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MORGAN MEMORIAL GOODWILL INDUSTRIES EMPLOYEE BENEFIT PLAN 401k Plan overview

Plan NameMORGAN MEMORIAL GOODWILL INDUSTRIES EMPLOYEE BENEFIT PLAN
Plan identification number 502

MORGAN MEMORIAL GOODWILL INDUSTRIES EMPLOYEE BENEFIT PLAN Benefits

401k Plan Type
Plan Features/Benefits

    401k Sponsoring company profile

    MORGAN MEMORIAL GOODWILL INDUSTRIES has sponsored the creation of one or more 401k plans.

    Company Name:MORGAN MEMORIAL GOODWILL INDUSTRIES
    Employer identification number (EIN):042106765
    NAIC Classification:624100
    NAIC Description: Individual and Family Services

    Form 5500 Filing Information

    Submission information for form 5500 for 401k plan MORGAN MEMORIAL GOODWILL INDUSTRIES EMPLOYEE BENEFIT PLAN

    Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
    5022019-01-01HEATHER KENNEY2020-07-14
    5022018-01-01
    5022017-01-01
    5022016-01-01JOHN RICKETTS
    5022015-01-01JOHN J. RICKETTS, CPA JOHN J. RICKETTS, CPA2016-06-03
    5022014-01-01JOHN J. RICKETTS, CPA JOHN J. RICKETTS, CPA2015-06-11
    5022013-01-01JOHN J. RICKETTS, CPA JOHN J. RICKETTS, CPA2014-06-30
    5022012-01-01JOHN J. RICKETTS, CPA JOHN J. RICKETTS, CPA2013-04-03
    5022011-01-01CAROL S. CARDOZO, VP FINANCE, CFO CAROL S. CARDOZO, VP FINANCE, CFO2012-06-06
    5022009-01-01PATRICK DUFF

    Plan Statistics for MORGAN MEMORIAL GOODWILL INDUSTRIES EMPLOYEE BENEFIT PLAN

    401k plan membership statisitcs for MORGAN MEMORIAL GOODWILL INDUSTRIES EMPLOYEE BENEFIT PLAN

    Measure Date Value
    2019
    Total participants, beginning-of-year2019-01-01317
    Total number of active participants reported on line 7a of the Form 55002019-01-01396
    Number of retired or separated participants receiving benefits2019-01-010
    Number of other retired or separated participants entitled to future benefits2019-01-010
    Total of all active and inactive participants2019-01-01396
    Number of employers contributing to the scheme2019-01-010
    2018
    Total participants, beginning-of-year2018-01-01331
    Total number of active participants reported on line 7a of the Form 55002018-01-01317
    Number of retired or separated participants receiving benefits2018-01-010
    Number of other retired or separated participants entitled to future benefits2018-01-010
    Total of all active and inactive participants2018-01-01317
    Number of employers contributing to the scheme2018-01-010
    2017
    Total participants, beginning-of-year2017-01-01357
    Total number of active participants reported on line 7a of the Form 55002017-01-01331
    Number of retired or separated participants receiving benefits2017-01-010
    Number of other retired or separated participants entitled to future benefits2017-01-010
    Total of all active and inactive participants2017-01-01331
    2016
    Total participants, beginning-of-year2016-01-01324
    Total number of active participants reported on line 7a of the Form 55002016-01-01357
    Number of retired or separated participants receiving benefits2016-01-010
    Number of other retired or separated participants entitled to future benefits2016-01-010
    Total of all active and inactive participants2016-01-01357
    2015
    Total participants, beginning-of-year2015-01-01346
    Total number of active participants reported on line 7a of the Form 55002015-01-01323
    Number of retired or separated participants receiving benefits2015-01-011
    Number of other retired or separated participants entitled to future benefits2015-01-010
    Total of all active and inactive participants2015-01-01324
    2014
    Total participants, beginning-of-year2014-01-01309
    Total number of active participants reported on line 7a of the Form 55002014-01-01344
    Number of retired or separated participants receiving benefits2014-01-012
    Number of other retired or separated participants entitled to future benefits2014-01-010
    Total of all active and inactive participants2014-01-01346
    2013
    Total participants, beginning-of-year2013-01-01279
    Total number of active participants reported on line 7a of the Form 55002013-01-01309
    Number of retired or separated participants receiving benefits2013-01-014
    Number of other retired or separated participants entitled to future benefits2013-01-010
    Total of all active and inactive participants2013-01-01313
    2012
    Total participants, beginning-of-year2012-01-01285
    Total number of active participants reported on line 7a of the Form 55002012-01-01275
    Number of retired or separated participants receiving benefits2012-01-014
    Number of other retired or separated participants entitled to future benefits2012-01-010
    Total of all active and inactive participants2012-01-01279
    2011
    Total participants, beginning-of-year2011-01-01289
    Total number of active participants reported on line 7a of the Form 55002011-01-01280
    Number of retired or separated participants receiving benefits2011-01-015
    Number of other retired or separated participants entitled to future benefits2011-01-010
    Total of all active and inactive participants2011-01-01285
    2009
    Total participants, beginning-of-year2009-01-01232
    Total number of active participants reported on line 7a of the Form 55002009-01-01248
    Number of retired or separated participants receiving benefits2009-01-012
    Number of other retired or separated participants entitled to future benefits2009-01-010
    Total of all active and inactive participants2009-01-01250

