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SAVINGS BANK EMPLOYEES GROUP INSURANCE FUND CAMBRIDGE SAVINGS BANK 401k Plan overview

Plan NameSAVINGS BANK EMPLOYEES GROUP INSURANCE FUND CAMBRIDGE SAVINGS BANK
Plan identification number 501

SAVINGS BANK EMPLOYEES GROUP INSURANCE FUND CAMBRIDGE SAVINGS BANK Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance

401k Sponsoring company profile

CAMBRIDGE SAVINGS BANK has sponsored the creation of one or more 401k plans.

Company Name:CAMBRIDGE SAVINGS BANK
Employer identification number (EIN):041145100
NAIC Classification:522120
NAIC Description:Savings Institutions

Additional information about CAMBRIDGE SAVINGS BANK

Jurisdiction of Incorporation: Commonwealth of Massachusetts Corporations Division
Incorporation Date:
Company Identification Number: 000034529

More information about CAMBRIDGE SAVINGS BANK

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SAVINGS BANK EMPLOYEES GROUP INSURANCE FUND CAMBRIDGE SAVINGS BANK

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01LINDA GRACE2023-06-28
5012021-01-01LINDA GRACE2023-06-28
5012019-01-01LINDA GRACE2023-06-28
5012018-01-01LINDA GRACE2023-06-28
5012017-01-01LINDA GRACE MICHAEL GILLES2018-08-01
5012016-01-01LINDA GRACE MICHAEL GILLES2017-07-05
5012015-01-01LINDA GRACE MICHAEL GILLES2016-10-13
5012014-01-01STEVE COUKOS MICHAEL GILLES2015-10-14
5012013-01-01MARIE S LODI MICHAEL GILLES2014-06-26
5012012-01-01MARIE LODI MICHAEL GILLES2013-07-16
5012011-01-01MARIE LODI WAYNE PATENAUDE2012-07-25
5012010-01-01MARIE LODI WAYNE PATENAUDE2011-09-09
5012009-09-01MARIE LODI WAYNE PATENAUDE2010-10-13

Plan Statistics for SAVINGS BANK EMPLOYEES GROUP INSURANCE FUND CAMBRIDGE SAVINGS BANK

401k plan membership statisitcs for SAVINGS BANK EMPLOYEES GROUP INSURANCE FUND CAMBRIDGE SAVINGS BANK

