?>
Logo

JOHNSTONE SUPPLY, INC BENEFITS PLAN 401k Plan overview

Plan NameJOHNSTONE SUPPLY, INC BENEFITS PLAN
Plan identification number 501

JOHNSTONE SUPPLY, INC BENEFITS PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover

401k Sponsoring company profile

JOHNSTONE SUPPLY, LLC. has sponsored the creation of one or more 401k plans.

Company Name:JOHNSTONE SUPPLY, LLC.
Employer identification number (EIN):930788192
NAIC Classification:423700

Form 5500 Filing Information

Submission information for form 5500 for 401k plan JOHNSTONE SUPPLY, INC BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01
5012021-01-01
5012020-01-01
5012019-01-01
5012018-01-01JOHANNA GLODE JOHANNA GLODE2019-07-16
5012017-01-01JOHANNA GLODE JOHANNA GLODE2018-07-17
5012016-01-01JOHANNA GLODE JOHANNA GLODE2017-06-28
5012015-01-01JOHANNA GLODE JOHANNA GLODE2016-07-21
5012014-01-01JOHANNA GLODE JOHANNA GLODE2015-07-15
5012013-01-01JOHANNA GLODE JOHANNA GLODE2014-07-24
5012012-01-01JOHANNA GLODE JOHANNA GLODE2013-07-19
5012011-01-01JOHANNA GLODE JOHANNA GLODE2012-07-18
5012010-01-01JOHANNA GLODE JOHANNA GLODE2011-07-14
5012009-01-01STEPHEN L BARKLEY CPA STEPHEN L BARKLEY CPA2010-08-17
5012009-01-01JOHANNA GLODE JOHANNA GLODE2010-08-16
5012009-01-01STEPHEN L BARKLEY CPA STEPHEN L BARKLEY CPA2010-08-17
5012009-01-01JOHANNA GLODE JOHANNA GLODE2010-07-29
5012009-01-01JOHANNA GLODE JOHANNA GLODE2010-07-28
5012009-01-01STEPHEN L BARKLEY CPA STEPHEN L BARKLEY CPA2010-08-17
5012009-01-01JOHANNA GLODE LISA L. OSBORNE2010-07-28
5012009-01-01STEPHEN L BARKLEY CPA STEPHEN L BARKLEY CPA2010-08-17

