P.C. RICHARD & SON LONG ISLAND CORP has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan GROUP LIFE & AD&D FOR EMPLOYEES OF P.C. RICHARD & SON
401k plan membership statisitcs for GROUP LIFE & AD&D FOR EMPLOYEES OF P.C. RICHARD & SON
| Measure | Date | Value |
|---|
| 2022: GROUP LIFE & AD&D FOR EMPLOYEES OF P.C. RICHARD & SON 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-01-01 | 2,056 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 1,904 |
| Total of all active and inactive participants | 2022-01-01 | 1,904 |
| 2021: GROUP LIFE & AD&D FOR EMPLOYEES OF P.C. RICHARD & SON 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-01-01 | 2,001 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 2,056 |
| Total of all active and inactive participants | 2021-01-01 | 2,056 |
| 2020: GROUP LIFE & AD&D FOR EMPLOYEES OF P.C. RICHARD & SON 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-01-01 | 1,970 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 2,001 |
| Total of all active and inactive participants | 2020-01-01 | 2,001 |
| 2019: GROUP LIFE & AD&D FOR EMPLOYEES OF P.C. RICHARD & SON 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-01-01 | 1,956 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 1,970 |
| Total of all active and inactive participants | 2019-01-01 | 1,970 |
| 2018: GROUP LIFE & AD&D FOR EMPLOYEES OF P.C. RICHARD & SON 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-01-01 | 2,021 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 1,956 |
| Total of all active and inactive participants | 2018-01-01 | 1,956 |
| 2017: GROUP LIFE & AD&D FOR EMPLOYEES OF P.C. RICHARD & SON 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-01-01 | 2,066 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 2,021 |
| Total of all active and inactive participants | 2017-01-01 | 2,021 |
| Total participants | 2017-01-01 | 2,021 |
| 2016: GROUP LIFE & AD&D FOR EMPLOYEES OF P.C. RICHARD & SON 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-01-01 | 2,162 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 2,066 |
| 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 | 2,066 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2016-01-01 | 0 |
| Total participants | 2016-01-01 | 2,066 |
| 2015: GROUP LIFE & AD&D FOR EMPLOYEES OF P.C. RICHARD & SON 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-01-01 | 2,148 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 2,162 |
| Total of all active and inactive participants | 2015-01-01 | 2,162 |
| Total participants | 2015-01-01 | 2,162 |
| 2014: GROUP LIFE & AD&D FOR EMPLOYEES OF P.C. RICHARD & SON 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-01-01 | 2,255 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 2,148 |
| Total of all active and inactive participants | 2014-01-01 | 2,148 |
| Total participants | 2014-01-01 | 2,148 |
| 2013: GROUP LIFE & AD&D FOR EMPLOYEES OF P.C. RICHARD & SON 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-01-01 | 2,200 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 2,255 |
| 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 | 2,255 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2013-01-01 | 0 |
| Total participants | 2013-01-01 | 2,255 |
| 2012: GROUP LIFE & AD&D FOR EMPLOYEES OF P.C. RICHARD & SON 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-01-01 | 2,309 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 2,200 |
| 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 | 2,200 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2012-01-01 | 0 |
| Total participants | 2012-01-01 | 2,200 |
| 2011: GROUP LIFE & AD&D FOR EMPLOYEES OF P.C. RICHARD & SON 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-01-01 | 2,409 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 2,309 |
| 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 | 2,309 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2011-01-01 | 0 |
| Total participants | 2011-01-01 | 2,309 |
| 2009: GROUP LIFE & AD&D FOR EMPLOYEES OF P.C. RICHARD & SON 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-01-01 | 2,005 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 2,218 |
| 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 | 2,218 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2009-01-01 | 0 |
| Total participants | 2009-01-01 | 2,218 |
| 2022: GROUP LIFE & AD&D FOR EMPLOYEES OF P.C. RICHARD & SON 2022 form 5500 responses |
|---|
| 2022-01-01 | Type of plan entity | Single employer plan |
| 2022-01-01 | Plan funding arrangement – Insurance | Yes |
| 2022-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2021: GROUP LIFE & AD&D FOR EMPLOYEES OF P.C. RICHARD & SON 2021 form 5500 responses |
|---|
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | Plan funding arrangement – Insurance | Yes |
| 2021-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2020: GROUP LIFE & AD&D FOR EMPLOYEES OF P.C. RICHARD & SON 2020 form 5500 responses |
|---|
| 2020-01-01 | Type of plan entity | Single employer plan |
| 2020-01-01 | Plan funding arrangement – Insurance | Yes |
| 2020-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2019: GROUP LIFE & AD&D FOR EMPLOYEES OF P.C. RICHARD & SON 2019 form 5500 responses |
