JOHNSTONE SUPPLY, LLC. has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan JOHNSTONE SUPPLY, INC BENEFITS PLAN
Measure | Date | Value |
---|
2022: JOHNSTONE SUPPLY, INC BENEFITS PLAN 2022 401k membership |
---|
Total participants, beginning-of-year | 2022-01-01 | 411 |
Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 392 |
Number of retired or separated participants receiving benefits | 2022-01-01 | 2 |
Number of other retired or separated participants entitled to future benefits | 2022-01-01 | 0 |
Total of all active and inactive participants | 2022-01-01 | 394 |
2021: JOHNSTONE SUPPLY, INC BENEFITS PLAN 2021 401k membership |
---|
Total participants, beginning-of-year | 2021-01-01 | 379 |
Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 364 |
Number of retired or separated participants receiving benefits | 2021-01-01 | 2 |
Number of other retired or separated participants entitled to future benefits | 2021-01-01 | 0 |
Total of all active and inactive participants | 2021-01-01 | 366 |
2020: JOHNSTONE SUPPLY, INC BENEFITS PLAN 2020 401k membership |
---|
Total participants, beginning-of-year | 2020-01-01 | 313 |
Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 323 |
Number of retired or separated participants receiving benefits | 2020-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2020-01-01 | 0 |
Total of all active and inactive participants | 2020-01-01 | 323 |
2019: JOHNSTONE SUPPLY, INC BENEFITS PLAN 2019 401k membership |
---|
Total participants, beginning-of-year | 2019-01-01 | 363 |
Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 313 |
Number of retired or separated participants receiving benefits | 2019-01-01 | 3 |
Number of other retired or separated participants entitled to future benefits | 2019-01-01 | 1 |
Total of all active and inactive participants | 2019-01-01 | 317 |
2018: JOHNSTONE SUPPLY, INC BENEFITS PLAN 2018 401k membership |
---|
Total participants, beginning-of-year | 2018-01-01 | 336 |
Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 294 |
Number of retired or separated participants receiving benefits | 2018-01-01 | 3 |
Number of other retired or separated participants entitled to future benefits | 2018-01-01 | 7 |
Total of all active and inactive participants | 2018-01-01 | 304 |
2017: JOHNSTONE SUPPLY, INC BENEFITS PLAN 2017 401k membership |
---|
Total participants, beginning-of-year | 2017-01-01 | 395 |
Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 349 |
Number of retired or separated participants receiving benefits | 2017-01-01 | 3 |
Number of other retired or separated participants entitled to future benefits | 2017-01-01 | 75 |
Total of all active and inactive participants | 2017-01-01 | 427 |
2016: JOHNSTONE SUPPLY, INC BENEFITS PLAN 2016 401k membership |
---|
Total participants, beginning-of-year | 2016-01-01 | 324 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 338 |
Number of retired or separated participants receiving benefits | 2016-01-01 | 2 |
Number of other retired or separated participants entitled to future benefits | 2016-01-01 | 7 |
Total of all active and inactive participants | 2016-01-01 | 347 |
2015: JOHNSTONE SUPPLY, INC BENEFITS PLAN 2015 401k membership |
---|
Total participants, beginning-of-year | 2015-01-01 | 292 |
Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 319 |
Number of retired or separated participants receiving benefits | 2015-01-01 | 1 |
Number of other retired or separated participants entitled to future benefits | 2015-01-01 | 6 |
Total of all active and inactive participants | 2015-01-01 | 326 |
2014: JOHNSTONE SUPPLY, INC BENEFITS PLAN 2014 401k membership |
---|
Total participants, beginning-of-year | 2014-01-01 | 354 |
Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 292 |
Number of retired or separated participants receiving benefits | 2014-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2014-01-01 | 24 |
Total of all active and inactive participants | 2014-01-01 | 316 |
2013: JOHNSTONE SUPPLY, INC BENEFITS PLAN 2013 401k membership |
---|
Total participants, beginning-of-year | 2013-01-01 | 292 |
Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 268 |
Total of all active and inactive participants | 2013-01-01 | 268 |
2012: JOHNSTONE SUPPLY, INC BENEFITS PLAN 2012 401k membership |
---|
Total participants, beginning-of-year | 2012-01-01 | 276 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 292 |
Total of all active and inactive participants | 2012-01-01 | 292 |
2011: JOHNSTONE SUPPLY, INC BENEFITS PLAN 2011 401k membership |
---|
Total participants, beginning-of-year | 2011-01-01 | 264 |
Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 276 |
Total of all active and inactive participants | 2011-01-01 | 276 |
2010: JOHNSTONE SUPPLY, INC BENEFITS PLAN 2010 401k membership |
---|
Total participants, beginning-of-year | 2010-01-01 | 274 |
Total number of active participants reported on line 7a of the Form 5500 | 2010-01-01 | 264 |
Total of all active and inactive participants | 2010-01-01 | 264 |
2009: JOHNSTONE SUPPLY, INC BENEFITS PLAN 2009 401k membership |
---|
Total participants, beginning-of-year | 2009-01-01 | 267 |
Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 274 |
Total of all active and inactive participants | 2009-01-01 | 274 |
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | ETB144041 |
Policy instance | 15 |
Insurance contract or identification number | ETB144041 | Number of Individuals Covered | 383 | Insurance policy start date | 2022-01-01 | Insurance policy end date | 2022-12-31 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,250 | 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 | 632134 |