Plan Statistics for JOHNSTONE SUPPLY, INC BENEFITS PLAN

401k plan membership statisitcs for JOHNSTONE SUPPLY, INC BENEFITS PLAN

Measure Date Value
2022: JOHNSTONE SUPPLY, INC BENEFITS PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01411
Total number of active participants reported on line 7a of the Form 55002022-01-01392
Number of retired or separated participants receiving benefits2022-01-012
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-01394
2021: JOHNSTONE SUPPLY, INC BENEFITS PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01379
Total number of active participants reported on line 7a of the Form 55002021-01-01364
Number of retired or separated participants receiving benefits2021-01-012
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-01366
2020: JOHNSTONE SUPPLY, INC BENEFITS PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01313
Total number of active participants reported on line 7a of the Form 55002020-01-01323
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-01323
2019: JOHNSTONE SUPPLY, INC BENEFITS PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01363
Total number of active participants reported on line 7a of the Form 55002019-01-01313
Number of retired or separated participants receiving benefits2019-01-013
Number of other retired or separated participants entitled to future benefits2019-01-011
Total of all active and inactive participants2019-01-01317
2018: JOHNSTONE SUPPLY, INC BENEFITS PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01336
Total number of active participants reported on line 7a of the Form 55002018-01-01294
Number of retired or separated participants receiving benefits2018-01-013
Number of other retired or separated participants entitled to future benefits2018-01-017
Total of all active and inactive participants2018-01-01304
2017: JOHNSTONE SUPPLY, INC BENEFITS PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01395
Total number of active participants reported on line 7a of the Form 55002017-01-01349
Number of retired or separated participants receiving benefits2017-01-013
Number of other retired or separated participants entitled to future benefits2017-01-0175
Total of all active and inactive participants2017-01-01427
2016: JOHNSTONE SUPPLY, INC BENEFITS PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01324
Total number of active participants reported on line 7a of the Form 55002016-01-01338
Number of retired or separated participants receiving benefits2016-01-012
Number of other retired or separated participants entitled to future benefits2016-01-017
Total of all active and inactive participants2016-01-01347
2015: JOHNSTONE SUPPLY, INC BENEFITS PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01292
Total number of active participants reported on line 7a of the Form 55002015-01-01319
Number of retired or separated participants receiving benefits2015-01-011
Number of other retired or separated participants entitled to future benefits2015-01-016
Total of all active and inactive participants2015-01-01326
2014: JOHNSTONE SUPPLY, INC BENEFITS PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01354
Total number of active participants reported on line 7a of the Form 55002014-01-01292
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-0124
Total of all active and inactive participants2014-01-01316
2013: JOHNSTONE SUPPLY, INC BENEFITS PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01292
Total number of active participants reported on line 7a of the Form 55002013-01-01268
Total of all active and inactive participants2013-01-01268
2012: JOHNSTONE SUPPLY, INC BENEFITS PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01276
Total number of active participants reported on line 7a of the Form 55002012-01-01292
Total of all active and inactive participants2012-01-01292
2011: JOHNSTONE SUPPLY, INC BENEFITS PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01264
Total number of active participants reported on line 7a of the Form 55002011-01-01276
Total of all active and inactive participants2011-01-01276
2010: JOHNSTONE SUPPLY, INC BENEFITS PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-01274
Total number of active participants reported on line 7a of the Form 55002010-01-01264
Total of all active and inactive participants2010-01-01264
2009: JOHNSTONE SUPPLY, INC BENEFITS PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01267
Total number of active participants reported on line 7a of the Form 55002009-01-01274
Total of all active and inactive participants2009-01-01274