Measure Date Value
2022: SAVINGS BANK EMPLOYEES GROUP INSURANCE FUND CAMBRIDGE SAVINGS BANK 2022 401k membership
Total participants, beginning-of-year2022-01-01443
Total number of active participants reported on line 7a of the Form 55002022-01-010
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-010
Number of employers contributing to the scheme2022-01-010
2021: SAVINGS BANK EMPLOYEES GROUP INSURANCE FUND CAMBRIDGE SAVINGS BANK 2021 401k membership
Total participants, beginning-of-year2021-01-01433
Total number of active participants reported on line 7a of the Form 55002021-01-01443
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-01443
Number of employers contributing to the scheme2021-01-010
2019: SAVINGS BANK EMPLOYEES GROUP INSURANCE FUND CAMBRIDGE SAVINGS BANK 2019 401k membership
Total participants, beginning-of-year2019-01-01350
Total number of active participants reported on line 7a of the Form 55002019-01-01386
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 participants2019-01-01386
Number of employers contributing to the scheme2019-01-010
2018: SAVINGS BANK EMPLOYEES GROUP INSURANCE FUND CAMBRIDGE SAVINGS BANK 2018 401k membership
Total participants, beginning-of-year2018-01-01403
Total number of active participants reported on line 7a of the Form 55002018-01-01350
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 participants2018-01-01350
Number of employers contributing to the scheme2018-01-010
2017: SAVINGS BANK EMPLOYEES GROUP INSURANCE FUND CAMBRIDGE SAVINGS BANK 2017 401k membership
Total participants, beginning-of-year2017-01-01405
Total number of active participants reported on line 7a of the Form 55002017-01-01368
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-0135
Total of all active and inactive participants2017-01-01403
2016: SAVINGS BANK EMPLOYEES GROUP INSURANCE FUND CAMBRIDGE SAVINGS BANK 2016 401k membership
Total participants, beginning-of-year2016-01-01411
Total number of active participants reported on line 7a of the Form 55002016-01-01370
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-0135
Total of all active and inactive participants2016-01-01405
2015: SAVINGS BANK EMPLOYEES GROUP INSURANCE FUND CAMBRIDGE SAVINGS BANK 2015 401k membership
Total participants, beginning-of-year2015-01-01340
Total number of active participants reported on line 7a of the Form 55002015-01-01375
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-0136
Total of all active and inactive participants2015-01-01411
2014: SAVINGS BANK EMPLOYEES GROUP INSURANCE FUND CAMBRIDGE SAVINGS BANK 2014 401k membership
Total participants, beginning-of-year2014-01-01306
Total number of active participants reported on line 7a of the Form 55002014-01-01330
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-0130
Total of all active and inactive participants2014-01-01360
2013: SAVINGS BANK EMPLOYEES GROUP INSURANCE FUND CAMBRIDGE SAVINGS BANK 2013 401k membership
Total participants, beginning-of-year2013-01-01275
Total number of active participants reported on line 7a of the Form 55002013-01-01307
Number of retired or separated participants receiving benefits2013-01-0131
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-01338
2012: SAVINGS BANK EMPLOYEES GROUP INSURANCE FUND CAMBRIDGE SAVINGS BANK 2012 401k membership
Total participants, beginning-of-year2012-01-01272
Total number of active participants reported on line 7a of the Form 55002012-01-01279
Number of retired or separated participants receiving benefits2012-01-0132
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-01311
2011: SAVINGS BANK EMPLOYEES GROUP INSURANCE FUND CAMBRIDGE SAVINGS BANK 2011 401k membership
Total participants, beginning-of-year2011-01-01258
Total number of active participants reported on line 7a of the Form 55002011-01-01272
Number of retired or separated participants receiving benefits2011-01-0134
Number of other retired or separated participants entitled to future benefits2011-01-010
Total of all active and inactive participants2011-01-01306
2010: SAVINGS BANK EMPLOYEES GROUP INSURANCE FUND CAMBRIDGE SAVINGS BANK 2010 401k membership
Total participants, beginning-of-year2010-01-01262
Total number of active participants reported on line 7a of the Form 55002010-01-01263
Number of retired or separated participants receiving benefits2010-01-0135
Number of other retired or separated participants entitled to future benefits2010-01-010
Total of all active and inactive participants2010-01-01298
2009: SAVINGS BANK EMPLOYEES GROUP INSURANCE FUND CAMBRIDGE SAVINGS BANK 2009 401k membership
Total participants, beginning-of-year2009-09-01300
Total number of active participants reported on line 7a of the Form 55002009-09-01302
Number of retired or separated participants receiving benefits2009-09-010
Number of other retired or separated participants entitled to future benefits2009-09-010
Total of all active and inactive participants2009-09-01302
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-09-010

