401k Plan data: NATIONAL MANAGEMENT RESOURCES CORPORATION WELFARE BENEFIT PLAN plan

NATIONAL MANAGEMENT RESOURCES CORPORATION WELFARE BENEFIT PLAN 401k Plan overview

Plan Name	NATIONAL MANAGEMENT RESOURCES CORPORATION WELFARE BENEFIT PLAN
Plan identification number	502

NATIONAL MANAGEMENT RESOURCES CORPORATION WELFARE BENEFIT PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

NATIONAL MANAGEMENT RESOURCES CORP. has sponsored the creation of one or more 401k plans.

Company Name: NATIONAL MANAGEMENT RESOURCES CORP.

Employer identification number (EIN): 840755858

NAIC Classification: 561720
NAIC Description: Janitorial Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NATIONAL MANAGEMENT RESOURCES CORPORATION WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
502 2022-06-01 ANDREW WILSON 2024-01-12
502 2021-06-01 SUSAN E. CARSON 2022-12-06
502 2020-06-01 SUSAN E. CARSON 2021-12-21 ANDREW WILSON 2021-12-21
502 2019-06-01 SUSAN E. CARSON 2020-11-16 ANDREW WILSON 2020-11-16
502 2018-06-01 SUSAN E CARSON 2019-08-27 ANDREW WILSON 2019-08-27
502 2017-06-01
502 2016-06-01
502 2015-06-01
502 2014-06-01
502 2013-06-01
502 2012-06-01 FRED D. HOPPE, JR
502 2011-06-01 FRED D. HOPPE, JR.
502 2010-06-01 FREDERICK D. HOPPE, JR.
502 2009-06-01 FREDERICK D. HOPPE, JR.

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
502	2022-06-01	ANDREW WILSON	2024-01-12
502	2021-06-01	SUSAN E. CARSON	2022-12-06
502	2020-06-01	SUSAN E. CARSON	2021-12-21	ANDREW WILSON	2021-12-21
502	2019-06-01	SUSAN E. CARSON	2020-11-16	ANDREW WILSON	2020-11-16
502	2018-06-01	SUSAN E CARSON	2019-08-27	ANDREW WILSON	2019-08-27
502	2017-06-01
502	2016-06-01
502	2015-06-01
502	2014-06-01
502	2013-06-01
502	2012-06-01	FRED D. HOPPE, JR
502	2011-06-01	FRED D. HOPPE, JR.
502	2010-06-01	FREDERICK D. HOPPE, JR.
502	2009-06-01	FREDERICK D. HOPPE, JR.

Plan Statistics for NATIONAL MANAGEMENT RESOURCES CORPORATION WELFARE BENEFIT PLAN

401k plan membership statisitcs for NATIONAL MANAGEMENT RESOURCES CORPORATION WELFARE BENEFIT PLAN