Policy instance | 1 |
Insurance contract or identification number | 632134 | Number of Individuals Covered | 383 | Insurance policy start date | 2021-05-01 | Insurance policy end date | 2022-04-30 | Total amount of commissions paid to insurance broker | USD $7,202 | Total amount of fees paid to insurance company | USD $2,056 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $102,807 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $7,202 | Amount paid for insurance broker fees | 2056 | Additional information about fees paid to insurance broker | ADDTL COMPENSATION | Insurance broker organization code? | 3 |
|
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 632135 |
Policy instance | 2 |
Insurance contract or identification number | 632135 | Number of Individuals Covered | 176 | Insurance policy start date | 2021-05-01 | Insurance policy end date | 2022-04-30 | Total amount of commissions paid to insurance broker | USD $9,691 | Total amount of fees paid to insurance company | USD $1,292 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $64,603 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $9,691 | Amount paid for insurance broker fees | 1292 | Additional information about fees paid to insurance broker | ADDTL COMPENSATION | Insurance broker organization code? | 3 |
|
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 716539 |
Policy instance | 3 |
Insurance contract or identification number | 716539 | Number of Individuals Covered | 547 | Insurance policy start date | 2021-05-01 | Insurance policy end date | 2022-04-30 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $719,449 | 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 | 434616 |
Policy instance | 4 |
Insurance contract or identification number | 434616 | Number of Individuals Covered | 110 | Insurance policy start date | 2021-05-01 | Insurance policy end date | 2022-04-30 | Total amount of commissions paid to insurance broker | USD $6,196 | Total amount of fees paid to insurance company | USD $1,999 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $39,971 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,196 | Amount paid for insurance broker fees | 1999 | Additional information about fees paid to insurance broker | ADTL COMP | Insurance broker organization code? | 3 |
|
PAUL REVERE VARIABLE ANNUITY INS. CO. (National Association of Insurance Commissioners NAIC id number: 67601 ) |
Policy contract number | 436417 |
Policy instance | 5 |
Insurance contract or identification number | 436417 | Number of Individuals Covered | 93 | Insurance policy start date | 2021-05-01 | Insurance policy end date | 2022-04-30 | Total amount of commissions paid to insurance broker | USD $2,034 | Total amount of fees paid to insurance company | USD $696 | Other welfare benefits provided | GROUP ACCIDENT | Welfare Benefit Premiums Paid to Carrier | USD $17,274 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,034 | Amount paid for insurance broker fees | 696 | Additional information about fees paid to insurance broker | ADDTL COMP | Insurance broker organization code? | 3 |
|
PAUL REVERE VARIABLE ANNUITY INS. CO. (National Association of Insurance Commissioners NAIC id number: 67601 ) |
Policy contract number | 436418 |
Policy instance | 6 |
Insurance contract or identification number | 436418 | Number of Individuals Covered | 33 | Insurance policy start date | 2021-05-01 | Insurance policy end date | 2022-04-30 | Total amount of commissions paid to insurance broker | USD $1,332 | Total amount of fees paid to insurance company | USD $444 | Health Insurance Welfare Benefit | Yes | Other welfare benefits provided | CRITICAL ILLNESS | Welfare Benefit Premiums Paid to Carrier | USD $8,882 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,332 | Amount paid for insurance broker fees | 444 | Additional information about fees paid to insurance broker | ADDTL COMP | Insurance broker organization code? | 3 |
|
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 716539 |
Policy instance | 7 |
Insurance contract or identification number | 716539 | Number of Individuals Covered | 493 | Insurance policy start date | 2022-05-01 | Insurance policy end date | 2022-12-31 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $418,436 | 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 | 436416 |
Policy instance | 8 |
Insurance contract or identification number | 436416 | Number of Individuals Covered | 129 | Insurance policy start date | 2022-05-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $5,460 | Total amount of fees paid to insurance company | USD $1,342 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $36,402 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,460 | Amount paid for insurance broker fees | 1342 | Additional information about fees paid to insurance broker | ADDTL COMP | Insurance broker organization code? | 3 |
|
PAUL REVERE VARIABLE ANNUITY INS. CO. (National Association of Insurance Commissioners NAIC id number: 67601 ) |
Policy contract number | 436417 |
Policy instance | 9 |
Insurance contract or identification number | 436417 | Number of Individuals Covered | 117 | Insurance policy start date | 2022-05-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $1,881 | Total amount of fees paid to insurance company | USD $542 | Other welfare benefits provided | GROUP ACCIDENT | Welfare Benefit Premiums Paid to Carrier | USD $15,260 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,881 | Amount paid for insurance broker fees | 542 | Additional information about fees paid to insurance broker | ADDTL COMP | Insurance broker organization code? | 3 |
