K & K EXCAVATION COMPANY, INC. has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan K & K EXCAVATION COMPANY, INC. INSURANCE PROGRAM
401k plan membership statisitcs for K & K EXCAVATION COMPANY, INC. INSURANCE PROGRAM
| Measure | Date | Value |
|---|
| 2019: K & K EXCAVATION COMPANY, INC. INSURANCE PROGRAM 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-01-01 | 3 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 3 |
| Total of all active and inactive participants | 2019-01-01 | 3 |
| 2018: K & K EXCAVATION COMPANY, INC. INSURANCE PROGRAM 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-01-01 | 3 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 3 |
| Total of all active and inactive participants | 2018-01-01 | 3 |
| 2017: K & K EXCAVATION COMPANY, INC. INSURANCE PROGRAM 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-01-01 | 3 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 3 |
| Total of all active and inactive participants | 2017-01-01 | 3 |
| 2016: K & K EXCAVATION COMPANY, INC. INSURANCE PROGRAM 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-01-01 | 3 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 3 |
| Number of retired or separated participants receiving benefits | 2016-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2016-01-01 | 0 |
| Total of all active and inactive participants | 2016-01-01 | 3 |
| 2015: K & K EXCAVATION COMPANY, INC. INSURANCE PROGRAM 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-01-01 | 3 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 3 |
| Total of all active and inactive participants | 2015-01-01 | 3 |
| 2014: K & K EXCAVATION COMPANY, INC. INSURANCE PROGRAM 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-01-01 | 3 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 3 |
| Number of retired or separated participants receiving benefits | 2014-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2014-01-01 | 0 |
| Total of all active and inactive participants | 2014-01-01 | 3 |
| 2013: K & K EXCAVATION COMPANY, INC. INSURANCE PROGRAM 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-01-01 | 3 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 3 |
| Number of retired or separated participants receiving benefits | 2013-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2013-01-01 | 0 |
| Total of all active and inactive participants | 2013-01-01 | 3 |
| 2012: K & K EXCAVATION COMPANY, INC. INSURANCE PROGRAM 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-01-01 | 3 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 3 |
| Number of retired or separated participants receiving benefits | 2012-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2012-01-01 | 0 |
| Total of all active and inactive participants | 2012-01-01 | 3 |
| 2011: K & K EXCAVATION COMPANY, INC. INSURANCE PROGRAM 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-01-01 | 3 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 3 |
| Number of retired or separated participants receiving benefits | 2011-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2011-01-01 | 0 |
| Total of all active and inactive participants | 2011-01-01 | 3 |
| 2010: K & K EXCAVATION COMPANY, INC. INSURANCE PROGRAM 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-01-01 | 3 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-01-01 | 3 |
| Number of retired or separated participants receiving benefits | 2010-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2010-01-01 | 0 |
| Total of all active and inactive participants | 2010-01-01 | 3 |
| 2009: K & K EXCAVATION COMPANY, INC. INSURANCE PROGRAM 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-01-01 | 3 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 3 |
| Number of retired or separated participants receiving benefits | 2009-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2009-01-01 | 0 |
| Total of all active and inactive participants | 2009-01-01 | 3 |
| Measure | Date | Value |
|---|
| 2019 : K & K EXCAVATION COMPANY, INC. INSURANCE PROGRAM 2019 401k financial data |
|---|
| Total income from all sources | 2019-12-31 | $4,024 |
| Expenses. Total of all expenses incurred | 2019-12-31 | $4,649 |
| Benefits paid (including direct rollovers) | 2019-12-31 | $4,563 |
| Total plan assets at end of year | 2019-12-31 | $659 |
| Total plan assets at beginning of year | 2019-12-31 | $1,284 |
| Net income (gross income less expenses) | 2019-12-31 | $-625 |
| Net plan assets at end of year (total assets less liabilities) | 2019-12-31 | $659 |
| Net plan assets at beginning of year (total assets less liabilities) | 2019-12-31 | $1,284 |
| Total contributions received or receivable from employer(s) | 2019-12-31 | $4,024 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2019-12-31 | $86 |