Form 5500 Responses for SAVINGS BANK EMPLOYEES GROUP INSURANCE FUND CAMBRIDGE SAVINGS BANK

2022: SAVINGS BANK EMPLOYEES GROUP INSURANCE FUND CAMBRIDGE SAVINGS BANK 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01This submission is the final filingYes
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – InsuranceYes
2021: SAVINGS BANK EMPLOYEES GROUP INSURANCE FUND CAMBRIDGE SAVINGS BANK 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – InsuranceYes
2019: SAVINGS BANK EMPLOYEES GROUP INSURANCE FUND CAMBRIDGE SAVINGS BANK 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: SAVINGS BANK EMPLOYEES GROUP INSURANCE FUND CAMBRIDGE SAVINGS BANK 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: SAVINGS BANK EMPLOYEES GROUP INSURANCE FUND CAMBRIDGE SAVINGS BANK 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: SAVINGS BANK EMPLOYEES GROUP INSURANCE FUND CAMBRIDGE SAVINGS BANK 2016 form 5500 responses
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 benefit arrangement – InsuranceYes
2015: SAVINGS BANK EMPLOYEES GROUP INSURANCE FUND CAMBRIDGE SAVINGS BANK 2015 form 5500 responses
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 benefit arrangement – InsuranceYes
2014: SAVINGS BANK EMPLOYEES GROUP INSURANCE FUND CAMBRIDGE SAVINGS BANK 2014 form 5500 responses
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 benefit arrangement – InsuranceYes
2013: SAVINGS BANK EMPLOYEES GROUP INSURANCE FUND CAMBRIDGE SAVINGS BANK 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
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 benefit arrangement – InsuranceYes
2012: SAVINGS BANK EMPLOYEES GROUP INSURANCE FUND CAMBRIDGE SAVINGS BANK 2012 form 5500 responses
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: SAVINGS BANK EMPLOYEES GROUP INSURANCE FUND CAMBRIDGE SAVINGS BANK 2011 form 5500 responses
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
2010: SAVINGS BANK EMPLOYEES GROUP INSURANCE FUND CAMBRIDGE SAVINGS BANK 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – InsuranceYes
2009: SAVINGS BANK EMPLOYEES GROUP INSURANCE FUND CAMBRIDGE SAVINGS BANK 2009 form 5500 responses
2009-09-01Type of plan entitySingle employer plan
2009-09-01Submission has been amendedNo
2009-09-01This submission is the final filingNo
2009-09-01This return/report is a short plan year return/report (less than 12 months)Yes
2009-09-01Plan is a collectively bargained planNo
2009-09-01Plan funding arrangement – InsuranceYes
2009-09-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number867880G
Policy instance 1
Insurance contract or identification number867880G
Number of Individuals Covered483
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $18,495
Total amount of fees paid to insurance companyUSD $635
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $138,997
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $18,495
Amount paid for insurance broker fees635
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number867880G
Policy instance 1
Insurance contract or identification number867880G
Number of Individuals Covered443
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $16,599
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $126,934
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,599
Amount paid for insurance broker fees0
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number867880G
Policy instance 1
Insurance contract or identification number867880G
Number of Individuals Covered386
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $15,984
Total amount of fees paid to insurance companyUSD $355
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $104,782
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,984
Amount paid for insurance broker fees355
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number867880G
Policy instance 1
Insurance contract or identification number867880G
Number of Individuals Covered350
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $16,874
Total amount of fees paid to insurance companyUSD $1,927
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $75,016
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,874
Amount paid for insurance broker fees1927
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number867880G
Policy instance 1
Insurance contract or identification number867880G
Number of Individuals Covered368
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $17,511
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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
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 $112,574
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17,511
Insurance broker organization code?3
Insurance broker nameMASS FNCL SVCS INS AGCY INC
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number867880G
Policy instance 1
Insurance contract or identification number867880G
Number of Individuals Covered375
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $6,177
Total amount of fees paid to insurance companyUSD $1,250
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
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 $105,195
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,177
Amount paid for insurance broker fees1250
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameMASS FNCL SVCS INS AGCY INC
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number867880G
Policy instance 1
Insurance contract or identification number867880G
Number of Individuals Covered340
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $6,125
Total amount of fees paid to insurance companyUSD $2,299
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
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 $100,034
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,125
Amount paid for insurance broker fees2299
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameMASS FNCL SVCS INS AGCY INC
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number867880G
Policy instance 1
Insurance contract or identification number867880G
Number of Individuals Covered333
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $6,005
Total amount of fees paid to insurance companyUSD $1,288
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
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 $91,954
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,005
Amount paid for insurance broker fees1288
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameMASS FNCL SVCS INS AGCY INC
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number867880G
Policy instance 1
Insurance contract or identification number867880G
Number of Individuals Covered577
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $6,157
Total amount of fees paid to insurance companyUSD $1,227
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
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 $103,175
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,157
Amount paid for insurance broker fees1227
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameMASS FNCL SVCS INS AGCY INC
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number867880G
Policy instance 1
Insurance contract or identification number867880G
Number of Individuals Covered302
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $6,140
Total amount of fees paid to insurance companyUSD $955
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
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 $101,437
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number867880G
Policy instance 1
Insurance contract or identification number867880G
Number of Individuals Covered267
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $6,976
Total amount of fees paid to insurance companyUSD $2,432
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
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 $87,546
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,976
Amount paid for insurance broker fees2432
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameMASS FNCL SVCS INS AGCY INC

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