|
PAUL REVERE VARIABLE ANNUITY INS. CO. (National Association of Insurance Commissioners NAIC id number: 67601 ) |
Policy contract number | 436418 |
Policy instance | 10 |
Insurance contract or identification number | 436418 | Number of Individuals Covered | 80 | Insurance policy start date | 2022-05-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $1,547 | Total amount of fees paid to insurance company | USD $232 | Health Insurance Welfare Benefit | Yes | Other welfare benefits provided | CRITICAL ILLNESS | Welfare Benefit Premiums Paid to Carrier | USD $10,315 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,547 | Amount paid for insurance broker fees | 232 | Additional information about fees paid to insurance broker | ADDTL COMP | Insurance broker organization code? | 3 |
|
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 632134 |
Policy instance | 11 |
Insurance contract or identification number | 632134 | Number of Individuals Covered | 495 | Insurance policy start date | 2022-05-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $6,986 | Total amount of fees paid to insurance company | USD $2,198 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $109,895 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,986 | Amount paid for insurance broker fees | 2198 | Additional information about fees paid to insurance broker | ADDTL COMP | Insurance broker organization code? | 3 |
|
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 632135 |
Policy instance | 12 |
Insurance contract or identification number | 632135 | Number of Individuals Covered | 198 | Insurance policy start date | 2022-05-01 | Insurance policy end date | 2022-12-31 | Total amount of commissions paid to insurance broker | USD $7,780 | Total amount of fees paid to insurance company | USD $1,037 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $51,865 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $7,780 | Amount paid for insurance broker fees | 1037 | Additional information about fees paid to insurance broker | ADDTL COMP | Insurance broker organization code? | 3 |
|
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 30103649 |
Policy instance | 13 |
Insurance contract or identification number | 30103649 | Number of Individuals Covered | 353 | Insurance policy start date | 2022-05-01 | Insurance policy end date | 2022-04-30 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $19,672 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
Policy contract number | 30103649 |
Policy instance | 14 |
Insurance contract or identification number | 30103649 | Number of Individuals Covered | 396 | Insurance policy start date | 2022-05-01 | Insurance policy end date | 2022-12-31 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $14,016 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) |
Policy contract number | 0010556930 |
Policy instance | 1 |
Insurance contract or identification number | 0010556930 | Number of Individuals Covered | 92 | Insurance policy start date | 2020-05-01 | Insurance policy end date | 2021-04-30 | Total amount of commissions paid to insurance broker | USD $1,989 | Total amount of fees paid to insurance company | USD $59 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $24,479 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,332 | Amount paid for insurance broker fees | 37 | Insurance broker organization code? | 3 | Additional information about fees paid to insurance broker | ADDTL COMPENSATION |
|
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | R0579839 |
Policy instance | 2 |
Insurance contract or identification number | R0579839 | Number of Individuals Covered | 114 | Insurance policy start date | 2020-05-01 | Insurance policy end date | 2021-04-30 | Total amount of commissions paid to insurance broker | USD $1,095 | Total amount of fees paid to insurance company | USD $1 | Health Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $19,659 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,095 | Amount paid for insurance broker fees | 1 | Additional information about fees paid to insurance broker | ADDTL COMPENSATION | Insurance broker organization code? | 3 |
|
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 632134 |
Policy instance | 3 |
Insurance contract or identification number | 632134 | Number of Individuals Covered | 380 | Insurance policy start date | 2020-05-01 | Insurance policy end date | 2021-04-30 | Total amount of commissions paid to insurance broker | USD $6,949 | Total amount of fees paid to insurance company | USD $1,323 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $90,545 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,949 | Amount paid for insurance broker fees | 1323 | Additional information about fees paid to insurance broker | ADDTL COMPENSATION | Insurance broker organization code? | 3 |
|
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 632135 |
Policy instance | 4 |
Insurance contract or identification number | 632135 | Number of Individuals Covered | 111 | Insurance policy start date | 2020-05-01 | Insurance policy end date | 2021-04-30 | Total amount of commissions paid to insurance broker | USD $5,837 | Total amount of fees paid to insurance company | USD $546 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $38,911 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,837 | Amount paid for insurance broker fees | 546 | Additional information about fees paid to insurance broker | ADDTL COMPENSATION | Insurance broker organization code? | 3 |