    Form 5500 Responses

    2019
    2019-01-01Type of plan entitySingle employer plan
    2019-01-01Plan funding arrangement – InsuranceYes
    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
    2018-01-01Type of plan entitySingle employer plan
    2018-01-01Plan funding arrangement – InsuranceYes
    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
    2017-01-01Type of plan entitySingle employer plan
    2017-01-01Plan funding arrangement – InsuranceYes
    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
    2016-01-01Type of plan entitySingle employer plan
    2016-01-01Submission has been amendedNo
    2016-01-01This submission is the final filingNo
    2016-01-01This return/report is a short plan year return/report (less than 12 months)No
    2016-01-01Plan is a collectively bargained planNo
    2016-01-01Plan funding arrangement – InsuranceYes
    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
    2015-01-01Type of plan entitySingle employer plan
    2015-01-01Submission has been amendedNo
    2015-01-01This submission is the final filingNo
    2015-01-01This return/report is a short plan year return/report (less than 12 months)No
    2015-01-01Plan is a collectively bargained planNo
    2015-01-01Plan funding arrangement – InsuranceYes
    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
    2014-01-01Type of plan entitySingle employer plan
    2014-01-01Submission has been amendedNo
    2014-01-01This submission is the final filingNo
    2014-01-01This return/report is a short plan year return/report (less than 12 months)No
    2014-01-01Plan is a collectively bargained planNo
    2014-01-01Plan funding arrangement – InsuranceYes
    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
    2013-01-01Type of plan entitySingle employer plan
    2013-01-01Submission has been amendedYes
    2013-01-01This submission is the final filingNo
    2013-01-01This return/report is a short plan year return/report (less than 12 months)No
    2013-01-01Plan is a collectively bargained planNo
    2013-01-01Plan funding arrangement – InsuranceYes
    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
    2012-01-01Type of plan entitySingle employer plan
    2012-01-01Submission has been amendedNo
    2012-01-01This submission is the final filingNo
    2012-01-01This return/report is a short plan year return/report (less than 12 months)No
    2012-01-01Plan is a collectively bargained planNo
    2012-01-01Plan funding arrangement – InsuranceYes
    2012-01-01Plan benefit arrangement – InsuranceYes
    2011
    2011-01-01Type of plan entitySingle employer plan
    2011-01-01Submission has been amendedNo
    2011-01-01This submission is the final filingNo
    2011-01-01This return/report is a short plan year return/report (less than 12 months)No
    2011-01-01Plan is a collectively bargained planNo
    2011-01-01Plan funding arrangement – InsuranceYes
    2011-01-01Plan benefit arrangement – InsuranceYes
    2009
    2009-01-01Type of plan entitySingle employer plan
    2009-01-01Submission has been amendedNo
    2009-01-01This submission is the final filingNo
    2009-01-01This return/report is a short plan year return/report (less than 12 months)No
    2009-01-01Plan is a collectively bargained planNo
    2009-01-01Plan funding arrangement – InsuranceYes
    2009-01-01Plan benefit arrangement – InsuranceYes