Form 5500 Responses for JOHNSTONE SUPPLY, INC BENEFITS PLAN

2022: JOHNSTONE SUPPLY, INC BENEFITS PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: JOHNSTONE SUPPLY, INC BENEFITS PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: JOHNSTONE SUPPLY, INC BENEFITS PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes
2019: JOHNSTONE SUPPLY, INC BENEFITS PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – General assets of the sponsorYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – General assets of the sponsorYes
2018: JOHNSTONE SUPPLY, INC BENEFITS PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – General assets of the sponsorYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – General assets of the sponsorYes
2017: JOHNSTONE SUPPLY, INC BENEFITS PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – General assets of the sponsorYes
2016: JOHNSTONE SUPPLY, INC BENEFITS PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – General assets of the sponsorYes
2015: JOHNSTONE SUPPLY, INC BENEFITS PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – General assets of the sponsorYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – General assets of the sponsorYes
2014: JOHNSTONE SUPPLY, INC BENEFITS PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – General assets of the sponsorYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – General assets of the sponsorYes
2013: JOHNSTONE SUPPLY, INC BENEFITS PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – General assets of the sponsorYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – General assets of the sponsorYes
2012: JOHNSTONE SUPPLY, INC BENEFITS PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – General assets of the sponsorYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – General assets of the sponsorYes
2011: JOHNSTONE SUPPLY, INC BENEFITS PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – General assets of the sponsorYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – General assets of the sponsorYes
2010: JOHNSTONE SUPPLY, INC BENEFITS PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Plan funding arrangement – General assets of the sponsorYes
2010-01-01Plan benefit arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – General assets of the sponsorYes
2009: JOHNSTONE SUPPLY, INC BENEFITS PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedYes
2009-01-01Plan funding arrangement – General assets of the sponsorYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract numberETB144041
Policy instance 15
Insurance contract or identification numberETB144041
Number of Individuals Covered383
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $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 number632134
Policy instance 1
Insurance contract or identification number632134
Number of Individuals Covered383
Insurance policy start date2021-05-01
Insurance policy end date2022-04-30
Total amount of commissions paid to insurance brokerUSD $7,202
Total amount of fees paid to insurance companyUSD $2,056
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $102,807
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,202
Amount paid for insurance broker fees2056
Additional information about fees paid to insurance brokerADDTL COMPENSATION
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number632135
Policy instance 2
Insurance contract or identification number632135
Number of Individuals Covered176
Insurance policy start date2021-05-01
Insurance policy end date2022-04-30
Total amount of commissions paid to insurance brokerUSD $9,691
Total amount of fees paid to insurance companyUSD $1,292
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $64,603
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,691
Amount paid for insurance broker fees1292
Additional information about fees paid to insurance brokerADDTL COMPENSATION
Insurance broker organization code?3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number716539
Policy instance 3
Insurance contract or identification number716539
Number of Individuals Covered547
Insurance policy start date2021-05-01
Insurance policy end date2022-04-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $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 number434616
Policy instance 4
Insurance contract or identification number434616
Number of Individuals Covered110
Insurance policy start date2021-05-01
Insurance policy end date2022-04-30
Total amount of commissions paid to insurance brokerUSD $6,196
Total amount of fees paid to insurance companyUSD $1,999
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $39,971
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,196
Amount paid for insurance broker fees1999
Additional information about fees paid to insurance brokerADTL COMP
Insurance broker organization code?3
PAUL REVERE VARIABLE ANNUITY INS. CO. (National Association of Insurance Commissioners NAIC id number: 67601 )
Policy contract number436417
Policy instance 5
Insurance contract or identification number436417
Number of Individuals Covered93
Insurance policy start date2021-05-01
Insurance policy end date2022-04-30
Total amount of commissions paid to insurance brokerUSD $2,034
Total amount of fees paid to insurance companyUSD $696
Other welfare benefits providedGROUP ACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $17,274
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,034
Amount paid for insurance broker fees696
Additional information about fees paid to insurance brokerADDTL COMP
Insurance broker organization code?3
PAUL REVERE VARIABLE ANNUITY INS. CO. (National Association of Insurance Commissioners NAIC id number: 67601 )
Policy contract number436418
Policy instance 6
Insurance contract or identification number436418
Number of Individuals Covered33
Insurance policy start date2021-05-01
Insurance policy end date2022-04-30
Total amount of commissions paid to insurance brokerUSD $1,332
Total amount of fees paid to insurance companyUSD $444
Health Insurance Welfare BenefitYes
Other welfare benefits providedCRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $8,882
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,332
Amount paid for insurance broker fees444
Additional information about fees paid to insurance brokerADDTL COMP
Insurance broker organization code?3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number716539