|---|
| 2019-01-01 | Type of plan entity | Single employer plan |
| 2019-01-01 | Plan funding arrangement – Insurance | Yes |
| 2019-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: GROUP LIFE & AD&D FOR EMPLOYEES OF P.C. RICHARD & SON 2018 form 5500 responses |
|---|
| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | Plan funding arrangement – Insurance | Yes |
| 2018-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: GROUP LIFE & AD&D FOR EMPLOYEES OF P.C. RICHARD & SON 2017 form 5500 responses |
|---|
| 2017-01-01 | Type of plan entity | Single employer plan |
| 2017-01-01 | Plan funding arrangement – Insurance | Yes |
| 2017-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: GROUP LIFE & AD&D FOR EMPLOYEES OF P.C. RICHARD & SON 2016 form 5500 responses |
|---|
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | Plan funding arrangement – Insurance | Yes |
| 2016-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: GROUP LIFE & AD&D FOR EMPLOYEES OF P.C. RICHARD & SON 2015 form 5500 responses |
|---|
| 2015-01-01 | Type of plan entity | Single employer plan |
| 2015-01-01 | Plan funding arrangement – Insurance | Yes |
| 2015-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: GROUP LIFE & AD&D FOR EMPLOYEES OF P.C. RICHARD & SON 2014 form 5500 responses |
|---|
| 2014-01-01 | Type of plan entity | Single employer plan |
| 2014-01-01 | Plan funding arrangement – Insurance | Yes |
| 2014-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: GROUP LIFE & AD&D FOR EMPLOYEES OF P.C. RICHARD & SON 2013 form 5500 responses |
|---|
| 2013-01-01 | Type of plan entity | Single employer plan |
| 2013-01-01 | Plan funding arrangement – Insurance | Yes |
| 2013-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: GROUP LIFE & AD&D FOR EMPLOYEES OF P.C. RICHARD & SON 2012 form 5500 responses |
|---|
| 2012-01-01 | Type of plan entity | Single employer plan |
| 2012-01-01 | Plan funding arrangement – Insurance | Yes |
| 2012-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: GROUP LIFE & AD&D FOR EMPLOYEES OF P.C. RICHARD & SON 2011 form 5500 responses |
|---|
| 2011-01-01 | Type of plan entity | Single employer plan |
| 2011-01-01 | Submission has been amended | Yes |
| 2011-01-01 | Plan funding arrangement – Insurance | Yes |
| 2011-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: GROUP LIFE & AD&D FOR EMPLOYEES OF P.C. RICHARD & SON 2009 form 5500 responses |
|---|
| 2009-01-01 | Type of plan entity | Single employer plan |
| 2009-01-01 | Plan funding arrangement – Insurance | Yes |
| 2009-01-01 | Plan benefit arrangement – Insurance | Yes |
| FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71005 ) |
| Policy contract number | GL159268 |
| Policy instance | 1 |
| Insurance contract or identification number | GL159268 | | Number of Individuals Covered | 1904 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2022-06-30 | | Total amount of commissions paid to insurance broker | USD $3,405 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $43,658 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,405 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | BROKER COMMISSION | | Insurance broker organization code? | 3 |
|
| FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71005 ) |
| Policy contract number | GL159268 |
| Policy instance | 1 |
| Insurance contract or identification number | GL159268 | | Number of Individuals Covered | 2056 | | Insurance policy start date | 2020-07-01 | | Insurance policy end date | 2021-06-30 | | Total amount of commissions paid to insurance broker | USD $3,719 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $47,673 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,719 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | BROKER COMMISSION | | Insurance broker organization code? | 3 |
|
| FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71005 ) |
| Policy contract number | GL159268 |
| Policy instance | 1 |
| Insurance contract or identification number | GL159268 | | Number of Individuals Covered | 2001 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2020-06-30 | | Total amount of commissions paid to insurance broker | USD $3,264 | | Total amount of fees paid to insurance company | USD $1,073 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $41,849 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,264 | | Amount paid for insurance broker fees | 1073 | | Additional information about fees paid to insurance broker | BROKER COMMISSION | | Insurance broker organization code? | 3 |
|
| FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71005 ) |
| Policy contract number | GL159268 |
| Policy instance | 1 |
| Insurance contract or identification number | GL159268 | | Number of Individuals Covered | 1970 | | Insurance policy start date | 2018-07-01 | | Insurance policy end date | 2019-06-30 | | Total amount of commissions paid to insurance broker | USD $3,238 | | Total amount of fees paid to insurance company | USD $740 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $41,519 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,238 | | Amount paid for insurance broker fees | 740 | | Additional information about fees paid to insurance broker | BROKER COMMISSION | | Insurance broker organization code? | 3 |