    Insurance Providers Used on plan

    BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 )
    Policy contract number4954744
    Policy instance 2
    Insurance contract or identification number4954744
    Number of Individuals Covered216
    Insurance policy start date2018-04-01
    Insurance policy end date2019-03-31
    Total amount of commissions paid to insurance brokerUSD $34,890
    Total amount of fees paid to insurance companyUSD $12,880
    Health Insurance Welfare BenefitYes
    Dental Insurance Welfare BenefitYes
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
    Commission paid to Insurance BrokerUSD $34,890
    Amount paid for insurance broker fees12880
    Additional information about fees paid to insurance brokerOTHER COMMISSION
    Insurance broker organization code?3
    VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
    Policy contract number30007240
    Policy instance 1
    Insurance contract or identification number30007240
    Number of Individuals Covered127
    Insurance policy start date2018-04-01
    Insurance policy end date2019-03-31
    Total amount of commissions paid to insurance brokerUSD $806
    Total amount of fees paid to insurance companyUSD $0
    Vision Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $11,576
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $806
    Amount paid for insurance broker fees0
    Insurance broker organization code?3
    THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
    Policy contract number10140700
    Policy instance 3
    Insurance contract or identification number10140700
    Number of Individuals Covered396
    Insurance policy start date2018-04-01
    Insurance policy end date2019-03-31
    Total amount of commissions paid to insurance brokerUSD $8,515
    Total amount of fees paid to insurance companyUSD $851
    Health Insurance Welfare BenefitNo
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitYes
    Temporary Disability Insurance Welfare BenefitYes
    Long Term Disability Insurance Welfare BenefitYes
    Unemployment Insurance Welfare BenefitNo
    Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
    Welfare Benefit Premiums Paid to CarrierUSD $103,909
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $8,515
    Amount paid for insurance broker fees0
    Insurance broker organization code?3
    Additional information about fees paid to insurance brokerBROKER BONUS
    THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
    Policy contract number10140702
    Policy instance 3
    Insurance contract or identification number10140702
    Number of Individuals Covered317
    Insurance policy start date2017-04-01
    Insurance policy end date2018-03-31
    Total amount of commissions paid to insurance brokerUSD $7,788
    Total amount of fees paid to insurance companyUSD $0
    Health Insurance Welfare BenefitNo
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitYes
    Temporary Disability Insurance Welfare BenefitYes
    Long Term Disability Insurance Welfare BenefitYes
    Unemployment Insurance Welfare BenefitNo
    Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
    Welfare Benefit Premiums Paid to CarrierUSD $92,620
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $7,788
    Amount paid for insurance broker fees0
    Insurance broker organization code?3
    BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 )
    Policy contract number4954744
    Policy instance 2
    Insurance contract or identification number4954744
    Number of Individuals Covered209
    Insurance policy start date2017-04-01
    Insurance policy end date2018-03-31
    Total amount of commissions paid to insurance brokerUSD $39,545
    Total amount of fees paid to insurance companyUSD $21,150
    Health Insurance Welfare BenefitYes
    Dental Insurance Welfare BenefitYes
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
    Commission paid to Insurance BrokerUSD $39,545
    Amount paid for insurance broker fees21150
    Additional information about fees paid to insurance brokerOTHER COMMISSION
    Insurance broker organization code?3
    VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
    Policy contract number30007240
    Policy instance 1
    Insurance contract or identification number30007240
    Number of Individuals Covered106
    Insurance policy start date2017-04-01
    Insurance policy end date2018-03-31
    Total amount of commissions paid to insurance brokerUSD $807
    Total amount of fees paid to insurance companyUSD $0
    Vision Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $11,589
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $807
    Amount paid for insurance broker fees0
    Insurance broker organization code?3
    VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
    Policy contract number30007240
    Policy instance 1
    Insurance contract or identification number30007240
    Number of Individuals Covered108
    Insurance policy start date2016-04-01
    Insurance policy end date2017-03-31
    Total amount of commissions paid to insurance brokerUSD $786
    Total amount of fees paid to insurance companyUSD $0
    Vision Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $10,999
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $786
    Amount paid for insurance broker fees0
    Insurance broker organization code?3
    Insurance broker nameGALLAGHER BENEFIT SERVICES, INC.
    BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 )
    Policy contract number4954744
    Policy instance 2
    Insurance contract or identification number4954744
    Number of Individuals Covered221
    Insurance policy start date2016-04-01
    Insurance policy end date2017-03-31
    Total amount of commissions paid to insurance brokerUSD $4,265
    Total amount of fees paid to insurance companyUSD $0
    Dental Insurance Welfare BenefitYes
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $4,265
    Amount paid for insurance broker fees0
    Insurance broker organization code?3
    Insurance broker nameGALLAGHER BENEFIT SERVICES, INC.
    THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
    Policy contract number10140702
    Policy instance 4
    Insurance contract or identification number10140702
    Number of Individuals Covered331
    Insurance policy start date2016-04-01
    Insurance policy end date2017-03-31
    Total amount of commissions paid to insurance brokerUSD $6,859
    Total amount of fees paid to insurance companyUSD $0
    Health Insurance Welfare BenefitNo
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitYes
    Temporary Disability Insurance Welfare BenefitYes
    Long Term Disability Insurance Welfare BenefitYes
    Unemployment Insurance Welfare BenefitNo
    Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
    Welfare Benefit Premiums Paid to CarrierUSD $70,001
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $6,859
    Amount paid for insurance broker fees0
    Insurance broker organization code?3
    Insurance broker nameGALLAGHER BENEFIT SERVICES, INC.
    TUFTS ASSOCIATED HEALTH MAINTENANCE ORG., INC. (National Association of Insurance Commissioners NAIC id number: 95688 )
    Policy contract number100324105022
    Policy instance 3
    Insurance contract or identification number100324105022
    Number of Individuals Covered217
    Insurance policy start date2016-04-01
    Insurance policy end date2017-03-31
    Total amount of commissions paid to insurance brokerUSD $24,771
    Total amount of fees paid to insurance companyUSD $238
    Health Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $1,275,355
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $24,771
    Amount paid for insurance broker fees238
    Additional information about fees paid to insurance brokerOTHER COMPENSATION
    Insurance broker organization code?3
    Insurance broker nameGALLAGHER BENEFIT SERVICES, INC.
    BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 )
    Policy contract number4954744
    Policy instance 1
    Insurance contract or identification number4954744
    Number of Individuals Covered239
    Insurance policy start date2014-04-01
    Insurance policy end date2015-03-31
    Total amount of commissions paid to insurance brokerUSD $4,271
    Total amount of fees paid to insurance companyUSD $1,341
    Are there contracts with allocated funds for individual policies?No
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
    Are there contracts with unallocated funds for contracts of type guaranteed investment?No
    Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
    Health Insurance Welfare BenefitNo
    Dental Insurance Welfare BenefitYes
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $4,271
    Amount paid for insurance broker fees1341