Policy instance 7
Insurance contract or identification number716539
Number of Individuals Covered493
Insurance policy start date2022-05-01
Insurance policy end date2022-12-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $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 number436416
Policy instance 8
Insurance contract or identification number436416
Number of Individuals Covered129
Insurance policy start date2022-05-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $5,460
Total amount of fees paid to insurance companyUSD $1,342
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $36,402
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,460
Amount paid for insurance broker fees1342
Additional information about fees paid to insurance brokerADDTL COMP
Insurance broker organization code?3
PAUL REVERE VARIABLE ANNUITY INS. CO. (National Association of Insurance Commissioners NAIC id number: 67601 )
Policy contract number436417
Policy instance 9
Insurance contract or identification number436417
Number of Individuals Covered117
Insurance policy start date2022-05-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $1,881
Total amount of fees paid to insurance companyUSD $542
Other welfare benefits providedGROUP ACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $15,260
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,881
Amount paid for insurance broker fees542
Additional information about fees paid to insurance brokerADDTL COMP
Insurance broker organization code?3
PAUL REVERE VARIABLE ANNUITY INS. CO. (National Association of Insurance Commissioners NAIC id number: 67601 )
Policy contract number436418
Policy instance 10
Insurance contract or identification number436418
Number of Individuals Covered80
Insurance policy start date2022-05-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $1,547
Total amount of fees paid to insurance companyUSD $232
Health Insurance Welfare BenefitYes
Other welfare benefits providedCRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $10,315
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,547
Amount paid for insurance broker fees232
Additional information about fees paid to insurance brokerADDTL COMP
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number632134
Policy instance 11
Insurance contract or identification number632134
Number of Individuals Covered495
Insurance policy start date2022-05-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $6,986
Total amount of fees paid to insurance companyUSD $2,198
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $109,895
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,986
Amount paid for insurance broker fees2198
Additional information about fees paid to insurance brokerADDTL COMP
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number632135
Policy instance 12
Insurance contract or identification number632135
Number of Individuals Covered198
Insurance policy start date2022-05-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $7,780
Total amount of fees paid to insurance companyUSD $1,037
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $51,865
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,780
Amount paid for insurance broker fees1037
Additional information about fees paid to insurance brokerADDTL COMP
Insurance broker organization code?3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30103649
Policy instance 13
Insurance contract or identification number30103649
Number of Individuals Covered353
Insurance policy start date2022-05-01
Insurance policy end date2022-04-30
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $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 number30103649
Policy instance 14
Insurance contract or identification number30103649
Number of Individuals Covered396
Insurance policy start date2022-05-01
Insurance policy end date2022-12-31
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $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 number0010556930
Policy instance 1
Insurance contract or identification number0010556930
Number of Individuals Covered92
Insurance policy start date2020-05-01
Insurance policy end date2021-04-30
Total amount of commissions paid to insurance brokerUSD $1,989
Total amount of fees paid to insurance companyUSD $59
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $24,479
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,332
Amount paid for insurance broker fees37
Insurance broker organization code?3
Additional information about fees paid to insurance brokerADDTL COMPENSATION
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberR0579839
Policy instance 2
Insurance contract or identification numberR0579839
Number of Individuals Covered114
Insurance policy start date2020-05-01
Insurance policy end date2021-04-30
Total amount of commissions paid to insurance brokerUSD $1,095
Total amount of fees paid to insurance companyUSD $1
Health Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $19,659
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,095
Amount paid for insurance broker fees1
Additional information about fees paid to insurance brokerADDTL COMPENSATION
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number632134
Policy instance 3
Insurance contract or identification number632134
Number of Individuals Covered380
Insurance policy start date2020-05-01
Insurance policy end date2021-04-30
Total amount of commissions paid to insurance brokerUSD $6,949
Total amount of fees paid to insurance companyUSD $1,323
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $90,545
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,949
Amount paid for insurance broker fees1323
Additional information about fees paid to insurance brokerADDTL COMPENSATION
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number632135
Policy instance 4
Insurance contract or identification number632135
Number of Individuals Covered111
Insurance policy start date2020-05-01
Insurance policy end date2021-04-30
Total amount of commissions paid to insurance brokerUSD $5,837
Total amount of fees paid to insurance companyUSD $546
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $38,911
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,837
Amount paid for insurance broker fees546
Additional information about fees paid to insurance brokerADDTL COMPENSATION