|
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 716539 |
Policy instance | 5 |
Insurance contract or identification number | 716539 | Number of Individuals Covered | 486 | Insurance policy start date | 2020-05-01 | Insurance policy end date | 2021-04-30 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $680,331 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) |
Policy contract number | 0010556930 |
Policy instance | 1 |
Insurance contract or identification number | 0010556930 | Number of Individuals Covered | 77 | Insurance policy start date | 2019-05-01 | Insurance policy end date | 2020-04-30 | Total amount of commissions paid to insurance broker | USD $769 | Total amount of fees paid to insurance company | USD $7 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $26,222 | 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 | Amount paid for insurance broker fees | 7 | Additional information about fees paid to insurance broker | ADDTL COMP | Insurance broker organization code? | 3 |
|
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | R0579839 |
Policy instance | 2 |
Insurance contract or identification number | R0579839 | Number of Individuals Covered | 115 | Insurance policy start date | 2019-05-01 | Insurance policy end date | 2020-04-30 | Total amount of commissions paid to insurance broker | USD $789 | Total amount of fees paid to insurance company | USD $4 | Health Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $24,943 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $789 | Amount paid for insurance broker fees | 4 | Additional information about fees paid to insurance broker | ADDTL COMP | Insurance broker organization code? | 3 |
|
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 632134 |
Policy instance | 3 |
Insurance contract or identification number | 632134 | Number of Individuals Covered | 368 | Insurance policy start date | 2019-05-01 | Insurance policy end date | 2020-04-30 | Total amount of commissions paid to insurance broker | USD $7,884 | Total amount of fees paid to insurance company | USD $932 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $89,547 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $7,884 | Amount paid for insurance broker fees | 932 | Additional information about fees paid to insurance broker | ADDTL COMP | Insurance broker organization code? | 3 |
|
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 632135 |
Policy instance | 4 |
Insurance contract or identification number | 632135 | Number of Individuals Covered | 112 | Insurance policy start date | 2019-05-01 | Insurance policy end date | 2020-04-30 | Total amount of commissions paid to insurance broker | USD $8,195 | Total amount of fees paid to insurance company | USD $465 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $43,670 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $8,195 | Amount paid for insurance broker fees | 465 | Additional information about fees paid to insurance broker | ADDTL COMP | Insurance broker organization code? | 3 |
|
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 716539 |
Policy instance | 5 |
Insurance contract or identification number | 716539 | Number of Individuals Covered | 502 | Insurance policy start date | 2019-05-01 | Insurance policy end date | 2020-04-30 | Health Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | ETB144041 |
Policy instance | 1 |
Insurance contract or identification number | ETB144041 | Number of Individuals Covered | 313 | Insurance policy start date | 2019-01-01 | Insurance policy end date | 2019-12-31 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,913 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) |
Policy contract number | 0010556930 |
Policy instance | 2 |
Insurance contract or identification number | 0010556930 | Number of Individuals Covered | 87 | Insurance policy start date | 2018-05-01 | Insurance policy end date | 2019-04-30 | Total amount of commissions paid to insurance broker | USD $1,742 | Total amount of fees paid to insurance company | USD $9 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $29,915 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,204 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 9 | Additional information about fees paid to insurance broker | ADDTL COMP |
|
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | R0579839 |
Policy instance | 3 |
Insurance contract or identification number | R0579839 | Number of Individuals Covered | 128 | Insurance policy start date | 2018-05-01 | Insurance policy end date | 2019-04-30 | Total amount of commissions paid to insurance broker | USD $1,215 | Total amount of fees paid to insurance company | USD $15 | Health Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $28,379 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,215 | Amount paid for insurance broker fees | 15 | Additional information about fees paid to insurance broker | ADDTL COMP | Insurance broker organization code? | 3 |
|
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 632134 |
Policy instance | 4 |
Insurance contract or identification number | 632134 | Number of Individuals Covered | 333 | Insurance policy start date | 2018-05-01 | Insurance policy end date | 2019-04-30 | Total amount of commissions paid to insurance broker | USD $6,089 | Total amount of fees paid to insurance company | USD $168 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $88,637 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,089 | Amount paid for insurance broker fees | 168 | Additional information about fees paid to insurance broker | ADDTL COMP | Insurance broker organization code? | 3 |