    Additional information about fees paid to insurance brokerBONUS AND PERSISTENCY COMMISSIONS
    Insurance broker organization code?3
    Insurance broker nameWILLIAM GALLAGHER ASSOCIATES
    CERIDIAN HEALTH AND PRODUCTIVITY SOLUTIONS (National Association of Insurance Commissioners NAIC id number: 54121 )
    Policy contract number8322
    Policy instance 2
    Insurance contract or identification number8322
    Number of Individuals Covered344
    Insurance policy start date2014-04-01
    Insurance policy end date2015-03-31
    Are there contracts with allocated funds for individual policies?No
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
    Are there contracts with unallocated funds for contracts of type guaranteed investment?No
    Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
    Health Insurance Welfare BenefitNo
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $2,335
    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 number000010140700
    Policy instance 3
    Insurance contract or identification number000010140700
    Number of Individuals Covered323
    Insurance policy start date2014-04-01
    Insurance policy end date2015-03-31
    Total amount of commissions paid to insurance brokerUSD $1,784
    Total amount of fees paid to insurance companyUSD $1,537
    Are there contracts with allocated funds for individual policies?No
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
    Are there contracts with unallocated funds for contracts of type guaranteed investment?No
    Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
    Health Insurance Welfare BenefitNo
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitYes
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Other welfare benefits providedADD
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $17,491
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $1,784
    Amount paid for insurance broker fees1537
    Additional information about fees paid to insurance brokerBROKER BONUS
    Insurance broker organization code?3
    Insurance broker nameWILLIAM GALLAGHER ASSOCIATES
    THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
    Policy contract number000010140702
    Policy instance 5
    Insurance contract or identification number000010140702
    Number of Individuals Covered210
    Insurance policy start date2014-04-01
    Insurance policy end date2015-03-31
    Total amount of commissions paid to insurance brokerUSD $2,788
    Total amount of fees paid to insurance companyUSD $1,224
    Are there contracts with allocated funds for individual policies?No
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
    Are there contracts with unallocated funds for contracts of type guaranteed investment?No
    Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
    Health Insurance Welfare BenefitNo
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitYes
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $43,908
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $2,788
    Amount paid for insurance broker fees1224
    Additional information about fees paid to insurance brokerBROKER BONUS
    Insurance broker organization code?3
    Insurance broker nameWILLIAM GALLAGHER ASSOCIATES
    TUFTS ASSOCIATED HEALTH MAINTENANCE ORG., INC. (National Association of Insurance Commissioners NAIC id number: 95688 )
    Policy contract number100324105022
    Policy instance 6
    Insurance contract or identification number100324105022
    Number of Individuals Covered213
    Insurance policy start date2014-04-01
    Insurance policy end date2015-03-31
    Total amount of commissions paid to insurance brokerUSD $28,245
    Total amount of fees paid to insurance companyUSD $498
    Are there contracts with allocated funds for individual policies?No
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
    Are there contracts with unallocated funds for contracts of type guaranteed investment?No
    Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
    Health Insurance Welfare BenefitYes
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $1,320,901
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $28,245
    Amount paid for insurance broker fees498
    Additional information about fees paid to insurance brokerOTHER BROKER COMPENSATION
    Insurance broker organization code?3
    Insurance broker nameWILLIAM GALLAGHER ASSOCIATES
    VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47093 )
    Policy contract number30007240
    Policy instance 7
    Insurance contract or identification number30007240
    Number of Individuals Covered90
    Insurance policy start date2014-04-01
    Insurance policy end date2015-03-31
    Total amount of commissions paid to insurance brokerUSD $730
    Total amount of fees paid to insurance companyUSD $0
    Are there contracts with allocated funds for individual policies?No
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
    Are there contracts with unallocated funds for contracts of type guaranteed investment?No
    Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
    Health Insurance Welfare BenefitNo
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitYes
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $9,599
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $730
    Insurance broker organization code?3
    Insurance broker nameWILLIAM GALLAGHER ASSOCIATES
    THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
    Policy contract number000010140701
    Policy instance 4
    Insurance contract or identification number000010140701
    Number of Individuals Covered209
    Insurance policy start date2014-04-01
    Insurance policy end date2015-03-31
    Total amount of commissions paid to insurance brokerUSD $3,377
    Total amount of fees paid to insurance companyUSD $1,598
    Are there contracts with allocated funds for individual policies?No
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
    Are there contracts with unallocated funds for contracts of type guaranteed investment?No
    Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
    Health Insurance Welfare BenefitNo
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitYes
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $27,549
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $3,377
    Amount paid for insurance broker fees1598
    Additional information about fees paid to insurance brokerBROKER BONUS
    Insurance broker organization code?3
    Insurance broker nameWILLIAM GALLAGHER ASSOCIATES
    THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
    Policy contract number000010140702
    Policy instance 6
    Insurance contract or identification number000010140702
    Number of Individuals Covered184
    Insurance policy start date2013-04-01
    Insurance policy end date2014-03-31
    Total amount of commissions paid to insurance brokerUSD $2,210
    Total amount of fees paid to insurance companyUSD $213
    Are there contracts with allocated funds for individual policies?No
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
    Are there contracts with unallocated funds for contracts of type guaranteed investment?No
    Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
    Health Insurance Welfare BenefitNo
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitYes
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $40,760
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $2,210
    Amount paid for insurance broker fees213
    Additional information about fees paid to insurance brokerBROKER BONUS
    Insurance broker organization code?3
    Insurance broker nameWILLIAM GALLAGHER ASSOCIATES
    CERIDIAN HEALTH AND PRODUCTIVITY SOLUTIONS (National Association of Insurance Commissioners NAIC id number: 54121 )
    Policy contract number8322
    Policy instance 8
    Insurance contract or identification number8322
    Number of Individuals Covered344
    Insurance policy start date2013-04-01
    Insurance policy end date2014-03-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Are there contracts with allocated funds for individual policies?No
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
    Are there contracts with unallocated funds for contracts of type guaranteed investment?No
    Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
    Health Insurance Welfare BenefitNo
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Other welfare benefits providedEMPLOYEE ASSISTANCE PLAN
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $2,156
    THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
    Policy contract number000010140701
    Policy instance 7
    Insurance contract or identification number000010140701
    Number of Individuals Covered184