Measure Date Value
2022: NATIONAL MANAGEMENT RESOURCES CORPORATION WELFARE BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year 2022-06-01 621
Total number of active participants reported on line 7a of the Form 5500 2022-06-01 368
Number of retired or separated participants receiving benefits 2022-06-01 1
Number of other retired or separated participants entitled to future benefits 2022-06-01 0
Total of all active and inactive participants 2022-06-01 369
2021: NATIONAL MANAGEMENT RESOURCES CORPORATION WELFARE BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year 2021-06-01 780
Total number of active participants reported on line 7a of the Form 5500 2021-06-01 534
Number of retired or separated participants receiving benefits 2021-06-01 1
Number of other retired or separated participants entitled to future benefits 2021-06-01 86
Total of all active and inactive participants 2021-06-01 621
2020: NATIONAL MANAGEMENT RESOURCES CORPORATION WELFARE BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year 2020-06-01 671
Total number of active participants reported on line 7a of the Form 5500 2020-06-01 647
Number of retired or separated participants receiving benefits 2020-06-01 5
Number of other retired or separated participants entitled to future benefits 2020-06-01 128
Total of all active and inactive participants 2020-06-01 780
2019: NATIONAL MANAGEMENT RESOURCES CORPORATION WELFARE BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year 2019-06-01 664
Total number of active participants reported on line 7a of the Form 5500 2019-06-01 602
Number of retired or separated participants receiving benefits 2019-06-01 3
Number of other retired or separated participants entitled to future benefits 2019-06-01 66
Total of all active and inactive participants 2019-06-01 671
2018: NATIONAL MANAGEMENT RESOURCES CORPORATION WELFARE BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year 2018-06-01 707
Total number of active participants reported on line 7a of the Form 5500 2018-06-01 612
Number of retired or separated participants receiving benefits 2018-06-01 7
Number of other retired or separated participants entitled to future benefits 2018-06-01 45
Total of all active and inactive participants 2018-06-01 664
2017: NATIONAL MANAGEMENT RESOURCES CORPORATION WELFARE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year 2017-06-01 658
Total number of active participants reported on line 7a of the Form 5500 2017-06-01 650
Number of retired or separated participants receiving benefits 2017-06-01 6
Number of other retired or separated participants entitled to future benefits 2017-06-01 51
Total of all active and inactive participants 2017-06-01 707
2016: NATIONAL MANAGEMENT RESOURCES CORPORATION WELFARE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year 2016-06-01 635
Total number of active participants reported on line 7a of the Form 5500 2016-06-01 620
Number of retired or separated participants receiving benefits 2016-06-01 6
Number of other retired or separated participants entitled to future benefits 2016-06-01 32
Total of all active and inactive participants 2016-06-01 658
2015: NATIONAL MANAGEMENT RESOURCES CORPORATION WELFARE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year 2015-06-01 287
Total number of active participants reported on line 7a of the Form 5500 2015-06-01 622
Number of retired or separated participants receiving benefits 2015-06-01 4
Number of other retired or separated participants entitled to future benefits 2015-06-01 9
Total of all active and inactive participants 2015-06-01 635
2014: NATIONAL MANAGEMENT RESOURCES CORPORATION WELFARE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year 2014-06-01 290
Total number of active participants reported on line 7a of the Form 5500 2014-06-01 275
Number of retired or separated participants receiving benefits 2014-06-01 1
Number of other retired or separated participants entitled to future benefits 2014-06-01 11
Total of all active and inactive participants 2014-06-01 287
2013: NATIONAL MANAGEMENT RESOURCES CORPORATION WELFARE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year 2013-06-01 398
Total number of active participants reported on line 7a of the Form 5500 2013-06-01 278
Number of retired or separated participants receiving benefits 2013-06-01 4
Number of other retired or separated participants entitled to future benefits 2013-06-01 8
Total of all active and inactive participants 2013-06-01 290
2012: NATIONAL MANAGEMENT RESOURCES CORPORATION WELFARE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-06-01 427
Total number of active participants reported on line 7a of the Form 5500 2012-06-01 394
Number of retired or separated participants receiving benefits 2012-06-01 2
Number of other retired or separated participants entitled to future benefits 2012-06-01 2
Total of all active and inactive participants 2012-06-01 398
2011: NATIONAL MANAGEMENT RESOURCES CORPORATION WELFARE BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-06-01 411
Total number of active participants reported on line 7a of the Form 5500 2011-06-01 423
Number of retired or separated participants receiving benefits 2011-06-01 2
Number of other retired or separated participants entitled to future benefits 2011-06-01 2
Total of all active and inactive participants 2011-06-01 427
2010: NATIONAL MANAGEMENT RESOURCES CORPORATION WELFARE BENEFIT PLAN 2010 401k membership
Total participants, beginning-of-year 2010-06-01 347
Total number of active participants reported on line 7a of the Form 5500 2010-06-01 407
Number of retired or separated participants receiving benefits 2010-06-01 2
Number of other retired or separated participants entitled to future benefits 2010-06-01 2
Total of all active and inactive participants 2010-06-01 411
2009: NATIONAL MANAGEMENT RESOURCES CORPORATION WELFARE BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-06-01 294
Total number of active participants reported on line 7a of the Form 5500 2009-06-01 345
Number of retired or separated participants receiving benefits 2009-06-01 2
Total of all active and inactive participants 2009-06-01 347