|
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 632135 |
Policy instance | 5 |
Insurance contract or identification number | 632135 | Number of Individuals Covered | 110 | Insurance policy start date | 2018-05-01 | Insurance policy end date | 2019-04-30 | Total amount of commissions paid to insurance broker | USD $5,178 | Total amount of fees paid to insurance company | USD $123 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $42,078 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,178 | Amount paid for insurance broker fees | 123 | Additional information about fees paid to insurance broker | ADDTL COMP | Insurance broker organization code? | 3 |
|
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 716539 |
Policy instance | 6 |
Insurance contract or identification number | 716539 | Number of Individuals Covered | 448 | Insurance policy start date | 2018-05-01 | Insurance policy end date | 2019-04-30 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $549,788 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 716539 |
Policy instance | 6 |
Insurance contract or identification number | 716539 | Number of Individuals Covered | 453 | Insurance policy start date | 2017-05-01 | Insurance policy end date | 2018-04-30 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $437,580 | 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 | 632135 |
Policy instance | 5 |
Insurance contract or identification number | 632135 | Number of Individuals Covered | 116 | Insurance policy start date | 2017-05-01 | Insurance policy end date | 2018-04-30 | Total amount of commissions paid to insurance broker | USD $6,375 | Total amount of fees paid to insurance company | USD $531 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $46,734 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,375 | Amount paid for insurance broker fees | 531 | Additional information about fees paid to insurance broker | ADDTL COMP | Insurance broker organization code? | 3 |
|
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 632134 |
Policy instance | 4 |
Insurance contract or identification number | 632134 | Number of Individuals Covered | 318 | Insurance policy start date | 2017-05-01 | Insurance policy end date | 2018-04-30 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $80,576 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Additional information about fees paid to insurance broker | ADDTL COMP | Insurance broker organization code? | 3 |
|
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | R0579839 |
Policy instance | 3 |
Insurance contract or identification number | R0579839 | Number of Individuals Covered | 151 | Insurance policy start date | 2017-05-01 | Insurance policy end date | 2018-04-30 | Total amount of commissions paid to insurance broker | USD $2,156 | Total amount of fees paid to insurance company | USD $65 | Health Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $31,532 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,156 | Amount paid for insurance broker fees | 65 | Additional information about fees paid to insurance broker | ADDTL COMP | Insurance broker organization code? | 3 |
|
PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) |
Policy contract number | 0010556930 |
Policy instance | 2 |
Insurance contract or identification number | 0010556930 | Number of Individuals Covered | 99 | Insurance policy start date | 2017-05-01 | Insurance policy end date | 2018-04-30 | Total amount of commissions paid to insurance broker | USD $1,720 | Total amount of fees paid to insurance company | USD $1 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $33,371 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $930 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 1 | Additional information about fees paid to insurance broker | ADDTL COMP |
|
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | ETB144041 |
Policy instance | 1 |
Insurance contract or identification number | ETB144041 | Number of Individuals Covered | 349 | Insurance policy start date | 2018-01-01 | Insurance policy end date | 2018-12-31 | Temporary Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
CASCADE CENTERS INC. (National Association of Insurance Commissioners NAIC id number: 62133 ) |
Policy contract number | JOHNSTONE |
Policy instance | 6 |
Insurance contract or identification number | JOHNSTONE | Number of Individuals Covered | 332 | Insurance policy start date | 2016-05-01 | Insurance policy end date | 2017-04-30 | Other welfare benefits provided | EAP | Welfare Benefit Premiums Paid to Carrier | USD $6,693 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | ETB144041 |
Policy instance | 1 |
Insurance contract or identification number | ETB144041 | Number of Individuals Covered | 349 | Insurance policy start date | 2017-01-01 | Insurance policy end date | 2017-12-31 | Temporary Disability Insurance Welfare Benefit | Yes | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) |
Policy contract number | 0010556930 |
Policy instance | 2 |
Insurance contract or identification number | 0010556930 | Number of Individuals Covered | 111 | Insurance policy start date | 2016-05-01 | Insurance policy end date | 2017-04-30 | Total amount of commissions paid to insurance broker | USD $3,159 | Total amount of fees paid to insurance company | USD $114 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $33,257 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,100 | Amount paid for insurance broker fees | 114 | Additional information about fees paid to insurance broker | ADDTL COMP | Insurance broker organization code? | 3 | Insurance broker name | JOHN J DAVIDSON |