    Insurance policy start date2013-04-01
    Insurance policy end date2014-03-31
    Total amount of commissions paid to insurance brokerUSD $2,425
    Total amount of fees paid to insurance companyUSD $131
    Are there contracts with allocated funds for individual policies?No
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
    Are there contracts with unallocated funds for contracts of type guaranteed investment?No
    Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
    Health Insurance Welfare BenefitNo
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitYes
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $25,545
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $2,425
    Amount paid for insurance broker fees131
    Additional information about fees paid to insurance brokerBROKER BONUS
    Insurance broker organization code?3
    Insurance broker nameWILLIAM GALLAGHER ASSOCIATES
    THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
    Policy contract number000010140700
    Policy instance 5
    Insurance contract or identification number000010140700
    Number of Individuals Covered320
    Insurance policy start date2013-04-01
    Insurance policy end date2014-03-31
    Total amount of commissions paid to insurance brokerUSD $-24,126
    Total amount of fees paid to insurance companyUSD $86
    Are there contracts with allocated funds for individual policies?No
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
    Are there contracts with unallocated funds for contracts of type guaranteed investment?No
    Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
    Health Insurance Welfare BenefitNo
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitYes
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Other welfare benefits providedADD
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $17,007
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $-24,126
    Amount paid for insurance broker fees86
    Additional information about fees paid to insurance brokerBROKER BONUS
    Insurance broker organization code?3
    Insurance broker nameWILLIAM GALLAGHER ASSOCIATES
    TUFTS ASSOCIATED HEALTH MAINTENANCE ORG., INC. (National Association of Insurance Commissioners NAIC id number: 95688 )
    Policy contract number68326000
    Policy instance 4
    Insurance contract or identification number68326000
    Number of Individuals Covered136
    Insurance policy start date2013-04-01
    Insurance policy end date2014-03-31
    Total amount of commissions paid to insurance brokerUSD $29,230
    Total amount of fees paid to insurance companyUSD $839
    Are there contracts with allocated funds for individual policies?No
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
    Are there contracts with unallocated funds for contracts of type guaranteed investment?No
    Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
    Health Insurance Welfare BenefitYes
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $1,380,037
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $29,230
    Amount paid for insurance broker fees839
    Additional information about fees paid to insurance brokerOTHER BROKER COMPENSATION
    Insurance broker organization code?3
    Insurance broker nameWILLIAM GALLAGHER ASSOCIATES
    TUFTS ASSOCIATED HEALTH MAINTENANCE ORG., INC. (National Association of Insurance Commissioners NAIC id number: 95688 )
    Policy contract number44839000
    Policy instance 3
    Insurance contract or identification number44839000
    Number of Individuals Covered12
    Insurance policy start date2013-04-01
    Insurance policy end date2014-03-31
    Total amount of commissions paid to insurance brokerUSD $1,955
    Total amount of fees paid to insurance companyUSD $56
    Are there contracts with allocated funds for individual policies?No
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
    Are there contracts with unallocated funds for contracts of type guaranteed investment?No
    Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
    Health Insurance Welfare BenefitYes
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $89,968
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $1,955
    Amount paid for insurance broker fees56
    Additional information about fees paid to insurance brokerOTHER BROKER COMPENSATION
    Insurance broker organization code?3
    Insurance broker nameWILLIAM GALLAGHER ASSOCIATES
    BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 )
    Policy contract number4954744
    Policy instance 2
    Insurance contract or identification number4954744
    Number of Individuals Covered246
    Insurance policy start date2013-04-01
    Insurance policy end date2014-03-31
    Total amount of commissions paid to insurance brokerUSD $4,302
    Total amount of fees paid to insurance companyUSD $1,224
    Are there contracts with allocated funds for individual policies?No
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
    Are there contracts with unallocated funds for contracts of type guaranteed investment?No
    Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
    Health Insurance Welfare BenefitNo
    Dental Insurance Welfare BenefitYes
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $4,302
    Amount paid for insurance broker fees1224
    Additional information about fees paid to insurance brokerBONUS AND PERSISTENCY COMMISSIONS
    Insurance broker organization code?3
    Insurance broker nameWILLIAM GALLAGHER ASSOCIATES
    VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47093 )
    Policy contract number30007240
    Policy instance 1
    Insurance contract or identification number30007240
    Number of Individuals Covered90
    Insurance policy start date2013-04-01
    Insurance policy end date2014-03-31
    Total amount of commissions paid to insurance brokerUSD $736
    Total amount of fees paid to insurance companyUSD $0
    Are there contracts with allocated funds for individual policies?No
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
    Are there contracts with unallocated funds for contracts of type guaranteed investment?No
    Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
    Health Insurance Welfare BenefitNo
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitYes
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $9,718
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $736
    Insurance broker organization code?3
    Insurance broker nameWILLIAM GALLAGHER ASSOCIATES
    BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 )
    Policy contract number4954744
    Policy instance 2
    Insurance contract or identification number4954744
    Number of Individuals Covered259
    Insurance policy start date2012-04-01
    Insurance policy end date2013-03-31
    Total amount of commissions paid to insurance brokerUSD $4,346
    Total amount of fees paid to insurance companyUSD $1,341
    Are there contracts with allocated funds for individual policies?No
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
    Are there contracts with unallocated funds for contracts of type guaranteed investment?No
    Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
    Health Insurance Welfare BenefitNo
    Dental Insurance Welfare BenefitYes
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $4,346
    Amount paid for insurance broker fees1341
    Additional information about fees paid to insurance brokerBONUS AND PERSISTENCY COMMISSIONS
    Insurance broker organization code?3
    Insurance broker nameWILLIAM GALLAGHER ASSOCIATES
    VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47093 )
    Policy contract number30007240
    Policy instance 1
    Insurance contract or identification number30007240
    Number of Individuals Covered80
    Insurance policy start date2012-04-01
    Insurance policy end date2013-03-31
    Total amount of commissions paid to insurance brokerUSD $705
    Total amount of fees paid to insurance companyUSD $0
    Are there contracts with allocated funds for individual policies?No
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
    Are there contracts with unallocated funds for contracts of type guaranteed investment?No
    Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
    Health Insurance Welfare BenefitNo
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitYes
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $9,096
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $705
    Insurance broker organization code?3
    Insurance broker nameWILLIAM GALLAGHER ASSOCIATES
    THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
    Policy contract number000010140702
    Policy instance 6
    Insurance contract or identification number000010140702
    Number of Individuals Covered176