Insurance broker organization code?3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number716539
Policy instance 5
Insurance contract or identification number716539
Number of Individuals Covered486
Insurance policy start date2020-05-01
Insurance policy end date2021-04-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $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 number0010556930
Policy instance 1
Insurance contract or identification number0010556930
Number of Individuals Covered77
Insurance policy start date2019-05-01
Insurance policy end date2020-04-30
Total amount of commissions paid to insurance brokerUSD $769
Total amount of fees paid to insurance companyUSD $7
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $26,222
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $428
Amount paid for insurance broker fees7
Additional information about fees paid to insurance brokerADDTL COMP
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberR0579839
Policy instance 2
Insurance contract or identification numberR0579839
Number of Individuals Covered115
Insurance policy start date2019-05-01
Insurance policy end date2020-04-30
Total amount of commissions paid to insurance brokerUSD $789
Total amount of fees paid to insurance companyUSD $4
Health Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $24,943
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $789
Amount paid for insurance broker fees4
Additional information about fees paid to insurance brokerADDTL COMP
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number632134
Policy instance 3
Insurance contract or identification number632134
Number of Individuals Covered368
Insurance policy start date2019-05-01
Insurance policy end date2020-04-30
Total amount of commissions paid to insurance brokerUSD $7,884
Total amount of fees paid to insurance companyUSD $932
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $89,547
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,884
Amount paid for insurance broker fees932
Additional information about fees paid to insurance brokerADDTL COMP
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number632135
Policy instance 4
Insurance contract or identification number632135
Number of Individuals Covered112
Insurance policy start date2019-05-01
Insurance policy end date2020-04-30
Total amount of commissions paid to insurance brokerUSD $8,195
Total amount of fees paid to insurance companyUSD $465
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $43,670
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,195
Amount paid for insurance broker fees465
Additional information about fees paid to insurance brokerADDTL COMP
Insurance broker organization code?3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number716539
Policy instance 5
Insurance contract or identification number716539
Number of Individuals Covered502
Insurance policy start date2019-05-01
Insurance policy end date2020-04-30
Health Insurance Welfare BenefitYes
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 numberETB144041
Policy instance 1
Insurance contract or identification numberETB144041
Number of Individuals Covered313
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $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 number0010556930
Policy instance 2
Insurance contract or identification number0010556930
Number of Individuals Covered87
Insurance policy start date2018-05-01
Insurance policy end date2019-04-30
Total amount of commissions paid to insurance brokerUSD $1,742
Total amount of fees paid to insurance companyUSD $9
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $29,915
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,204
Insurance broker organization code?3
Amount paid for insurance broker fees9
Additional information about fees paid to insurance brokerADDTL COMP
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberR0579839
Policy instance 3
Insurance contract or identification numberR0579839
Number of Individuals Covered128
Insurance policy start date2018-05-01
Insurance policy end date2019-04-30
Total amount of commissions paid to insurance brokerUSD $1,215
Total amount of fees paid to insurance companyUSD $15
Health Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $28,379
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,215
Amount paid for insurance broker fees15
Additional information about fees paid to insurance brokerADDTL COMP
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number632134
Policy instance 4
Insurance contract or identification number632134
Number of Individuals Covered333
Insurance policy start date2018-05-01
Insurance policy end date2019-04-30
Total amount of commissions paid to insurance brokerUSD $6,089
Total amount of fees paid to insurance companyUSD $168
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $88,637
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,089
Amount paid for insurance broker fees168
Additional information about fees paid to insurance brokerADDTL COMP
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number632135
Policy instance 5
Insurance contract or identification number632135
Number of Individuals Covered110
Insurance policy start date2018-05-01
Insurance policy end date2019-04-30
Total amount of commissions paid to insurance brokerUSD $5,178
Total amount of fees paid to insurance companyUSD $123
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $42,078
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,178
Amount paid for insurance broker fees123
Additional information about fees paid to insurance brokerADDTL COMP
Insurance broker organization code?3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number716539
Policy instance 6
Insurance contract or identification number716539
Number of Individuals Covered448
Insurance policy start date2018-05-01
Insurance policy end date2019-04-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $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 number716539
Policy instance 6
Insurance contract or identification number716539
Number of Individuals Covered453
Insurance policy start date2017-05-01
Insurance policy end date2018-04-30
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $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 number632135
Policy instance 5
Insurance contract or identification number632135
Number of Individuals Covered116
Insurance policy start date2017-05-01
