance policy end date | 2016-09-30 | Total amount of commissions paid to insurance broker | USD $119,867 | Welfare Benefit Premiums Paid to Carrier | USD $414,113 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $119,867 | Insurance broker organization code? | 3 | Insurance broker name | LOCKTON COMPANIES, LLC |
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DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
Policy contract number | MX41188 |
Policy instance | 6 |
Insurance contract or identification number | MX41188 | Number of Individuals Covered | 2 | Insurance policy start date | 2014-10-01 | Insurance policy end date | 2015-09-30 | Total amount of fees paid to insurance company | USD $318 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,058 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 318 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | PEAK1 ADMINISTRATION LLC |
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FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
Policy contract number | 0007714517 |
Policy instance | 7 |
Insurance contract or identification number | 0007714517 | Number of Individuals Covered | 7 | Insurance policy start date | 2014-10-01 | Insurance policy end date | 2015-09-30 | Total amount of commissions paid to insurance broker | USD $282 | Total amount of fees paid to insurance company | USD $66 | Other welfare benefits provided | ACCIDENT | Welfare Benefit Premiums Paid to Carrier | USD $605 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $141 | Amount paid for insurance broker fees | 33 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | HEALTH & BENEFIT SYSTEMS, INC. |
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PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) |
Policy contract number | 0007714517 |
Policy instance | 5 |
Insurance contract or identification number | 0007714517 | Number of Individuals Covered | 930 | Insurance policy start date | 2014-10-01 | Insurance policy end date | 2015-09-30 | Total amount of commissions paid to insurance broker | USD $55,767 | Total amount of fees paid to insurance company | USD $5,956 | Other welfare benefits provided | CRITICAL ILLNESS, ACCIDENT | Welfare Benefit Premiums Paid to Carrier | USD $227,606 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $27,849 | Amount paid for insurance broker fees | 2975 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | HEALTH & BENEFIT SYSTEMS, INC. |
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DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
Policy contract number | MM041188 |
Policy instance | 4 |
Insurance contract or identification number | MM041188 | Number of Individuals Covered | 36 | Insurance policy start date | 2014-10-01 | Insurance policy end date | 2015-09-30 | Total amount of fees paid to insurance company | USD $6,531 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | VOLUNTARY AD&D | Welfare Benefit Premiums Paid to Carrier | USD $21,771 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 6531 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | PEAK1 ADMINISTRATION LLC |
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HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 852142G |
Policy instance | 3 |
Insurance contract or identification number | 852142G | Number of Individuals Covered | 379 | Insurance policy start date | 2014-10-01 | Insurance policy end date | 2015-09-30 | Total amount of commissions paid to insurance broker | USD $23,057 | Total amount of fees paid to insurance company | USD $2,767 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $92,227 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $23,057 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 2767 | Additional information about fees paid to insurance broker | BONUS | Insurance broker name | LOCKTON COMPANIES, LLC |
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BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) |
Policy contract number | X46702 |
Policy instance | 1 |
Insurance contract or identification number | X46702 | Number of Individuals Covered | 1186 | Insurance policy start date | 2014-10-01 | Insurance policy end date | 2015-09-30 | Total amount of commissions paid to insurance broker | USD $107,190 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $339,734 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $107,190 | Insurance broker organization code? | 3 | Insurance broker name | LOCKTON COMPANIES, LLC |
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PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
Policy contract number | 1036339 |
Policy instance | 2 |
Insurance contract or identification number | 1036339 | Number of Individuals Covered | 969 | Insurance policy start date | 2014-10-01 | Insurance policy end date | 2015-09-30 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $17,818 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
Policy contract number | MX41188 |
Policy instance | 2 |
Insurance contract or identification number | MX41188 | Number of Individuals Covered | 2 | Insurance policy start date | 2013-10-01 | Insurance policy end date | 2014-09-30 | Total amount of fees paid to insurance company | USD $293 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $977 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 293 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | PEAK1 ADMINISTRATION LLC |
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HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 852142G |
Policy instance | 1 |
Insurance contract or identification number | 852142G | Number of Individuals Covered | 200 | Insurance policy start date | 2013-10-01 | Insurance policy end date | 2014-09-30 | Total amount of commissions paid to insurance broker | USD $21,299 | Total amount of fees paid to insurance company | USD $2,593 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $85,192 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $7,432 | Amount paid for insurance broker fees | 2593 | Additional information about fees paid to insurance broker | BONUS | Insurance broker organization code? | 3 | Insurance broker name | HEALTH & BENEFIT SYSTEM, INC. |
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PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
Policy contract number | 1036339 |
Policy instance | 4 |
Insurance contract or identification number | 1036339 | Number of Individuals Covered | 926 | Insurance policy start date | 2013-10-01 | Insurance policy end date | 2014-09-30 | Total amount of fees paid to insurance company | USD $103 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $19,023 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 103 | Additional information about fees paid to insurance broker | BONUS | Insurance broker organization code? | 3 | Insurance broker name | LOCKTON COMPANIES, LLC |
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PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) |
Policy contract number | 0007714517 |
Policy instance | 5 |