    Insurance policy start date2012-04-01
    Insurance policy end date2013-03-31
    Total amount of commissions paid to insurance brokerUSD $2,702
    Total amount of fees paid to insurance companyUSD $676
    Are there contracts with allocated funds for individual policies?No
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
    Are there contracts with unallocated funds for contracts of type guaranteed investment?No
    Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
    Health Insurance Welfare BenefitNo
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitYes
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $39,595
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $2,702
    Amount paid for insurance broker fees676
    Additional information about fees paid to insurance brokerBROKER BONUS
    Insurance broker organization code?3
    Insurance broker nameWILLIAM GALLAGHER ASSOCIATES
    TUFTS ASSOCIATED HEALTH MAINTENANCE ORG., INC. (National Association of Insurance Commissioners NAIC id number: 95688 )
    Policy contract number68326000
    Policy instance 4
    Insurance contract or identification number68326000
    Number of Individuals Covered128
    Insurance policy start date2012-04-01
    Insurance policy end date2013-03-31
    Total amount of commissions paid to insurance brokerUSD $31,662
    Total amount of fees paid to insurance companyUSD $789
    Are there contracts with allocated funds for individual policies?No
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
    Are there contracts with unallocated funds for contracts of type guaranteed investment?No
    Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
    Health Insurance Welfare BenefitYes
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $1,252,141
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $31,662
    Amount paid for insurance broker fees789
    Additional information about fees paid to insurance brokerOTHER BROKER COMPENSATION
    Insurance broker organization code?3
    Insurance broker nameWILLIAM GALLAGHER ASSOCIATES
    THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
    Policy contract number000010140700
    Policy instance 5
    Insurance contract or identification number000010140700
    Number of Individuals Covered309
    Insurance policy start date2012-04-01
    Insurance policy end date2013-03-31
    Total amount of commissions paid to insurance brokerUSD $1,684
    Total amount of fees paid to insurance companyUSD $254
    Are there contracts with allocated funds for individual policies?No
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
    Are there contracts with unallocated funds for contracts of type guaranteed investment?No
    Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
    Health Insurance Welfare BenefitNo
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitYes
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Other welfare benefits providedADD
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $16,055
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $1,684
    Amount paid for insurance broker fees254
    Additional information about fees paid to insurance brokerBROKER BONUS
    Insurance broker organization code?3
    Insurance broker nameWILLIAM GALLAGHER ASSOCIATES
    CERIDIAN HEALTH AND PRODUCTIVITY SOLUTIONS (National Association of Insurance Commissioners NAIC id number: 54121 )
    Policy contract number8322
    Policy instance 8
    Insurance contract or identification number8322
    Number of Individuals Covered650
    Insurance policy start date2012-04-01
    Insurance policy end date2013-03-31
    Total amount of commissions paid to insurance brokerUSD $0
    Total amount of fees paid to insurance companyUSD $0
    Are there contracts with allocated funds for individual policies?No
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
    Are there contracts with unallocated funds for contracts of type guaranteed investment?No
    Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
    Health Insurance Welfare BenefitNo
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $3,600
    THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
    Policy contract number000010140701
    Policy instance 7
    Insurance contract or identification number000010140701
    Number of Individuals Covered176
    Insurance policy start date2012-04-01
    Insurance policy end date2013-03-31
    Total amount of commissions paid to insurance brokerUSD $3,234
    Total amount of fees paid to insurance companyUSD $373
    Are there contracts with allocated funds for individual policies?No
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
    Are there contracts with unallocated funds for contracts of type guaranteed investment?No
    Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
    Health Insurance Welfare BenefitNo
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitYes
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $24,836
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $3,234
    Amount paid for insurance broker fees373
    Additional information about fees paid to insurance brokerBROKER BONUS
    Insurance broker organization code?3
    Insurance broker nameWILLIAM GALLAGHER ASSOCIATES
    TUFTS ASSOCIATED HEALTH MAINTENANCE ORG., INC. (National Association of Insurance Commissioners NAIC id number: 95688 )
    Policy contract number44839000
    Policy instance 3
    Insurance contract or identification number44839000
    Number of Individuals Covered9
    Insurance policy start date2012-04-01
    Insurance policy end date2013-03-31
    Total amount of commissions paid to insurance brokerUSD $2,390
    Total amount of fees paid to insurance companyUSD $63
    Are there contracts with allocated funds for individual policies?No
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
    Are there contracts with unallocated funds for contracts of type guaranteed investment?No
    Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
    Health Insurance Welfare BenefitYes
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $105,379
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $2,390
    Amount paid for insurance broker fees63
    Additional information about fees paid to insurance brokerOTHER BROKER COMPENSATION
    Insurance broker organization code?3
    Insurance broker nameWILLIAM GALLAGHER ASSOCIATES
    TUFTS ASSOCIATED HEALTH MAINTENANCE ORG., INC. (National Association of Insurance Commissioners NAIC id number: 95688 )
    Policy contract number68326000
    Policy instance 4
    Insurance contract or identification number68326000
    Number of Individuals Covered126
    Insurance policy start date2011-04-01
    Insurance policy end date2012-03-31
    Total amount of commissions paid to insurance brokerUSD $36,549
    Total amount of fees paid to insurance companyUSD $757
    Are there contracts with allocated funds for individual policies?No
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
    Are there contracts with unallocated funds for contracts of type guaranteed investment?No
    Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
    Health Insurance Welfare BenefitYes
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $1,254,384
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $36,549
    Amount paid for insurance broker fees757
    Additional information about fees paid to insurance brokerOTHER BROKER COMPENSATION
    Insurance broker organization code?3
    Insurance broker nameWILLIAM GALLAGHER ASSOCIATES
    THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
    Policy contract number000010140700
    Policy instance 5
    Insurance contract or identification number000010140700
    Number of Individuals Covered275
    Insurance policy start date2011-04-01
    Insurance policy end date2012-03-31
    Total amount of commissions paid to insurance brokerUSD $1,624
    Total amount of fees paid to insurance companyUSD $0
    Are there contracts with allocated funds for individual policies?No
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
    Are there contracts with unallocated funds for contracts of type guaranteed investment?No
    Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
    Health Insurance Welfare BenefitNo
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitYes
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Other welfare benefits providedAD&D
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $15,200
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $1,624
    Insurance broker organization code?3
    Insurance broker nameWILLIAM GALLAGHER ASSOCIATES
    TUFTS ASSOCIATED HEALTH MAINTENANCE ORG., INC. (National Association of Insurance Commissioners NAIC id number: 95688 )