Insurance policy end date2018-04-30
Total amount of commissions paid to insurance brokerUSD $6,375
Total amount of fees paid to insurance companyUSD $531
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $46,734
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,375
Amount paid for insurance broker fees531
Additional information about fees paid to insurance brokerADDTL COMP
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number632134
Policy instance 4
Insurance contract or identification number632134
Number of Individuals Covered318
Insurance policy start date2017-05-01
Insurance policy end date2018-04-30
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $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 brokerADDTL COMP
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberR0579839
Policy instance 3
Insurance contract or identification numberR0579839
Number of Individuals Covered151
Insurance policy start date2017-05-01
Insurance policy end date2018-04-30
Total amount of commissions paid to insurance brokerUSD $2,156
Total amount of fees paid to insurance companyUSD $65
Health Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $31,532
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,156
Amount paid for insurance broker fees65
Additional information about fees paid to insurance brokerADDTL COMP
Insurance broker organization code?3
PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 )
Policy contract number0010556930
Policy instance 2
Insurance contract or identification number0010556930
Number of Individuals Covered99
Insurance policy start date2017-05-01
Insurance policy end date2018-04-30
Total amount of commissions paid to insurance brokerUSD $1,720
Total amount of fees paid to insurance companyUSD $1
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $33,371
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $930
Insurance broker organization code?3
Amount paid for insurance broker fees1
Additional information about fees paid to insurance brokerADDTL COMP
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract numberETB144041
Policy instance 1
Insurance contract or identification numberETB144041
Number of Individuals Covered349
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Temporary Disability Insurance Welfare BenefitYes
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 numberJOHNSTONE
Policy instance 6
Insurance contract or identification numberJOHNSTONE
Number of Individuals Covered332
Insurance policy start date2016-05-01
Insurance policy end date2017-04-30
Other welfare benefits providedEAP
Welfare Benefit Premiums Paid to CarrierUSD $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 numberETB144041
Policy instance 1
Insurance contract or identification numberETB144041
Number of Individuals Covered349
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Temporary Disability Insurance Welfare BenefitYes
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 number0010556930
Policy instance 2
Insurance contract or identification number0010556930
Number of Individuals Covered111
Insurance policy start date2016-05-01
Insurance policy end date2017-04-30
Total amount of commissions paid to insurance brokerUSD $3,159
Total amount of fees paid to insurance companyUSD $114
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $33,257
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,100
Amount paid for insurance broker fees114
Additional information about fees paid to insurance brokerADDTL COMP
Insurance broker organization code?3
Insurance broker nameJOHN J DAVIDSON
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number0010556930
Policy instance 3
Insurance contract or identification number0010556930
Number of Individuals Covered160
Insurance policy start date2016-05-01
Insurance policy end date2017-04-30
Total amount of commissions paid to insurance brokerUSD $3,704
Total amount of fees paid to insurance companyUSD $119
Health Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $30,741
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,704
Amount paid for insurance broker fees119
Insurance broker organization code?3
Insurance broker nameDAVIDSON BENEFITS PLANNING LLC
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number632134
Policy instance 4
Insurance contract or identification number632134
Number of Individuals Covered313
Insurance policy start date2016-05-01
Insurance policy end date2017-04-30
Total amount of commissions paid to insurance brokerUSD $5,665
Total amount of fees paid to insurance companyUSD $808
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $64,634
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,665
Amount paid for insurance broker fees808
Additional information about fees paid to insurance brokerADDTL COMP
Insurance broker organization code?3
Insurance broker nameDAVIDSON BENEFITS PLANNING LLC
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number632135
Policy instance 5
Insurance contract or identification number632135
Number of Individuals Covered122
Insurance policy start date2016-05-01
Insurance policy end date2017-04-30
Total amount of commissions paid to insurance brokerUSD $6,682
Total amount of fees paid to insurance companyUSD $604
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $44,549
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,682
Amount paid for insurance broker fees604
Additional information about fees paid to insurance brokerADDTL COMP
Insurance broker organization code?3
Insurance broker nameDAVIDSON BENEFITS PLANNING LLC
RELIANT BEHAVIORAL HEALTH (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number15008651
Policy instance 1
Insurance contract or identification number15008651
Number of Individuals Covered292
Insurance policy start date2014-05-01
Insurance policy end date2015-04-30
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $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 number10070764
Policy instance 2
Insurance contract or identification number10070764
Number of Individuals Covered292
Insurance policy start date2014-05-01
Insurance policy end date2015-04-30
Total amount of commissions paid to insurance brokerUSD $2,115
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $22,540
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,115
Insurance broker organization code?3
Insurance broker nameDAVIDSON BENEFITS PLANNING LLC