Measure	Date	Value
2022: NATIONAL MANAGEMENT RESOURCES CORPORATION WELFARE BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year	2022-06-01	621
Total number of active participants reported on line 7a of the Form 5500	2022-06-01	368
Number of retired or separated participants receiving benefits	2022-06-01	1
Number of other retired or separated participants entitled to future benefits	2022-06-01	0
Total of all active and inactive participants	2022-06-01	369
2021: NATIONAL MANAGEMENT RESOURCES CORPORATION WELFARE BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year	2021-06-01	780
Total number of active participants reported on line 7a of the Form 5500	2021-06-01	534
Number of retired or separated participants receiving benefits	2021-06-01	1
Number of other retired or separated participants entitled to future benefits	2021-06-01	86
Total of all active and inactive participants	2021-06-01	621
2020: NATIONAL MANAGEMENT RESOURCES CORPORATION WELFARE BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year	2020-06-01	671
Total number of active participants reported on line 7a of the Form 5500	2020-06-01	647
Number of retired or separated participants receiving benefits	2020-06-01	5
Number of other retired or separated participants entitled to future benefits	2020-06-01	128
Total of all active and inactive participants	2020-06-01	780
2019: NATIONAL MANAGEMENT RESOURCES CORPORATION WELFARE BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year	2019-06-01	664
Total number of active participants reported on line 7a of the Form 5500	2019-06-01	602
Number of retired or separated participants receiving benefits	2019-06-01	3
Number of other retired or separated participants entitled to future benefits	2019-06-01	66
Total of all active and inactive participants	2019-06-01	671
2018: NATIONAL MANAGEMENT RESOURCES CORPORATION WELFARE BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year	2018-06-01	707
Total number of active participants reported on line 7a of the Form 5500	2018-06-01	612
Number of retired or separated participants receiving benefits	2018-06-01	7
Number of other retired or separated participants entitled to future benefits	2018-06-01	45
Total of all active and inactive participants	2018-06-01	664
2017: NATIONAL MANAGEMENT RESOURCES CORPORATION WELFARE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year	2017-06-01	658
Total number of active participants reported on line 7a of the Form 5500	2017-06-01	650
Number of retired or separated participants receiving benefits	2017-06-01	6
Number of other retired or separated participants entitled to future benefits	2017-06-01	51
Total of all active and inactive participants	2017-06-01	707
2016: NATIONAL MANAGEMENT RESOURCES CORPORATION WELFARE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year	2016-06-01	635
Total number of active participants reported on line 7a of the Form 5500	2016-06-01	620
Number of retired or separated participants receiving benefits	2016-06-01	6
Number of other retired or separated participants entitled to future benefits	2016-06-01	32
Total of all active and inactive participants	2016-06-01	658
2015: NATIONAL MANAGEMENT RESOURCES CORPORATION WELFARE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year	2015-06-01	287
Total number of active participants reported on line 7a of the Form 5500	2015-06-01	622
Number of retired or separated participants receiving benefits	2015-06-01	4
Number of other retired or separated participants entitled to future benefits	2015-06-01	9
Total of all active and inactive participants	2015-06-01	635
2014: NATIONAL MANAGEMENT RESOURCES CORPORATION WELFARE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year	2014-06-01	290
Total number of active participants reported on line 7a of the Form 5500	2014-06-01	275
Number of retired or separated participants receiving benefits	2014-06-01	1
Number of other retired or separated participants entitled to future benefits	2014-06-01	11
Total of all active and inactive participants	2014-06-01	287
2013: NATIONAL MANAGEMENT RESOURCES CORPORATION WELFARE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-06-01	398
Total number of active participants reported on line 7a of the Form 5500	2013-06-01	278
Number of retired or separated participants receiving benefits	2013-06-01	4
Number of other retired or separated participants entitled to future benefits	2013-06-01	8
Total of all active and inactive participants	2013-06-01	290
2012: NATIONAL MANAGEMENT RESOURCES CORPORATION WELFARE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-06-01	427
Total number of active participants reported on line 7a of the Form 5500	2012-06-01	394
Number of retired or separated participants receiving benefits	2012-06-01	2
Number of other retired or separated participants entitled to future benefits	2012-06-01	2
Total of all active and inactive participants	2012-06-01	398
2011: NATIONAL MANAGEMENT RESOURCES CORPORATION WELFARE BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-06-01	411
Total number of active participants reported on line 7a of the Form 5500	2011-06-01	423
Number of retired or separated participants receiving benefits	2011-06-01	2
Number of other retired or separated participants entitled to future benefits	2011-06-01	2
Total of all active and inactive participants	2011-06-01	427
2010: NATIONAL MANAGEMENT RESOURCES CORPORATION WELFARE BENEFIT PLAN 2010 401k membership
Total participants, beginning-of-year	2010-06-01	347
Total number of active participants reported on line 7a of the Form 5500	2010-06-01	407
Number of retired or separated participants receiving benefits	2010-06-01	2
Number of other retired or separated participants entitled to future benefits	2010-06-01	2
Total of all active and inactive participants	2010-06-01	411
2009: NATIONAL MANAGEMENT RESOURCES CORPORATION WELFARE BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-06-01	294
Total number of active participants reported on line 7a of the Form 5500	2009-06-01	345
Number of retired or separated participants receiving benefits	2009-06-01	2
Total of all active and inactive participants	2009-06-01	347