|
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 0010556930 |
Policy instance | 3 |
Insurance contract or identification number | 0010556930 | Number of Individuals Covered | 160 | Insurance policy start date | 2016-05-01 | Insurance policy end date | 2017-04-30 | Total amount of commissions paid to insurance broker | USD $3,704 | Total amount of fees paid to insurance company | USD $119 | Health Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $30,741 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,704 | Amount paid for insurance broker fees | 119 | Insurance broker organization code? | 3 | Insurance broker name | DAVIDSON BENEFITS PLANNING LLC |
|
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 632134 |
Policy instance | 4 |
Insurance contract or identification number | 632134 | Number of Individuals Covered | 313 | Insurance policy start date | 2016-05-01 | Insurance policy end date | 2017-04-30 | Total amount of commissions paid to insurance broker | USD $5,665 | Total amount of fees paid to insurance company | USD $808 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $64,634 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,665 | Amount paid for insurance broker fees | 808 | Additional information about fees paid to insurance broker | ADDTL COMP | Insurance broker organization code? | 3 | Insurance broker name | DAVIDSON BENEFITS PLANNING LLC |
|
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
Policy contract number | 632135 |
Policy instance | 5 |
Insurance contract or identification number | 632135 | Number of Individuals Covered | 122 | Insurance policy start date | 2016-05-01 | Insurance policy end date | 2017-04-30 | Total amount of commissions paid to insurance broker | USD $6,682 | Total amount of fees paid to insurance company | USD $604 | Life Insurance Welfare Benefit | Yes | Other welfare benefits provided | AD&D | Welfare Benefit Premiums Paid to Carrier | USD $44,549 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,682 | Amount paid for insurance broker fees | 604 | Additional information about fees paid to insurance broker | ADDTL COMP | Insurance broker organization code? | 3 | Insurance broker name | DAVIDSON BENEFITS PLANNING LLC |
|
RELIANT BEHAVIORAL HEALTH (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 15008651 |
Policy instance | 1 |
Insurance contract or identification number | 15008651 | Number of Individuals Covered | 292 | Insurance policy start date | 2014-05-01 | Insurance policy end date | 2015-04-30 | Other welfare benefits provided | EMPLOYEE ASSISTANCE PROGRAM | Welfare Benefit Premiums Paid to Carrier | USD $8,100 | 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 | 10070764 |
Policy instance | 2 |
Insurance contract or identification number | 10070764 | Number of Individuals Covered | 292 | Insurance policy start date | 2014-05-01 | Insurance policy end date | 2015-04-30 | Total amount of commissions paid to insurance broker | USD $2,115 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $22,540 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,115 | Insurance broker organization code? | 3 | Insurance broker name | DAVIDSON BENEFITS PLANNING LLC |
|
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 10070765 |
Policy instance | 3 |
Insurance contract or identification number | 10070765 | Number of Individuals Covered | 291 | Insurance policy start date | 2014-05-01 | Insurance policy end date | 2015-04-30 | Total amount of commissions paid to insurance broker | USD $3,849 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $36,989 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,849 | Insurance broker organization code? | 3 | Insurance broker name | DAVIDSON BENEFITS PLANNING LLC |
|
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 716539 |
Policy instance | 4 |
Insurance contract or identification number | 716539 | Number of Individuals Covered | 254 | Insurance policy start date | 2014-05-01 | Insurance policy end date | 2015-04-30 | Welfare Benefit Premiums Paid to Carrier | USD $310,671 | 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 | 10070765 |
Policy instance | 3 |
Insurance contract or identification number | 10070765 | Number of Individuals Covered | 288 | Insurance policy start date | 2013-05-01 | Insurance policy end date | 2014-04-30 | Total amount of commissions paid to insurance broker | USD $3,834 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $36,686 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,834 | Insurance broker organization code? | 3 | Insurance broker name | DAVIDSON BENEFITS PLANNING LLC |
|
RELIANT BEHAVIORAL HEALTH (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 15008651 |
Policy instance | 1 |
Insurance contract or identification number | 15008651 | Number of Individuals Covered | 292 | Insurance policy start date | 2013-05-01 | Insurance policy end date | 2014-04-30 | Other welfare benefits provided | EMPLOYEE ASSISTANCE PROGRAM | Welfare Benefit Premiums Paid to Carrier | USD $7,349 | 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 | 10070764 |
Policy instance | 2 |
Insurance contract or identification number | 10070764 | Number of Individuals Covered | 288 | Insurance policy start date | 2013-05-01 | Insurance policy end date | 2014-04-30 | Total amount of commissions paid to insurance broker | USD $2,123 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $22,334 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,123 | Insurance broker organization code? | 3 | Insurance broker name | DAVIDSON BENEFITS PLANNING LLC |