Insurance contract or identification number | 0007714517 | Number of Individuals Covered | 942 | Insurance policy start date | 2013-10-01 | Insurance policy end date | 2014-09-30 | Total amount of commissions paid to insurance broker | USD $58,392 | Total amount of fees paid to insurance company | USD $11,718 | Temporary Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | CRITICAL ILLNESS, ACCIDENT | Welfare Benefit Premiums Paid to Carrier | USD $213,390 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $29,196 | Amount paid for insurance broker fees | 5859 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | LOCKTON COMPANIES, LLC |
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FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) |
Policy contract number | 0007714517 |
Policy instance | 6 |
Insurance contract or identification number | 0007714517 | Number of Individuals Covered | 3 | Insurance policy start date | 2013-10-01 | Insurance policy end date | 2014-09-30 | Total amount of commissions paid to insurance broker | USD $164 | Total amount of fees paid to insurance company | USD $10 | Other welfare benefits provided | ACCIDENT | Welfare Benefit Premiums Paid to Carrier | USD $587 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $82 | Amount paid for insurance broker fees | 5 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | HEALTH & BENEFIT SYSTEMS, INC. |
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DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
Policy contract number | MM041188 |
Policy instance | 3 |
Insurance contract or identification number | MM041188 | Number of Individuals Covered | 43 | Insurance policy start date | 2013-10-01 | Insurance policy end date | 2014-09-30 | Total amount of fees paid to insurance company | USD $7,442 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $24,808 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 7442 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | PEAK1 ADMINISTRATION LLC |
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DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
Policy contract number | MX41188 |
Policy instance | 2 |
Insurance contract or identification number | MX41188 | Number of Individuals Covered | 2 | Insurance policy start date | 2012-10-01 | Insurance policy end date | 2013-09-30 | Total amount of fees paid to insurance company | USD $352 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,174 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 352 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | PEAK1 ADMINISTRATION LLC |
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SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 010599 |
Policy instance | 3 |
Insurance contract or identification number | 010599 | Number of Individuals Covered | 868 | Insurance policy start date | 2012-10-01 | Insurance policy end date | 2013-09-30 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $22,531 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
Policy contract number | MM041188 |
Policy instance | 4 |
Insurance contract or identification number | MM041188 | Number of Individuals Covered | 44 | Insurance policy start date | 2012-10-01 | Insurance policy end date | 2013-09-30 | Total amount of fees paid to insurance company | USD $7,853 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $26,178 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 7853 | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | PEAK1 ADMINISTRATION LLC |
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HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 852142G |
Policy instance | 1 |
Insurance contract or identification number | 852142G | Number of Individuals Covered | 167 | Insurance policy start date | 2012-10-01 | Insurance policy end date | 2013-09-30 | Total amount of commissions paid to insurance broker | USD $16,482 | Total amount of fees paid to insurance company | USD $2,773 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $65,925 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $16,482 | Amount paid for insurance broker fees | 2773 | Additional information about fees paid to insurance broker | BONUS | Insurance broker organization code? | 3 | Insurance broker name | LOCKTON COMPANIES LLC |
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SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 010599 |
Policy instance | 3 |
Insurance contract or identification number | 010599 | Number of Individuals Covered | 863 | Insurance policy start date | 2011-10-01 | Insurance policy end date | 2012-09-30 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $21,069 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
Policy contract number | MM041188 |
Policy instance | 4 |
Insurance contract or identification number | MM041188 | Number of Individuals Covered | 48 | Insurance policy start date | 2011-10-01 | Insurance policy end date | 2012-09-30 | Total amount of fees paid to insurance company | USD $7,276 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | VOLUNTARY ADD | Welfare Benefit Premiums Paid to Carrier | USD $24,253 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
Policy contract number | MX41188 |
Policy instance | 2 |
Insurance contract or identification number | MX41188 | Number of Individuals Covered | 3 | Insurance policy start date | 2011-10-01 | Insurance policy end date | 2012-09-30 | Total amount of fees paid to insurance company | USD $655 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,183 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 852142G |
Policy instance | 1 |
Insurance contract or identification number | 852142G | Number of Individuals Covered | 186 | Insurance policy start date | 2011-10-01 | Insurance policy end date | 2012-09-30 | Total amount of commissions paid to insurance broker | USD $15,065 | Total amount of fees paid to insurance company | USD $1,947 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $60,259 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
Policy contract number | 010599 |
Policy instance | 4 |
Insurance contract or identification number | 010599 | Number of Individuals Covered | 843 | Insurance policy start date | 2010-10-01 | Insurance policy end date | 2011-09-30 | Life Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $21,336 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | 852142G |
Policy instance | 2 |
Insurance contract or identification number | 852142G | Number of Individuals Covered | 176 | Insurance policy start date | 2010-10-01 | Insurance policy end date | 2011-09-30 | Total amount of commissions paid to insurance broker | USD $16,901 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $62,772 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
Policy contract number | MM041188 |
Policy instance | 1 |
Insurance contract or identification number | MM041188 | Number of Individuals Covered | 50 | Insurance policy start date | 2010-10-01 | Insurance policy end date | 2011-09-30 | Total amount of commissions paid to insurance broker | USD $7,584 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $24,439 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
Policy contract number | MX41188 |
Policy instance | 3 |
Insurance contract or identification number | MX41188 | Number of Individuals Covered | 3 | Insurance policy start date | 2010-10-01 | Insurance policy end date | 2011-09-30 | Total amount of fees paid to insurance company | USD $523 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,691 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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