    Policy contract number44839000
    Policy instance 3
    Insurance contract or identification number44839000
    Number of Individuals Covered10
    Insurance policy start date2011-04-01
    Insurance policy end date2012-03-31
    Total amount of commissions paid to insurance brokerUSD $2,016
    Total amount of fees paid to insurance companyUSD $44
    Are there contracts with allocated funds for individual policies?No
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
    Are there contracts with unallocated funds for contracts of type guaranteed investment?No
    Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
    Health Insurance Welfare BenefitYes
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $75,269
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $2,016
    Amount paid for insurance broker fees44
    Additional information about fees paid to insurance brokerOTHER BROKER COMPENSATION
    Insurance broker organization code?3
    Insurance broker nameWILLIAM GALLAGHER ASSOCIATES
    THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
    Policy contract number000010140702
    Policy instance 6
    Insurance contract or identification number000010140702
    Number of Individuals Covered175
    Insurance policy start date2011-04-01
    Insurance policy end date2012-03-31
    Total amount of commissions paid to insurance brokerUSD $2,708
    Total amount of fees paid to insurance companyUSD $0
    Are there contracts with allocated funds for individual policies?No
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
    Are there contracts with unallocated funds for contracts of type guaranteed investment?No
    Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
    Health Insurance Welfare BenefitNo
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitYes
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $39,878
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $2,708
    Insurance broker organization code?3
    Insurance broker nameWILLIAM GALLAGHER ASSOCIATES
    BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 )
    Policy contract number4954744
    Policy instance 2
    Insurance contract or identification number4954744
    Number of Individuals Covered243
    Insurance policy start date2011-04-01
    Insurance policy end date2012-03-31
    Total amount of commissions paid to insurance brokerUSD $4,127
    Total amount of fees paid to insurance companyUSD $1,359
    Are there contracts with allocated funds for individual policies?No
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
    Are there contracts with unallocated funds for contracts of type guaranteed investment?No
    Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
    Health Insurance Welfare BenefitNo
    Dental Insurance Welfare BenefitYes
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $4,127
    Amount paid for insurance broker fees1359
    Additional information about fees paid to insurance brokerBONUS AND PERSISTENCY COMMISSIONS
    Insurance broker organization code?3
    Insurance broker nameWILLIAM GALLAGHER ASSOCIATES
    VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47093 )
    Policy contract number30007240
    Policy instance 1
    Insurance contract or identification number30007240
    Number of Individuals Covered79
    Insurance policy start date2011-04-01
    Insurance policy end date2012-03-31
    Total amount of commissions paid to insurance brokerUSD $681
    Total amount of fees paid to insurance companyUSD $0
    Are there contracts with allocated funds for individual policies?No
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
    Are there contracts with unallocated funds for contracts of type guaranteed investment?No
    Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
    Health Insurance Welfare BenefitNo
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitYes
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $8,615
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $681
    Insurance broker organization code?3
    Insurance broker nameWILLIAM GALLAGHER ASSOCIATES
    THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
    Policy contract number000010140701000
    Policy instance 7
    Insurance contract or identification number000010140701000
    Number of Individuals Covered175
    Insurance policy start date2011-04-01
    Insurance policy end date2012-03-31
    Total amount of commissions paid to insurance brokerUSD $2,954
    Total amount of fees paid to insurance companyUSD $0
    Are there contracts with allocated funds for individual policies?No
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
    Are there contracts with unallocated funds for contracts of type guaranteed investment?No
    Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
    Health Insurance Welfare BenefitNo
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitYes
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $22,039
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $2,954
    Insurance broker organization code?3
    Insurance broker nameWILLIAM GALLAGHER ASSOCIATES
    VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47093 )
    Policy contract number30007240
    Policy instance 7
    Insurance contract or identification number30007240
    Number of Individuals Covered71
    Insurance policy start date2010-04-01
    Insurance policy end date2011-03-31
    Total amount of commissions paid to insurance brokerUSD $296
    Total amount of fees paid to insurance companyUSD $0
    Are there contracts with allocated funds for individual policies?No
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
    Are there contracts with unallocated funds for contracts of type guaranteed investment?No
    Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
    Health Insurance Welfare BenefitNo
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitYes
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $7,891
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
    Policy contract numberGUG 01116
    Policy instance 6
    Insurance contract or identification numberGUG 01116
    Number of Individuals Covered189
    Insurance policy start date2010-04-01
    Insurance policy end date2011-04-01
    Total amount of commissions paid to insurance brokerUSD $2,301
    Total amount of fees paid to insurance companyUSD $0
    Are there contracts with allocated funds for individual policies?No
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
    Are there contracts with unallocated funds for contracts of type guaranteed investment?No
    Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
    Health Insurance Welfare BenefitNo
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitYes
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $23,016
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
    Policy contract numberGLUG01116
    Policy instance 4
    Insurance contract or identification numberGLUG01116
    Number of Individuals Covered280
    Insurance policy start date2010-04-01
    Insurance policy end date2011-04-01
    Total amount of commissions paid to insurance brokerUSD $1,465
    Total amount of fees paid to insurance companyUSD $0
    Are there contracts with allocated funds for individual policies?No
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
    Are there contracts with unallocated funds for contracts of type guaranteed investment?No
    Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
    Health Insurance Welfare BenefitNo
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitYes
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Other welfare benefits providedAD&D
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $14,655
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
    Policy contract numberGLTD01116
    Policy instance 5
    Insurance contract or identification numberGLTD01116
    Number of Individuals Covered189
    Insurance policy start date2010-04-01
    Insurance policy end date2011-04-01
    Total amount of commissions paid to insurance brokerUSD $3,338
    Total amount of fees paid to insurance companyUSD $0
    Are there contracts with allocated funds for individual policies?No
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
    Are there contracts with unallocated funds for contracts of type guaranteed investment?No
    Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
    Health Insurance Welfare BenefitNo
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitYes
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $26,768
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 )
    Policy contract number4954744
    Policy instance 1
    Insurance contract or identification number4954744