Form 5500 Responses for NATIONAL MANAGEMENT RESOURCES CORPORATION WELFARE BENEFIT PLAN

2022: NATIONAL MANAGEMENT RESOURCES CORPORATION WELFARE BENEFIT PLAN 2022 form 5500 responses
2022-06-01	Type of plan entity	Single employer plan
2022-06-01	Submission has been amended	No
2022-06-01	This submission is the final filing	No
2022-06-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-06-01	Plan is a collectively bargained plan	No
2022-06-01	Plan funding arrangement – Insurance	Yes
2022-06-01	Plan benefit arrangement – Insurance	Yes
2021: NATIONAL MANAGEMENT RESOURCES CORPORATION WELFARE BENEFIT PLAN 2021 form 5500 responses
2021-06-01	Type of plan entity	Single employer plan
2021-06-01	Submission has been amended	No
2021-06-01	This submission is the final filing	No
2021-06-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-06-01	Plan is a collectively bargained plan	No
2021-06-01	Plan funding arrangement – Insurance	Yes
2021-06-01	Plan benefit arrangement – Insurance	Yes
2020: NATIONAL MANAGEMENT RESOURCES CORPORATION WELFARE BENEFIT PLAN 2020 form 5500 responses
2020-06-01	Type of plan entity	Single employer plan
2020-06-01	Plan funding arrangement – Insurance	Yes
2020-06-01	Plan benefit arrangement – Insurance	Yes
2019: NATIONAL MANAGEMENT RESOURCES CORPORATION WELFARE BENEFIT PLAN 2019 form 5500 responses
2019-06-01	Type of plan entity	Single employer plan
2019-06-01	Plan funding arrangement – Insurance	Yes
2019-06-01	Plan benefit arrangement – Insurance	Yes
2018: NATIONAL MANAGEMENT RESOURCES CORPORATION WELFARE BENEFIT PLAN 2018 form 5500 responses
2018-06-01	Type of plan entity	Single employer plan
2018-06-01	Plan funding arrangement – Insurance	Yes
2018-06-01	Plan benefit arrangement – Insurance	Yes
2017: NATIONAL MANAGEMENT RESOURCES CORPORATION WELFARE BENEFIT PLAN 2017 form 5500 responses
2017-06-01	Type of plan entity	Single employer plan
2017-06-01	Plan funding arrangement – Insurance	Yes
2017-06-01	Plan benefit arrangement – Insurance	Yes
2016: NATIONAL MANAGEMENT RESOURCES CORPORATION WELFARE BENEFIT PLAN 2016 form 5500 responses
2016-06-01	Type of plan entity	Single employer plan
2016-06-01	Plan funding arrangement – Insurance	Yes
2016-06-01	Plan benefit arrangement – Insurance	Yes
2015: NATIONAL MANAGEMENT RESOURCES CORPORATION WELFARE BENEFIT PLAN 2015 form 5500 responses
2015-06-01	Type of plan entity	Single employer plan
2015-06-01	Plan funding arrangement – Insurance	Yes
2015-06-01	Plan benefit arrangement – Insurance	Yes
2014: NATIONAL MANAGEMENT RESOURCES CORPORATION WELFARE BENEFIT PLAN 2014 form 5500 responses
2014-06-01	Type of plan entity	Single employer plan
2014-06-01	Plan funding arrangement – Insurance	Yes
2014-06-01	Plan benefit arrangement – Insurance	Yes
2013: NATIONAL MANAGEMENT RESOURCES CORPORATION WELFARE BENEFIT PLAN 2013 form 5500 responses
2013-06-01	Type of plan entity	Single employer plan
2013-06-01	Plan funding arrangement – Insurance	Yes
2013-06-01	Plan benefit arrangement – Insurance	Yes
2012: NATIONAL MANAGEMENT RESOURCES CORPORATION WELFARE BENEFIT PLAN 2012 form 5500 responses
2012-06-01	Type of plan entity	Single employer plan
2012-06-01	Plan funding arrangement – Insurance	Yes
2012-06-01	Plan benefit arrangement – Insurance	Yes
2011: NATIONAL MANAGEMENT RESOURCES CORPORATION WELFARE BENEFIT PLAN 2011 form 5500 responses
2011-06-01	Type of plan entity	Single employer plan
2011-06-01	Plan funding arrangement – Insurance	Yes
2011-06-01	Plan benefit arrangement – Insurance	Yes
2010: NATIONAL MANAGEMENT RESOURCES CORPORATION WELFARE BENEFIT PLAN 2010 form 5500 responses
2010-06-01	Type of plan entity	Single employer plan
2010-06-01	Plan funding arrangement – Insurance	Yes
2010-06-01	Plan benefit arrangement – Insurance	Yes
2009: NATIONAL MANAGEMENT RESOURCES CORPORATION WELFARE BENEFIT PLAN 2009 form 5500 responses
2009-06-01	Type of plan entity	Single employer plan
2009-06-01	Plan funding arrangement – Insurance	Yes
2009-06-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

000010270573

Policy instance

Insurance contract or identification number	000010270573
Number of Individuals Covered	1110
Insurance policy start date	2022-06-01
Insurance policy end date	2023-05-31
Total amount of commissions paid to insurance broker	USD $33,789
Total amount of fees paid to insurance company	USD $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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	WEEKLY INCOME
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 Carrier	USD $225,262
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $33,789
Insurance broker organization code?	3

CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 )

Policy contract number

20413

Policy instance

Insurance contract or identification number	20413
Number of Individuals Covered	316
Insurance policy start date	2022-06-01
Insurance policy end date	2023-05-31
Total amount of commissions paid to insurance broker	USD $21,779
Total amount of fees paid to insurance company	USD $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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	AFLAC SUPPLEMENTAL INSURANCE
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 Carrier	USD $136,893
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $21,779
Insurance broker organization code?	3

BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC/ (G0385) (National Association of Insurance Commissioners NAIC id number: 54801 )

Policy contract number

GA5963

Policy instance

Insurance contract or identification number	GA5963
Number of Individuals Covered	610
Insurance policy start date	2022-06-01
Insurance policy end date	2023-05-31
Total amount of commissions paid to insurance broker	USD $18,068
Total amount of fees paid to insurance company	USD $2,147
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 Carrier	USD $218,354
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $18,068
Amount paid for insurance broker fees	2147
Additional information about fees paid to insurance broker	FEES
Insurance broker organization code?	3

COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )

Policy contract number

E3005840

Policy instance

Insurance contract or identification number	E3005840
Number of Individuals Covered	29
Insurance policy start date	2022-06-01
Insurance policy end date	2023-05-31
Total amount of commissions paid to insurance broker	USD $410
Total amount of fees paid to insurance company	USD $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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 Carrier	USD $11,629
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $131
Insurance broker organization code?	3