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10070765
Policy instance 3
Insurance contract or identification number10070765
Number of Individuals Covered291
Insurance policy start date2014-05-01
Insurance policy end date2015-04-30
Total amount of commissions paid to insurance brokerUSD $3,849
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $36,989
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,849
Insurance broker organization code?3
Insurance broker nameDAVIDSON BENEFITS PLANNING LLC
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number716539
Policy instance 4
Insurance contract or identification number716539
Number of Individuals Covered254
Insurance policy start date2014-05-01
Insurance policy end date2015-04-30
Welfare Benefit Premiums Paid to CarrierUSD $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 number10070765
Policy instance 3
Insurance contract or identification number10070765
Number of Individuals Covered288
Insurance policy start date2013-05-01
Insurance policy end date2014-04-30
Total amount of commissions paid to insurance brokerUSD $3,834
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $36,686
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,834
Insurance broker organization code?3
Insurance broker nameDAVIDSON BENEFITS PLANNING LLC
RELIANT BEHAVIORAL HEALTH (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number15008651
Policy instance 1
Insurance contract or identification number15008651
Number of Individuals Covered292
Insurance policy start date2013-05-01
Insurance policy end date2014-04-30
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $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 number10070764
Policy instance 2
Insurance contract or identification number10070764
Number of Individuals Covered288
Insurance policy start date2013-05-01
Insurance policy end date2014-04-30
Total amount of commissions paid to insurance brokerUSD $2,123
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $22,334
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,123
Insurance broker organization code?3
Insurance broker nameDAVIDSON BENEFITS PLANNING LLC
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number716539
Policy instance 4
Insurance contract or identification number716539
Number of Individuals Covered251
Insurance policy start date2013-05-01
Insurance policy end date2014-04-30
Welfare Benefit Premiums Paid to CarrierUSD $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 number10070764
Policy instance 2
Insurance contract or identification number10070764
Number of Individuals Covered268
Insurance policy start date2012-05-01
Insurance policy end date2013-04-30
Total amount of commissions paid to insurance brokerUSD $1,877
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $18,810
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,877
Insurance broker organization code?3
Insurance broker nameDAVIDSON BENEFITS PLANNING LLC
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10070765
Policy instance 3
Insurance contract or identification number10070765
Number of Individuals Covered268
Insurance policy start date2012-05-01
Insurance policy end date2013-04-30
Total amount of commissions paid to insurance brokerUSD $3,963
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $39,251
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,963
Insurance broker organization code?3
Insurance broker nameDAVIDSON BENEFITS PLANNING LLC
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number716539
Policy instance 4
Insurance contract or identification number716539
Number of Individuals Covered239
Insurance policy start date2012-05-01
Insurance policy end date2013-04-30
Welfare Benefit Premiums Paid to CarrierUSD $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 number9696923
Policy instance 5
Insurance contract or identification number9696923
Number of Individuals Covered396
Insurance policy start date2012-05-01
Insurance policy end date2013-04-30
Total amount of commissions paid to insurance brokerUSD $271
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $11,486
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $271
Insurance broker organization code?3
Insurance broker nameDAVIDSON BENEFITS PLANNING LLC
RELIANT BEHAVIORAL HEALTH (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number15008651
Policy instance 1
Insurance contract or identification number15008651
Number of Individuals Covered292
Insurance policy start date2012-05-01
Insurance policy end date2013-04-30
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $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 number716539
Policy instance 4
Insurance contract or identification number716539
Number of Individuals Covered244
Insurance policy start date2011-05-01
Insurance policy end date2012-04-30
Welfare Benefit Premiums Paid to CarrierUSD $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 number15008651
Policy instance 1
Insurance contract or identification number15008651
Number of Individuals Covered292
Insurance policy start date2011-05-01
Insurance policy end date2012-04-30
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $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 number10070764
Policy instance 2
Insurance contract or identification number10070764
Number of Individuals Covered260
Insurance policy start date2011-05-01
Insurance policy end date2012-04-30
Total amount of commissions paid to insurance brokerUSD $1,931
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $19,585
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,931
Insurance broker organization code?3
Insurance broker nameDAVIDSON BENEFITS PLANNING LLC
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10070765
Policy instance 3
Insurance contract or identification number10070765
Number of Individuals Covered260
Insurance policy start date2011-05-01
Insurance policy end date2012-04-30
Total amount of commissions paid to insurance brokerUSD $4,037
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $40,747
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,037
Insurance broker organization code?3
Insurance broker nameDAVIDSON BENEFITS PLANNING LLC
FIDELITY SECURITY LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 67288 )
Policy contract number9696923
Policy instance 5
Insurance contract or identification number9696923
Number of Individuals Covered411
Insurance policy start date2011-05-01