| 2018 : K & K EXCAVATION COMPANY, INC. INSURANCE PROGRAM 2018 401k financial data |
|---|
| Total income from all sources | 2018-12-31 | $3,941 |
| Expenses. Total of all expenses incurred | 2018-12-31 | $3,653 |
| Benefits paid (including direct rollovers) | 2018-12-31 | $3,538 |
| Total plan assets at end of year | 2018-12-31 | $1,284 |
| Total plan assets at beginning of year | 2018-12-31 | $996 |
| Net income (gross income less expenses) | 2018-12-31 | $288 |
| Net plan assets at end of year (total assets less liabilities) | 2018-12-31 | $1,284 |
| Net plan assets at beginning of year (total assets less liabilities) | 2018-12-31 | $996 |
| Total contributions received or receivable from employer(s) | 2018-12-31 | $3,941 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2018-12-31 | $115 |
| 2017 : K & K EXCAVATION COMPANY, INC. INSURANCE PROGRAM 2017 401k financial data |
|---|
| Total income from all sources | 2017-12-31 | $3,990 |
| Expenses. Total of all expenses incurred | 2017-12-31 | $3,753 |
| Benefits paid (including direct rollovers) | 2017-12-31 | $3,520 |
| Total plan assets at end of year | 2017-12-31 | $996 |
| Total plan assets at beginning of year | 2017-12-31 | $759 |
| Net income (gross income less expenses) | 2017-12-31 | $237 |
| Net plan assets at end of year (total assets less liabilities) | 2017-12-31 | $996 |
| Net plan assets at beginning of year (total assets less liabilities) | 2017-12-31 | $759 |
| Total contributions received or receivable from employer(s) | 2017-12-31 | $3,990 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2017-12-31 | $233 |
| 2016 : K & K EXCAVATION COMPANY, INC. INSURANCE PROGRAM 2016 401k financial data |
|---|
| Total income from all sources | 2016-12-31 | $3,533 |
| Expenses. Total of all expenses incurred | 2016-12-31 | $3,533 |
| Benefits paid (including direct rollovers) | 2016-12-31 | $3,911 |
| Total plan assets at end of year | 2016-12-31 | $759 |
| Total plan assets at beginning of year | 2016-12-31 | $759 |
| Net income (gross income less expenses) | 2016-12-31 | $0 |
| Net plan assets at end of year (total assets less liabilities) | 2016-12-31 | $759 |
| Net plan assets at beginning of year (total assets less liabilities) | 2016-12-31 | $759 |
| Total contributions received or receivable from employer(s) | 2016-12-31 | $3,533 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2016-12-31 | $-378 |
| 2015 : K & K EXCAVATION COMPANY, INC. INSURANCE PROGRAM 2015 401k financial data |
|---|
| Total income from all sources | 2015-12-31 | $3,847 |
| Expenses. Total of all expenses incurred | 2015-12-31 | $3,587 |
| Benefits paid (including direct rollovers) | 2015-12-31 | $3,917 |
| Total plan assets at end of year | 2015-12-31 | $980 |
| Total plan assets at beginning of year | 2015-12-31 | $720 |
| Net income (gross income less expenses) | 2015-12-31 | $260 |
| Net plan assets at end of year (total assets less liabilities) | 2015-12-31 | $980 |
| Net plan assets at beginning of year (total assets less liabilities) | 2015-12-31 | $720 |
| Total contributions received or receivable from employer(s) | 2015-12-31 | $3,847 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2015-12-31 | $-330 |
| 2014 : K & K EXCAVATION COMPANY, INC. INSURANCE PROGRAM 2014 401k financial data |
|---|
| Total income from all sources | 2014-12-31 | $2,569 |
| Expenses. Total of all expenses incurred | 2014-12-31 | $3,304 |
| Benefits paid (including direct rollovers) | 2014-12-31 | $2,429 |
| Total plan assets at end of year | 2014-12-31 | $720 |
| Total plan assets at beginning of year | 2014-12-31 | $1,455 |
| Value of fidelity bond covering the plan | 2014-12-31 | $1,000 |
| Net income (gross income less expenses) | 2014-12-31 | $-735 |
| Net plan assets at end of year (total assets less liabilities) | 2014-12-31 | $720 |
| Net plan assets at beginning of year (total assets less liabilities) | 2014-12-31 | $1,455 |
| Total contributions received or receivable from employer(s) | 2014-12-31 | $2,569 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2014-12-31 | $875 |
| 2013 : K & K EXCAVATION COMPANY, INC. INSURANCE PROGRAM 2013 401k financial data |
|---|
| Total income from all sources | 2013-12-31 | $3,957 |
| Expenses. Total of all expenses incurred | 2013-12-31 | $3,690 |
| Benefits paid (including direct rollovers) | 2013-12-31 | $3,258 |
| Total plan assets at end of year | 2013-12-31 | $1,455 |
| Total plan assets at beginning of year | 2013-12-31 | $1,188 |
| Value of fidelity bond covering the plan | 2013-12-31 | $50,000 |
| Net income (gross income less expenses) | 2013-12-31 | $267 |
| Net plan assets at end of year (total assets less liabilities) | 2013-12-31 | $1,455 |
| Net plan assets at beginning of year (total assets less liabilities) | 2013-12-31 | $1,188 |