GREATER GEORGIA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97217 )

Policy contract number

GA5963

Policy instance

Insurance contract or identification number	GA5963
Number of Individuals Covered	450
Insurance policy start date	2022-06-01
Insurance policy end date	2023-05-31
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 Carrier	USD $51,051
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

000010270572

Policy instance

Insurance contract or identification number	000010270572
Number of Individuals Covered	48
Insurance policy start date	2022-06-01
Insurance policy end date	2023-05-31
Total amount of commissions paid to insurance broker	USD $4,199
Total amount of fees paid to insurance company	USD $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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
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 Carrier	USD $27,996
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,199
Insurance broker organization code?	3

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

000010270575

Policy instance

Insurance contract or identification number	000010270575
Number of Individuals Covered	175
Insurance policy start date	2022-06-01
Insurance policy end date	2023-05-31
Total amount of commissions paid to insurance broker	USD $8,186
Total amount of fees paid to insurance company	USD $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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
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 Carrier	USD $54,575
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $8,186
Insurance broker organization code?	3

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

Policy contract number

000000600052

Policy instance

Insurance contract or identification number	000000600052
Number of Individuals Covered	90
Insurance policy start date	2021-06-01
Insurance policy end date	2022-05-31
Total amount of commissions paid to insurance broker	USD $7,310
Total amount of fees paid to insurance company	USD $1,722
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	STD, LTD
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 Carrier	USD $90,543
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $7,310
Insurance broker organization code?	3
Amount paid for insurance broker fees	1722
Additional information about fees paid to insurance broker	ADDITIONAL COMPENSATION PAID

COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )

Policy contract number

E3005840

Policy instance

Insurance contract or identification number	E3005840
Number of Individuals Covered	31
Insurance policy start date	2021-06-01
Insurance policy end date	2022-05-31
Total amount of commissions paid to insurance broker	USD $428
Total amount of fees paid to insurance company	USD $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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 Carrier	USD $12,234
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $428
Insurance broker organization code?	3

BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC/ (G0385) (National Association of Insurance Commissioners NAIC id number: 54801 )

Policy contract number

GA5963

Policy instance

Insurance contract or identification number	GA5963
Number of Individuals Covered	626
Insurance policy start date	2021-06-01
Insurance policy end date	2022-05-31
Total amount of commissions paid to insurance broker	USD $18,207
Total amount of fees paid to insurance company	USD $2,035
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 Carrier	USD $221,069
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $18,207
Amount paid for insurance broker fees	2035
Additional information about fees paid to insurance broker	FEES
Insurance broker organization code?	3

CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 )

Policy contract number

20413

Policy instance

Insurance contract or identification number	20413
Number of Individuals Covered	356
Insurance policy start date	2021-06-01
Insurance policy end date	2022-05-31
Total amount of commissions paid to insurance broker	USD $24,323
Total amount of fees paid to insurance company	USD $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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	AFLAC SUPPLEMENTAL INSURANCE
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 Carrier	USD $168,834
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $24,323
Insurance broker organization code?	3

GREATER GEORGIA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97217 )

Policy contract number

GA5963

Policy instance

Insurance contract or identification number	GA5963
Number of Individuals Covered	487
Insurance policy start date	2021-06-01
Insurance policy end date	2022-05-31
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 Carrier	USD $49,382
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 )

Policy contract number

GA5963

Policy instance

Insurance contract or identification number	GA5963
Number of Individuals Covered	0
Insurance policy start date	2020-06-01
Insurance policy end date	2021-05-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Welfare Benefit Premiums Paid to Carrier	USD $-448
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

GREATER GEORGIA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97217 )

Policy contract number

GA5963

Policy instance

Insurance contract or identification number	GA5963
Number of Individuals Covered	493
Insurance policy start date	2020-06-01
Insurance policy end date	2021-05-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $45,826
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 number

20413

Policy instance

Insurance contract or identification number	20413
Number of Individuals Covered	1025
Insurance policy start date	2020-06-01
Insurance policy end date	2021-05-31
Total amount of commissions paid to insurance broker	USD $22,881
Total amount of fees paid to insurance company	USD $0
Other welfare benefits provided	AFLAC SUPPLEMENTAL INSURANCE
Welfare Benefit Premiums Paid to Carrier	USD $212,571
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $22,881
Insurance broker organization code?	3

BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC/ (G0385) (National Association of Insurance Commissioners NAIC id number: 54801 )

Policy contract number

GA5963

Policy instance

Insurance contract or identification number	GA5963
Number of Individuals Covered	635
Insurance policy start date	2020-06-01
Insurance policy end date	2021-05-31
Total amount of commissions paid to insurance broker	USD $25,992
Total amount of fees paid to insurance company	USD $3,210
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $199,907
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $25,992
Amount paid for insurance broker fees	3210
Additional information about fees paid to insurance broker	FEES
Insurance broker organization code?	3

COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )

Policy contract number

E3005840

Policy instance

Insurance contract or identification number	E3005840
Number of Individuals Covered	33
Insurance policy start date	2020-06-01
Insurance policy end date	2021-05-31
Total amount of commissions paid to insurance broker	USD $447
Total amount of fees paid to insurance company	USD $0
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $13,469
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $447
Insurance broker organization code?	3