    Number of Individuals Covered243
    Insurance policy start date2010-04-01
    Insurance policy end date2011-03-31
    Total amount of commissions paid to insurance brokerUSD $4,341
    Total amount of fees paid to insurance companyUSD $4,688
    Are there contracts with allocated funds for individual policies?No
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
    Are there contracts with unallocated funds for contracts of type guaranteed investment?No
    Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
    Health Insurance Welfare BenefitNo
    Dental Insurance Welfare BenefitYes
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    TUFTS ASSOCIATED HEALTH MAINTENANCE ORG., INC. (National Association of Insurance Commissioners NAIC id number: 95688 )
    Policy contract number44839000
    Policy instance 2
    Insurance contract or identification number44839000
    Number of Individuals Covered9
    Insurance policy start date2010-04-01
    Insurance policy end date2011-03-31
    Total amount of commissions paid to insurance brokerUSD $2,177
    Total amount of fees paid to insurance companyUSD $0
    Are there contracts with allocated funds for individual policies?No
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
    Are there contracts with unallocated funds for contracts of type guaranteed investment?No
    Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
    Health Insurance Welfare BenefitYes
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $78,550
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    TUFTS ASSOCIATED HEALTH MAINTENANCE ORG., INC. (National Association of Insurance Commissioners NAIC id number: 95688 )
    Policy contract number68326000
    Policy instance 3
    Insurance contract or identification number68326000
    Number of Individuals Covered135
    Insurance policy start date2010-04-01
    Insurance policy end date2011-03-31
    Total amount of commissions paid to insurance brokerUSD $35,022
    Total amount of fees paid to insurance companyUSD $0
    Are there contracts with allocated funds for individual policies?No
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
    Are there contracts with unallocated funds for contracts of type guaranteed investment?No
    Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
    Health Insurance Welfare BenefitYes
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $1,171,526
    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: 47093 )
    Policy contract number30007240
    Policy instance 6
    Insurance contract or identification number30007240
    Number of Individuals Covered75
    Insurance policy start date2009-04-01
    Insurance policy end date2010-03-31
    Total amount of commissions paid to insurance brokerUSD $634
    Total amount of fees paid to insurance companyUSD $0
    Are there contracts with allocated funds for individual policies?No
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
    Are there contracts with unallocated funds for contracts of type guaranteed investment?No
    Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
    Health Insurance Welfare BenefitNo
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitYes
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $7,670
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $634
    Insurance broker organization code?3
    Insurance broker namePARADIGM INSURANCE AGENCY INC.
    MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
    Policy contract numberGLTD01116
    Policy instance 4
    Insurance contract or identification numberGLTD01116
    Number of Individuals Covered196
    Insurance policy start date2009-04-01
    Insurance policy end date2010-04-01
    Total amount of commissions paid to insurance brokerUSD $3,361
    Total amount of fees paid to insurance companyUSD $0
    Are there contracts with allocated funds for individual policies?No
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
    Are there contracts with unallocated funds for contracts of type guaranteed investment?No
    Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
    Health Insurance Welfare BenefitNo
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitYes
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $27,213
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $3,361
    Insurance broker organization code?3
    Insurance broker namePARADIGM INSURANCE AGENCY
    MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
    Policy contract numberGLUG01116
    Policy instance 3
    Insurance contract or identification numberGLUG01116
    Number of Individuals Covered279
    Insurance policy start date2009-04-01
    Insurance policy end date2010-04-01
    Total amount of commissions paid to insurance brokerUSD $1,432
    Total amount of fees paid to insurance companyUSD $0
    Are there contracts with allocated funds for individual policies?No
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
    Are there contracts with unallocated funds for contracts of type guaranteed investment?No
    Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
    Health Insurance Welfare BenefitNo
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitYes
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Other welfare benefits providedAD&D
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $14,323
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $1,432
    Insurance broker organization code?3
    Insurance broker namePARADIGM INSURANCE AGENCY
    BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 )
    Policy contract number4954744
    Policy instance 2
    Insurance contract or identification number4954744
    Number of Individuals Covered254
    Insurance policy start date2009-04-01
    Insurance policy end date2010-03-31
    Total amount of commissions paid to insurance brokerUSD $26,737
    Total amount of fees paid to insurance companyUSD $9,023
    Are there contracts with allocated funds for individual policies?No
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
    Are there contracts with unallocated funds for contracts of type guaranteed investment?No
    Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
    Health Insurance Welfare BenefitYes
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $26,737
    Amount paid for insurance broker fees9023
    Additional information about fees paid to insurance brokerBONUS AND PERSISTENCY COMMISSIONS
    Insurance broker organization code?3
    Insurance broker namePARADIGM INSURANCE AGENCY, INC.
    BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 )
    Policy contract number4954744
    Policy instance 1
    Insurance contract or identification number4954744
    Number of Individuals Covered256
    Insurance policy start date2009-04-01
    Insurance policy end date2010-03-31
    Total amount of commissions paid to insurance brokerUSD $4,375
    Total amount of fees paid to insurance companyUSD $0
    Are there contracts with allocated funds for individual policies?No
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
    Are there contracts with unallocated funds for contracts of type guaranteed investment?No
    Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
    Health Insurance Welfare BenefitNo
    Dental Insurance Welfare BenefitYes
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitNo
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $4,375
    Insurance broker organization code?3
    Insurance broker namePARADIGM INSURANCE AGENCY, INC.
    MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
    Policy contract numberGUG 01116
    Policy instance 5
    Insurance contract or identification numberGUG 01116
    Number of Individuals Covered196
    Insurance policy start date2009-04-01
    Insurance policy end date2010-04-01
    Total amount of commissions paid to insurance brokerUSD $2,313
    Total amount of fees paid to insurance companyUSD $0
    Are there contracts with allocated funds for individual policies?No
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
    Are there contracts with unallocated funds for contracts of type guaranteed investment?No
    Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
    Health Insurance Welfare BenefitNo
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitNo
    Life Insurance Welfare BenefitNo
    Temporary Disability Insurance Welfare BenefitYes
    Long Term Disability Insurance Welfare BenefitNo
    Unemployment Insurance Welfare BenefitNo
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $23,128
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $2,313
    Insurance broker organization code?3
    Insurance broker namePARADIGM INSURANCE AGENCY

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