| Total contributions received or receivable from employer(s) | 2013-12-31 | $3,957 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2013-12-31 | $432 |
| 2012 : K & K EXCAVATION COMPANY, INC. INSURANCE PROGRAM 2012 401k financial data |
|---|
| Total income from all sources | 2012-12-31 | $3,634 |
| Expenses. Total of all expenses incurred | 2012-12-31 | $3,426 |
| Benefits paid (including direct rollovers) | 2012-12-31 | $3,193 |
| Total plan assets at end of year | 2012-12-31 | $1,188 |
| Total plan assets at beginning of year | 2012-12-31 | $980 |
| Value of fidelity bond covering the plan | 2012-12-31 | $50,000 |
| Net income (gross income less expenses) | 2012-12-31 | $208 |
| Net plan assets at end of year (total assets less liabilities) | 2012-12-31 | $1,188 |
| Net plan assets at beginning of year (total assets less liabilities) | 2012-12-31 | $980 |
| Total contributions received or receivable from employer(s) | 2012-12-31 | $3,634 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2012-12-31 | $233 |
| 2011 : K & K EXCAVATION COMPANY, INC. INSURANCE PROGRAM 2011 401k financial data |
|---|
| Total income from all sources | 2011-12-31 | $3,687 |
| Expenses. Total of all expenses incurred | 2011-12-31 | $3,427 |
| Benefits paid (including direct rollovers) | 2011-12-31 | $3,193 |
| Total plan assets at end of year | 2011-12-31 | $980 |
| Total plan assets at beginning of year | 2011-12-31 | $720 |
| Value of fidelity bond covering the plan | 2011-12-31 | $50,000 |
| Net income (gross income less expenses) | 2011-12-31 | $260 |
| Net plan assets at end of year (total assets less liabilities) | 2011-12-31 | $980 |
| Net plan assets at beginning of year (total assets less liabilities) | 2011-12-31 | $720 |
| Total contributions received or receivable from employer(s) | 2011-12-31 | $3,687 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2011-12-31 | $234 |
| 2010 : K & K EXCAVATION COMPANY, INC. INSURANCE PROGRAM 2010 401k financial data |
|---|
| Total income from all sources | 2010-12-31 | $3,384 |
| Expenses. Total of all expenses incurred | 2010-12-31 | $3,427 |
| Benefits paid (including direct rollovers) | 2010-12-31 | $3,193 |
| Total plan assets at end of year | 2010-12-31 | $720 |
| Total plan assets at beginning of year | 2010-12-31 | $763 |
| Net income (gross income less expenses) | 2010-12-31 | $-43 |
| Net plan assets at end of year (total assets less liabilities) | 2010-12-31 | $720 |
| Net plan assets at beginning of year (total assets less liabilities) | 2010-12-31 | $763 |
| Total contributions received or receivable from employer(s) | 2010-12-31 | $3,384 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2010-12-31 | $234 |
| 2019: K & K EXCAVATION COMPANY, INC. INSURANCE PROGRAM 2019 form 5500 responses |
|---|
| 2019-01-01 | Type of plan entity | Single employer plan |
| 2019-01-01 | Submission has been amended | No |
| 2019-01-01 | This submission is the final filing | No |
| 2019-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2019-01-01 | Plan is a collectively bargained plan | No |
| 2019-01-01 | Plan funding arrangement – Insurance | Yes |
| 2019-01-01 | Plan funding arrangement – Trust | Yes |
| 2019-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2019-01-01 | Plan benefit arrangement - Trust | Yes |
| 2018: K & K EXCAVATION COMPANY, INC. INSURANCE PROGRAM 2018 form 5500 responses |
|---|
| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | Submission has been amended | No |
| 2018-01-01 | This submission is the final filing | No |
| 2018-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2018-01-01 | Plan is a collectively bargained plan | No |
| 2018-01-01 | Plan funding arrangement – Insurance | Yes |
| 2018-01-01 | Plan funding arrangement – Trust | Yes |
| 2018-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2018-01-01 | Plan benefit arrangement - Trust | Yes |
| 2017: K & K EXCAVATION COMPANY, INC. INSURANCE PROGRAM 2017 form 5500 responses |
|---|
| 2017-01-01 | Type of plan entity | Single employer plan |
| 2017-01-01 | Submission has been amended | No |
| 2017-01-01 | This submission is the final filing | No |
| 2017-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2017-01-01 | Plan is a collectively bargained plan | No |
| 2017-01-01 | Plan funding arrangement – Insurance | Yes |
| 2017-01-01 | Plan funding arrangement – Trust | Yes |
| 2017-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2017-01-01 | Plan benefit arrangement - Trust | Yes |
| 2016: K & K EXCAVATION COMPANY, INC. INSURANCE PROGRAM 2016 form 5500 responses |
|---|
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | Submission has been amended | No |
| 2016-01-01 | This submission is the final filing | No |
| 2016-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-01-01 | Plan is a collectively bargained plan | No |
| 2016-01-01 | Plan funding arrangement – Insurance | Yes |