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

Policy contract number

000000600052

Policy instance

Insurance contract or identification number	000000600052
Number of Individuals Covered	238
Insurance policy start date	2020-06-01
Insurance policy end date	2021-06-01
Total amount of commissions paid to insurance broker	USD $7,144
Total amount of fees paid to insurance company	USD $1,380
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	STD, LTD
Welfare Benefit Premiums Paid to Carrier	USD $78,860
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $7,144
Insurance broker organization code?	3
Amount paid for insurance broker fees	1380
Additional information about fees paid to insurance broker	ADDITIONAL COMPENSATION PAID

BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 )

Policy contract number

GA5963

Policy instance

Insurance contract or identification number	GA5963
Number of Individuals Covered	339
Insurance policy start date	2019-06-01
Insurance policy end date	2020-05-31
Total amount of commissions paid to insurance broker	USD $156,817
Total amount of fees paid to insurance company	USD $2,150
Welfare Benefit Premiums Paid to Carrier	USD $3,085,471
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $156,817
Amount paid for insurance broker fees	2150
Additional information about fees paid to insurance broker	FEES
Insurance broker organization code?	3

CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 )

Policy contract number

20413

Policy instance

Insurance contract or identification number	20413
Number of Individuals Covered	960
Insurance policy start date	2019-06-01
Insurance policy end date	2020-05-31
Total amount of commissions paid to insurance broker	USD $67,400
Total amount of fees paid to insurance company	USD $0
Other welfare benefits provided	AFLAC SUPPLEMENTAL INSURANCE
Welfare Benefit Premiums Paid to Carrier	USD $254,298
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $67,400
Insurance broker organization code?	3

COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )

Policy contract number

E3005840

Policy instance

Insurance contract or identification number	E3005840
Number of Individuals Covered	37
Insurance policy start date	2019-06-01
Insurance policy end date	2020-05-31
Total amount of commissions paid to insurance broker	USD $557
Total amount of fees paid to insurance company	USD $0
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $15,803
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $557
Insurance broker organization code?	3

BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC/ (G0385) (National Association of Insurance Commissioners NAIC id number: 54801 )

Policy contract number

GA5963

Policy instance

Insurance contract or identification number	GA5963
Number of Individuals Covered	615
Insurance policy start date	2019-06-01
Insurance policy end date	2020-05-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $263,717
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

000000600052

Policy instance

Insurance contract or identification number	000000600052
Number of Individuals Covered	185
Insurance policy start date	2019-06-01
Insurance policy end date	2020-06-01
Total amount of commissions paid to insurance broker	USD $6,048
Total amount of fees paid to insurance company	USD $889
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	STD, LTD
Welfare Benefit Premiums Paid to Carrier	USD $60,615
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $6,048
Insurance broker organization code?	3
Amount paid for insurance broker fees	889
Additional information about fees paid to insurance broker	ADDITIONAL COMPENSATION

GREATER GEORGIA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97217 )

Policy contract number

GA5963

Policy instance

Insurance contract or identification number	GA5963
Number of Individuals Covered	517
Insurance policy start date	2019-06-01
Insurance policy end date	2020-05-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $59,991
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

GREATER GEORGIA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97217 )

Policy contract number

GA5963

Policy instance

Insurance contract or identification number	GA5963
Number of Individuals Covered	444
Insurance policy start date	2017-06-01
Insurance policy end date	2018-05-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $40,048
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )

Policy contract number

E3005840

Policy instance

Insurance contract or identification number	E3005840
Number of Individuals Covered	46
Insurance policy start date	2017-06-01
Insurance policy end date	2018-05-31
Total amount of commissions paid to insurance broker	USD $812
Total amount of fees paid to insurance company	USD $0
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $20,896
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $812
Insurance broker organization code?	3
Insurance broker name	STATEMENT ATTACHED

BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC/ (G0385) (National Association of Insurance Commissioners NAIC id number: 54801 )

Policy contract number

GA5963

Policy instance

Insurance contract or identification number	GA5963
Number of Individuals Covered	402
Insurance policy start date	2017-06-01
Insurance policy end date	2018-05-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $186,129
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 number

20413

Policy instance

Insurance contract or identification number	20413
Number of Individuals Covered	768
Insurance policy start date	2017-06-01
Insurance policy end date	2018-05-31
Total amount of commissions paid to insurance broker	USD $41,637
Total amount of fees paid to insurance company	USD $0
Other welfare benefits provided	AFLAC SUPPLEMENTAL INSURANCE
Welfare Benefit Premiums Paid to Carrier	USD $203,284
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $41,637
Insurance broker organization code?	3
Insurance broker name	STATEMENT ATTACHED

BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 )