|
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 716539 |
Policy instance | 4 |
Insurance contract or identification number | 716539 | Number of Individuals Covered | 251 | Insurance policy start date | 2013-05-01 | Insurance policy end date | 2014-04-30 | Welfare Benefit Premiums Paid to Carrier | USD $310,163 | 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 | 10070764 |
Policy instance | 2 |
Insurance contract or identification number | 10070764 | Number of Individuals Covered | 268 | Insurance policy start date | 2012-05-01 | Insurance policy end date | 2013-04-30 | Total amount of commissions paid to insurance broker | USD $1,877 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $18,810 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,877 | Insurance broker organization code? | 3 | Insurance broker name | DAVIDSON BENEFITS PLANNING LLC |
|
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 10070765 |
Policy instance | 3 |
Insurance contract or identification number | 10070765 | Number of Individuals Covered | 268 | Insurance policy start date | 2012-05-01 | Insurance policy end date | 2013-04-30 | Total amount of commissions paid to insurance broker | USD $3,963 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $39,251 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,963 | Insurance broker organization code? | 3 | Insurance broker name | DAVIDSON BENEFITS PLANNING LLC |
|
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 716539 |
Policy instance | 4 |
Insurance contract or identification number | 716539 | Number of Individuals Covered | 239 | Insurance policy start date | 2012-05-01 | Insurance policy end date | 2013-04-30 | Welfare Benefit Premiums Paid to Carrier | USD $263,686 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
FIDELITY SECURITY LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 67288 ) |
Policy contract number | 9696923 |
Policy instance | 5 |
Insurance contract or identification number | 9696923 | Number of Individuals Covered | 396 | Insurance policy start date | 2012-05-01 | Insurance policy end date | 2013-04-30 | Total amount of commissions paid to insurance broker | USD $271 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $11,486 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $271 | Insurance broker organization code? | 3 | Insurance broker name | DAVIDSON BENEFITS PLANNING LLC |
|
RELIANT BEHAVIORAL HEALTH (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 15008651 |
Policy instance | 1 |
Insurance contract or identification number | 15008651 | Number of Individuals Covered | 292 | Insurance policy start date | 2012-05-01 | Insurance policy end date | 2013-04-30 | Other welfare benefits provided | EMPLOYEE ASSISTANCE PROGRAM | Welfare Benefit Premiums Paid to Carrier | USD $6,545 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 716539 |
Policy instance | 4 |
Insurance contract or identification number | 716539 | Number of Individuals Covered | 244 | Insurance policy start date | 2011-05-01 | Insurance policy end date | 2012-04-30 | Welfare Benefit Premiums Paid to Carrier | USD $230,239 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
RELIANT BEHAVIORAL HEALTH (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 15008651 |
Policy instance | 1 |
Insurance contract or identification number | 15008651 | Number of Individuals Covered | 292 | Insurance policy start date | 2011-05-01 | Insurance policy end date | 2012-04-30 | Other welfare benefits provided | EMPLOYEE ASSISTANCE PROGRAM | Welfare Benefit Premiums Paid to Carrier | USD $6,363 | 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 | 10070764 |
Policy instance | 2 |
Insurance contract or identification number | 10070764 | Number of Individuals Covered | 260 | Insurance policy start date | 2011-05-01 | Insurance policy end date | 2012-04-30 | Total amount of commissions paid to insurance broker | USD $1,931 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $19,585 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,931 | Insurance broker organization code? | 3 | Insurance broker name | DAVIDSON BENEFITS PLANNING LLC |
|
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 10070765 |
Policy instance | 3 |
Insurance contract or identification number | 10070765 | Number of Individuals Covered | 260 | Insurance policy start date | 2011-05-01 | Insurance policy end date | 2012-04-30 | Total amount of commissions paid to insurance broker | USD $4,037 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $40,747 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,037 | Insurance broker organization code? | 3 | Insurance broker name | DAVIDSON BENEFITS PLANNING LLC |
|
FIDELITY SECURITY LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 67288 ) |
Policy contract number | 9696923 |
Policy instance | 5 |
Insurance contract or identification number | 9696923 | Number of Individuals Covered | 411 | Insurance policy start date | 2011-05-01 | Insurance policy end date | 2012-04-30 | Total amount of commissions paid to insurance broker | USD $261 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $10,728 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $261 | Insurance broker organization code? | 3 | Insurance broker name | DAVIDSON BENEFITS PLANNING LLC |
|
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 10070765 |
Policy instance | 3 |