Insurance policy end date2012-04-30
Total amount of commissions paid to insurance brokerUSD $261
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $10,728
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $261
Insurance broker organization code?3
Insurance broker nameDAVIDSON BENEFITS PLANNING LLC
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10070765
Policy instance 3
Insurance contract or identification number10070765
Number of Individuals Covered265
Insurance policy start date2010-05-01
Insurance policy end date2011-04-30
Total amount of commissions paid to insurance brokerUSD $3,965
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $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 number15008651
Policy instance 1
Insurance contract or identification number15008651
Number of Individuals Covered303
Insurance policy start date2010-07-01
Insurance policy end date2011-06-30
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $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 number716539
Policy instance 4
Insurance contract or identification number716539
Number of Individuals Covered249
Insurance policy start date2010-05-01
Insurance policy end date2011-04-30
Welfare Benefit Premiums Paid to CarrierUSD $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 number9696923
Policy instance 5
Insurance contract or identification number9696923
Number of Individuals Covered428
Insurance policy start date2010-07-01
Insurance policy end date2011-06-30
Total amount of commissions paid to insurance brokerUSD $263
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $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 number10070764
Policy instance 2
Insurance contract or identification number10070764
Number of Individuals Covered276
Insurance policy start date2010-05-01
Insurance policy end date2011-04-30
Total amount of commissions paid to insurance brokerUSD $1,918
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $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 number15008651
Policy instance 1
Insurance contract or identification number15008651
Number of Individuals Covered303
Insurance policy start date2009-07-01
Insurance policy end date2010-06-30
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $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 number10070764
Policy instance 2
Insurance contract or identification number10070764
Number of Individuals Covered264
Insurance policy start date2009-07-01
Insurance policy end date2010-06-30
Total amount of commissions paid to insurance brokerUSD $1,867
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $18,665
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,867
Insurance broker organization code?3
Insurance broker nameDAVIDSON BENEFITS PLANNING LLC
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10070765
Policy instance 4
Insurance contract or identification number10070765
Number of Individuals Covered265
Insurance policy start date2009-07-01
Insurance policy end date2010-06-30
Total amount of commissions paid to insurance brokerUSD $3,870
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $37,395
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,870
Insurance broker organization code?3
Insurance broker nameDAVIDSON BENEFITS PLANNING LLC
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number716539
Policy instance 5
Insurance contract or identification number716539
Number of Individuals Covered270
Insurance policy start date2009-05-01
Insurance policy end date2010-04-30
Welfare Benefit Premiums Paid to CarrierUSD $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 numberETB144041
Policy instance 6
Insurance contract or identification numberETB144041
Number of Individuals Covered279
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $338
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,250
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $338
Insurance broker organization code?3
Insurance broker nameDAVIDSON BENEFITS PLANNING LLC
FIDELITY SECURITY LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 67288 )
Policy contract number9696923
Policy instance 7
Insurance contract or identification number9696923
Number of Individuals Covered429
Insurance policy start date2009-07-01
Insurance policy end date2010-06-30
Total amount of commissions paid to insurance brokerUSD $257
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $14,195
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $257
Insurance broker organization code?3
Insurance broker nameDAVIDSON BENEFITS PLANNING LLC
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number40000100004516
Policy instance 3
Insurance contract or identification number40000100004516
Number of Individuals Covered54
Insurance policy start date2009-07-01
Insurance policy end date2010-06-30
Total amount of commissions paid to insurance brokerUSD $2,061
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $13,739
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,061
Insurance broker organization code?3
Insurance broker nameDAVIDSON BENEFITS PLANNING LLC

Was this data useful?
If you found the data here useful, PLEASE HELP US. We are a start-up and believe in making information freely available. By linking to us, posting on twitter, facebook and linkedin about us and generally spreading the word, you'll help us to grow. Our vision is to provide high quality data about the activities of all the companies in the world and where possible make it free to use and view. Finding and integrating data from thousands of data sources is time consuming and needs lots of effort. By simply spreading the word about us, you will help us.

Please use the share buttons. It will only take a few seconds of your time. Thanks for helping

Information Disclaimer
The information provided on this website is not advice, endorsement or recommendation
The information published is supplied by third parties so we make no warranty on the accuracy, completeness etc. This information is provided "as-is". The information is subject to change as we obtain updates and corrections from the primary information sources.
You are free to use the information for your own personal research on the understanding to do so is at your own risk.

See full terms and conditions

Copyright © Market Footprint Ltd
Contact us   Datalog Company Directory
401k Lookup     VAT Lookup S3