Policy contract number

GA5963

Policy instance

Insurance contract or identification number	GA5963
Number of Individuals Covered	269
Insurance policy start date	2017-06-01
Insurance policy end date	2018-05-31
Total amount of commissions paid to insurance broker	USD $142,444
Total amount of fees paid to insurance company	USD $11,009
Welfare Benefit Premiums Paid to Carrier	USD $2,551,740
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $108,847
Insurance broker organization code?	3
Amount paid for insurance broker fees	11009
Additional information about fees paid to insurance broker	FEES
Insurance broker name	J SMITH LANIER & COMPANY

COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )

Policy contract number

E3005840

Policy instance

Insurance contract or identification number	E3005840
Number of Individuals Covered	46
Insurance policy start date	2015-06-01
Insurance policy end date	2016-05-31
Total amount of commissions paid to insurance broker	USD $890
Total amount of fees paid to insurance company	USD $0
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $24,389
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $890
Insurance broker organization code?	3
Insurance broker name	STATEMENT ATTACHED

CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 )

Policy contract number

20413

Policy instance

Insurance contract or identification number	20413
Number of Individuals Covered	540
Insurance policy start date	2015-06-01
Insurance policy end date	2016-05-30
Total amount of commissions paid to insurance broker	USD $53,605
Total amount of fees paid to insurance company	USD $0
Other welfare benefits provided	AFLAC SUPPLEMENTAL INSURANCE
Welfare Benefit Premiums Paid to Carrier	USD $179,329
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $53,605
Insurance broker organization code?	3
Insurance broker name	STATEMENT ATTACHED

BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC/ (G0385) (National Association of Insurance Commissioners NAIC id number: 54801 )

Policy contract number

GA5963

Policy instance

Insurance contract or identification number	GA5963
Number of Individuals Covered	389
Insurance policy start date	2015-06-01
Insurance policy end date	2016-05-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $134,584
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 )

Policy contract number

GA5963

Policy instance

Insurance contract or identification number	GA5963
Number of Individuals Covered	278
Insurance policy start date	2015-06-01
Insurance policy end date	2016-05-31
Total amount of commissions paid to insurance broker	USD $106,637
Total amount of fees paid to insurance company	USD $12,482
Welfare Benefit Premiums Paid to Carrier	USD $1,746,177
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $106,637
Amount paid for insurance broker fees	12482
Additional information about fees paid to insurance broker	OTHER FEES
Insurance broker organization code?	3
Insurance broker name	J SMITH LANIER & COMPANY

GREATER GEORGIA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97217 )

Policy contract number

GA5963

Policy instance

Insurance contract or identification number	GA5963
Number of Individuals Covered	386
Insurance policy start date	2015-06-01
Insurance policy end date	2016-05-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $30,408
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

GREATER GEORGIA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97217 )

Policy contract number

GA5963

Policy instance

Insurance contract or identification number	GA5963
Number of Individuals Covered	385
Insurance policy start date	2014-06-01
Insurance policy end date	2015-05-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $39,176
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC/ (G0385) (National Association of Insurance Commissioners NAIC id number: 54801 )

Policy contract number

GA5963

Policy instance

Insurance contract or identification number	GA5963
Number of Individuals Covered	356
Insurance policy start date	2014-06-01
Insurance policy end date	2015-05-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $186,130
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 )

Policy contract number

GA5963

Policy instance

Insurance contract or identification number	GA5963
Number of Individuals Covered	305
Insurance policy start date	2014-06-01
Insurance policy end date	2015-05-31
Total amount of commissions paid to insurance broker	USD $125,684
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Welfare Benefit Premiums Paid to Carrier	USD $1,853,837
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $125,684
Insurance broker organization code?	3
Insurance broker name	J SMITH LANIER & COMPANY

CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 )

Policy contract number

20413

Policy instance

Insurance contract or identification number	20413
Number of Individuals Covered	306
Insurance policy start date	2014-06-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $42,392
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Other welfare benefits provided	SUPPLEMENTAL INSURANCE
Welfare Benefit Premiums Paid to Carrier	USD $66,378
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $42,392
Insurance broker organization code?	3
Insurance broker name	STATEMENT ATTACHED

COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )

Policy contract number

E3005840

Policy instance

Insurance contract or identification number	E3005840
Number of Individuals Covered	53
Insurance policy start date	2014-06-01
Insurance policy end date	2015-05-31
Total amount of commissions paid to insurance broker	USD $3,295
Total amount of fees paid to insurance company	USD $138
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $48,626
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,295
Amount paid for insurance broker fees	138
Additional information about fees paid to insurance broker	OTHER FEES
Insurance broker organization code?	3
Insurance broker name	STATEMENT ATTACHED

BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 )

Policy contract number

GA5963

Policy instance

Insurance contract or identification number	GA5963
Number of Individuals Covered	296
Insurance policy start date	2013-06-01
Insurance policy end date	2014-05-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Welfare Benefit Premiums Paid to Carrier	USD $1,482,965
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC/ (G0385) (National Association of Insurance Commissioners NAIC id number: 54801 )

Policy contract number

GA5963

Policy instance

Insurance contract or identification number	GA5963
Number of Individuals Covered	345
Insurance policy start date	2013-06-01
Insurance policy end date	2014-05-31
Total amount of commissions paid to insurance broker	USD $127,880
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $113,121
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $127,880
Insurance broker organization code?	3
Insurance broker name	J SMITH LANIER & CO.