| 2016-01-01 | Plan funding arrangement – Trust | Yes |
| 2016-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2016-01-01 | Plan benefit arrangement - Trust | Yes |
| 2015: K & K EXCAVATION COMPANY, INC. INSURANCE PROGRAM 2015 form 5500 responses |
|---|
| 2015-01-01 | Type of plan entity | Single employer plan |
| 2015-01-01 | Submission has been amended | No |
| 2015-01-01 | This submission is the final filing | No |
| 2015-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-01-01 | Plan is a collectively bargained plan | No |
| 2015-01-01 | Plan funding arrangement – Insurance | Yes |
| 2015-01-01 | Plan funding arrangement – Trust | Yes |
| 2015-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2015-01-01 | Plan benefit arrangement - Trust | Yes |
| 2014: K & K EXCAVATION COMPANY, INC. INSURANCE PROGRAM 2014 form 5500 responses |
|---|
| 2014-01-01 | Type of plan entity | Single employer plan |
| 2014-01-01 | Submission has been amended | No |
| 2014-01-01 | This submission is the final filing | No |
| 2014-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2014-01-01 | Plan is a collectively bargained plan | No |
| 2014-01-01 | Plan funding arrangement – Insurance | Yes |
| 2014-01-01 | Plan funding arrangement – Trust | Yes |
| 2014-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2014-01-01 | Plan benefit arrangement - Trust | Yes |
| 2013: K & K EXCAVATION COMPANY, INC. INSURANCE PROGRAM 2013 form 5500 responses |
|---|
| 2013-01-01 | Type of plan entity | Single employer plan |
| 2013-01-01 | Submission has been amended | No |
| 2013-01-01 | This submission is the final filing | No |
| 2013-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2013-01-01 | Plan is a collectively bargained plan | No |
| 2013-01-01 | Plan funding arrangement – Insurance | Yes |
| 2013-01-01 | Plan funding arrangement – Trust | Yes |
| 2013-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2013-01-01 | Plan benefit arrangement - Trust | Yes |
| 2012: K & K EXCAVATION COMPANY, INC. INSURANCE PROGRAM 2012 form 5500 responses |
|---|
| 2012-01-01 | Type of plan entity | Single employer plan |
| 2012-01-01 | Submission has been amended | No |
| 2012-01-01 | This submission is the final filing | No |
| 2012-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2012-01-01 | Plan is a collectively bargained plan | No |
| 2012-01-01 | Plan funding arrangement – Insurance | Yes |
| 2012-01-01 | Plan funding arrangement – Trust | Yes |
| 2012-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2012-01-01 | Plan benefit arrangement - Trust | Yes |
| 2011: K & K EXCAVATION COMPANY, INC. INSURANCE PROGRAM 2011 form 5500 responses |
|---|
| 2011-01-01 | Type of plan entity | Single employer plan |
| 2011-01-01 | Submission has been amended | No |
| 2011-01-01 | This submission is the final filing | No |
| 2011-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2011-01-01 | Plan is a collectively bargained plan | No |
| 2011-01-01 | Plan funding arrangement – Insurance | Yes |
| 2011-01-01 | Plan funding arrangement – Trust | Yes |
| 2011-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2011-01-01 | Plan benefit arrangement - Trust | Yes |
| 2010: K & K EXCAVATION COMPANY, INC. INSURANCE PROGRAM 2010 form 5500 responses |
|---|
| 2010-01-01 | Type of plan entity | Single employer plan |
| 2010-01-01 | Submission has been amended | No |
| 2010-01-01 | This submission is the final filing | No |
| 2010-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2010-01-01 | Plan is a collectively bargained plan | No |
| 2010-01-01 | Plan funding arrangement – Insurance | Yes |
| 2010-01-01 | Plan funding arrangement – Trust | Yes |
| 2010-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2010-01-01 | Plan benefit arrangement - Trust | Yes |
| 2009: K & K EXCAVATION COMPANY, INC. INSURANCE PROGRAM 2009 form 5500 responses |
|---|
| 2009-01-01 | Type of plan entity | Single employer plan |
| 2009-01-01 | Submission has been amended | No |
| 2009-01-01 | This submission is the final filing | No |
| 2009-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2009-01-01 | Plan is a collectively bargained plan | No |
| 2009-01-01 | Plan funding arrangement – Insurance | Yes |
| 2009-01-01 | Plan funding arrangement – Trust | Yes |
| 2009-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2009-01-01 | Plan benefit arrangement - Trust | Yes |
| SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 ) |
| Policy contract number | 234615 |
| Policy instance | 1 |
| Insurance contract or identification number | 234615 | | Number of Individuals Covered | 3 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $4,563 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | | Commission paid to Insurance Broker | USD $0 | | Insurance broker organization code? | 3 |
|
| SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 ) |
| Policy contract number | 234615 |
| Policy instance | 1 |
| Insurance contract or identification number | 234615 | | Number of Individuals Covered | 3 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $336 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $3,538 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | | Commission paid to Insurance Broker | USD $336 | | Insurance broker organization code? | 3 |
|
| SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 ) |
| Policy contract number | 234615 |
| Policy instance | 1 |
| Insurance contract or identification number | 234615 | | Number of Individuals Covered | 3 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $44 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $3,520 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | | Commission paid to Insurance Broker | USD $44 | | Insurance broker organization code? | 3 | | Insurance broker name | BENECO |
|
| SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 ) |
| Policy contract number | 234615 |
| Policy instance | 1 |
| Insurance contract or identification number | 234615 | | Number of Individuals Covered | 3 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $398 | | Total amount of fees paid to insurance company | USD $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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $3,917 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | | Commission paid to Insurance Broker | USD $398 | | Insurance broker organization code? | 3 | | Insurance broker name | BENECO |
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| SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 ) |
| Policy contract number | 100-5280-00 |
| Policy instance | 1 |
| Insurance contract or identification number | 100-5280-00 | | Number of Individuals Covered | 3 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $285 | | Total amount of fees paid to insurance company | USD $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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $2,429 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $285 | | Insurance broker organization code? | 3 | | Insurance broker name | RHETT R. SMITH |
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| SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 ) |
| Policy contract number | 100-5280-00 |
| Policy instance | 1 |
| Insurance contract or identification number | 100-5280-00 | | Number of Individuals Covered | 3 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $489 | | Total amount of fees paid to insurance company | USD $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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $3,257 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $489 | | Insurance broker organization code? | 3 | | Insurance broker name | RHETT R. SMITH |
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| SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 ) |
| Policy contract number | 100-5280-00 |
| Policy instance | 1 |
| Insurance contract or identification number | 100-5280-00 | | Number of Individuals Covered | 3 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $439 | | Total amount of fees paid to insurance company | USD $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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $3,193 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $439 | | Insurance broker organization code? | 3 | | Insurance broker name | RHETT R. SMITH |
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| SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 ) |
| Policy contract number | 100-5280-00 |
| Policy instance | 1 |
| Insurance contract or identification number | 100-5280-00 | | Number of Individuals Covered | 3 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $519 | | Total amount of fees paid to insurance company | USD $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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $3,193 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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| SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 ) |
| Policy contract number | 100-5280-00 |
| Policy instance | 1 |
| Insurance contract or identification number | 100-5280-00 | | Number of Individuals Covered | 3 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $479 | | Total amount of fees paid to insurance company | USD $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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $3,193 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $479 | | Insurance broker organization code? | 3 | | Insurance broker name | RHETT R. SMITH |
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