Insurance contract or identification number | 10070765 | Number of Individuals Covered | 265 | Insurance policy start date | 2010-05-01 | Insurance policy end date | 2011-04-30 | Total amount of commissions paid to insurance broker | USD $3,965 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $39,296 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
RELIANT BEHAVIORAL HEALTH (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 15008651 |
Policy instance | 1 |
Insurance contract or identification number | 15008651 | Number of Individuals Covered | 303 | Insurance policy start date | 2010-07-01 | Insurance policy end date | 2011-06-30 | Other welfare benefits provided | EMPLOYEE ASSISTANCE PROGRAM | Welfare Benefit Premiums Paid to Carrier | USD $6,363 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 716539 |
Policy instance | 4 |
Insurance contract or identification number | 716539 | Number of Individuals Covered | 249 | Insurance policy start date | 2010-05-01 | Insurance policy end date | 2011-04-30 | Welfare Benefit Premiums Paid to Carrier | USD $181,160 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
FIDELITY SECURITY LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 67288 ) |
Policy contract number | 9696923 |
Policy instance | 5 |
Insurance contract or identification number | 9696923 | Number of Individuals Covered | 428 | Insurance policy start date | 2010-07-01 | Insurance policy end date | 2011-06-30 | Total amount of commissions paid to insurance broker | USD $263 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $12,576 | 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 | 10070764 |
Policy instance | 2 |
Insurance contract or identification number | 10070764 | Number of Individuals Covered | 276 | Insurance policy start date | 2010-05-01 | Insurance policy end date | 2011-04-30 | Total amount of commissions paid to insurance broker | USD $1,918 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $19,348 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
RELIANT BEHAVIORAL HEALTH (National Association of Insurance Commissioners NAIC id number: 00000 ) |
Policy contract number | 15008651 |
Policy instance | 1 |
Insurance contract or identification number | 15008651 | Number of Individuals Covered | 303 | Insurance policy start date | 2009-07-01 | Insurance policy end date | 2010-06-30 | Other welfare benefits provided | EMPLOYEE ASSISTANCE PROGRAM | Welfare Benefit Premiums Paid to Carrier | USD $5,549 | 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 | 10070764 |
Policy instance | 2 |
Insurance contract or identification number | 10070764 | Number of Individuals Covered | 264 | Insurance policy start date | 2009-07-01 | Insurance policy end date | 2010-06-30 | Total amount of commissions paid to insurance broker | USD $1,867 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $18,665 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,867 | Insurance broker organization code? | 3 | Insurance broker name | DAVIDSON BENEFITS PLANNING LLC |
|
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 10070765 |
Policy instance | 4 |
Insurance contract or identification number | 10070765 | Number of Individuals Covered | 265 | Insurance policy start date | 2009-07-01 | Insurance policy end date | 2010-06-30 | Total amount of commissions paid to insurance broker | USD $3,870 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $37,395 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,870 | Insurance broker organization code? | 3 | Insurance broker name | DAVIDSON BENEFITS PLANNING LLC |
|
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 716539 |
Policy instance | 5 |
Insurance contract or identification number | 716539 | Number of Individuals Covered | 270 | Insurance policy start date | 2009-05-01 | Insurance policy end date | 2010-04-30 | Welfare Benefit Premiums Paid to Carrier | USD $149,801 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
Policy contract number | ETB144041 |
Policy instance | 6 |
Insurance contract or identification number | ETB144041 | Number of Individuals Covered | 279 | Insurance policy start date | 2010-01-01 | Insurance policy end date | 2010-12-31 | Total amount of commissions paid to insurance broker | USD $338 | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $2,250 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $338 | Insurance broker organization code? | 3 | Insurance broker name | DAVIDSON BENEFITS PLANNING LLC |
|
FIDELITY SECURITY LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 67288 ) |
Policy contract number | 9696923 |
Policy instance | 7 |
Insurance contract or identification number | 9696923 | Number of Individuals Covered | 429 | Insurance policy start date | 2009-07-01 | Insurance policy end date | 2010-06-30 | Total amount of commissions paid to insurance broker | USD $257 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $14,195 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $257 | Insurance broker organization code? | 3 | Insurance broker name | DAVIDSON BENEFITS PLANNING LLC |
|
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 40000100004516 |
Policy instance | 3 |
Insurance contract or identification number | 40000100004516 | Number of Individuals Covered | 54 | Insurance policy start date | 2009-07-01 | Insurance policy end date | 2010-06-30 | Total amount of commissions paid to insurance broker | USD $2,061 | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $13,739 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,061 | Insurance broker organization code? | 3 | Insurance broker name | DAVIDSON BENEFITS PLANNING LLC |
|