GREATER GEORGIA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97217 )

Policy contract number

GA5963

Policy instance

Insurance contract or identification number	GA5963
Number of Individuals Covered	411
Insurance policy start date	2013-06-01
Insurance policy end date	2014-05-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $32,901
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )

Policy contract number

E3005840

Policy instance

Insurance contract or identification number	E3005840
Number of Individuals Covered	190
Insurance policy start date	2013-06-01
Insurance policy end date	2014-05-31
Total amount of commissions paid to insurance broker	USD $14,652
Total amount of fees paid to insurance company	USD $1,151
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $118,416
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $14,652
Amount paid for insurance broker fees	1151
Additional information about fees paid to insurance broker	BONUS & NON-CASH INCENTIVES
Insurance broker organization code?	3
Insurance broker name	STATEMENT ATTACHED

BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC/ (G0385) (National Association of Insurance Commissioners NAIC id number: 54801 )

Policy contract number

1036156000

Policy instance

Insurance contract or identification number	1036156000
Number of Individuals Covered	0
Insurance policy start date	2012-06-01
Insurance policy end date	2013-05-31
Total amount of commissions paid to insurance broker	USD $7,117
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $2,618
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $7,117
Insurance broker organization code?	3
Insurance broker name	J SMITH LANIER & CO.

BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC/ (G0385) (National Association of Insurance Commissioners NAIC id number: 54801 )

Policy contract number

GA5963

Policy instance

Insurance contract or identification number	GA5963
Number of Individuals Covered	276
Insurance policy start date	2012-06-30
Insurance policy end date	2013-05-31
Total amount of commissions paid to insurance broker	USD $66,086
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,117,326
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $66,086
Insurance broker organization code?	3
Insurance broker name	J SMITH LANIER & CO.

BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 )

Policy contract number

GA5963

Policy instance

Insurance contract or identification number	GA5963
Number of Individuals Covered	72
Insurance policy start date	2012-06-01
Insurance policy end date	2013-05-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Welfare Benefit Premiums Paid to Carrier	USD $421,821
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )

Policy contract number

E3005840

Policy instance

Insurance contract or identification number	E3005840
Number of Individuals Covered	238
Insurance policy start date	2012-06-01
Insurance policy end date	2013-05-31
Total amount of commissions paid to insurance broker	USD $21,704
Total amount of fees paid to insurance company	USD $2,442
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $121,882
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $21,704
Amount paid for insurance broker fees	2442
Additional information about fees paid to insurance broker	BONUS & NON-CASH INCENTIVES
Insurance broker organization code?	3
Insurance broker name	STATEMENT ATTACHED

GREATER GEORGIA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97217 )

Policy contract number

GA5963

Policy instance

Insurance contract or identification number	GA5963
Number of Individuals Covered	360
Insurance policy start date	2012-06-01
Insurance policy end date	2013-05-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $33,566
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

GREATER GEORGIA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97217 )

Policy contract number

1036156000

Policy instance

Insurance contract or identification number	1036156000
Number of Individuals Covered	369
Insurance policy start date	2011-06-01
Insurance policy end date	2012-05-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $34,083
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )

Policy contract number

E3005840

Policy instance

Insurance contract or identification number	E3005840
Number of Individuals Covered	201
Insurance policy start date	2011-06-01
Insurance policy end date	2012-05-31
Total amount of commissions paid to insurance broker	USD $21,239
Total amount of fees paid to insurance company	USD $2,498
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $113,457
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC/ (G0385) (National Association of Insurance Commissioners NAIC id number: 54801 )

Policy contract number

1036156000

Policy instance

Insurance contract or identification number	1036156000
Number of Individuals Covered	269
Insurance policy start date	2011-06-01
Insurance policy end date	2012-05-31
Total amount of commissions paid to insurance broker	USD $103,207
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,675,733
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

GREATER GEORGIA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97217 )

Policy contract number

1036156000

Policy instance

Insurance contract or identification number	1036156000
Number of Individuals Covered	340
Insurance policy start date	2010-06-01
Insurance policy end date	2011-05-31
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $30,284
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )

Policy contract number

E3005840

Policy instance

Insurance contract or identification number	E3005840
Number of Individuals Covered	175
Insurance policy start date	2010-06-01
Insurance policy end date	2011-05-31
Total amount of commissions paid to insurance broker	USD $13,748
Total amount of fees paid to insurance company	USD $711
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $90,482
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC/ (G0385) (National Association of Insurance Commissioners NAIC id number: 54801 )

Policy contract number

1036156000

Policy instance

Insurance contract or identification number	1036156000
Number of Individuals Covered	266
Insurance policy start date	2010-06-01
Insurance policy end date	2011-05-31
Total amount of commissions paid to insurance broker	USD $85,611
Total amount of fees paid to insurance company	USD $3,383
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,484,394
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	NATIONAL MANAGEMENT RESOURCES CORP.
Employer identification number (EIN):	840755858
NAIC Classification:	561720
NAIC Description:	Janitorial Services