|
| FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71005 ) |
| Policy contract number | GL159268 |
| Policy instance | 2 |
| Insurance contract or identification number | GL159268 | | Number of Individuals Covered | 1956 | | Insurance policy start date | 2018-07-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $1,443 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $18,502 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,443 | | Additional information about fees paid to insurance broker | BROKER COMMISSION | | Insurance broker organization code? | 3 |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 107050 |
| Policy instance | 1 |
| Insurance contract or identification number | 107050 | | Number of Individuals Covered | 1975 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-06-30 | | Total amount of commissions paid to insurance broker | USD $1,338 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $22,864 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,338 | | Additional information about fees paid to insurance broker | BROKER COMMISSION | | Insurance broker organization code? | 3 |
|
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) |
| Policy contract number | 107050 |
| Policy instance | 2 |
| Insurance contract or identification number | 107050 | | Number of Individuals Covered | 2021 | | Insurance policy start date | 2017-07-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $1,195 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $22,969 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,195 | | Additional information about fees paid to insurance broker | BROKER COMMISSION | | Insurance broker organization code? | 3 | | Insurance broker name | KINLOCH CONSULTING GROUP, INC. |
|
| LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 ) |
| Policy contract number | SA382009267201 |
| Policy instance | 1 |
| Insurance contract or identification number | SA382009267201 | | Number of Individuals Covered | 2042 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-06-30 | | Total amount of commissions paid to insurance broker | USD $3,411 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $26,205 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,411 | | Additional information about fees paid to insurance broker | BROKER COMMISSION | | Insurance broker organization code? | 3 | | Insurance broker name | KINLOCH CONSULTING GROUP, INC. |
|
| LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 ) |
| Policy contract number | SA382009267201 |
| Policy instance | 1 |
| Insurance contract or identification number | SA382009267201 | | Number of Individuals Covered | 2162 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $4,343 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $55,709 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,343 | | Additional information about fees paid to insurance broker | BROKER COMMISSION | | Insurance broker organization code? | 3 | | Insurance broker name | KINLOCH CONSULTING GROUP, INC. |
|
| LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 ) |
| Policy contract number | SA382009267201 |
| Policy instance | 1 |
| Insurance contract or identification number | SA382009267201 | | Number of Individuals Covered | 2148 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $4,733 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $55,497 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,733 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | BROKER COMMISSION | | Insurance broker organization code? | 3 | | Insurance broker name | KINLOCH CONSULTING GROUP, INC. |
|
| LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 ) |
| Policy contract number | SA382009267201 |
| Policy instance | 1 |
| Insurance contract or identification number | SA382009267201 | | Number of Individuals Covered | 2255 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $4,102 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $57,583 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,102 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | BROKER COMMISSION | | Insurance broker organization code? | 3 | | Insurance broker name | KINLOCH CONSULTING GROUP, INC. |
|
| LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 ) |
| Policy contract number | SA382009267201 |
| Policy instance | 1 |
| Insurance contract or identification number | SA382009267201 | | Number of Individuals Covered | 2200 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $4,393 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $50,035 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,393 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | BROKER COMMISSION | | Insurance broker organization code? | 3 | | Insurance broker name | KINLOCH CONSULTING GROUP, INC. |
|
| LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 ) |
| Policy contract number | SA382009267201 |
| Policy instance | 1 |
| Insurance contract or identification number | SA382009267201 | | Number of Individuals Covered | 2309 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $3,750 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $47,916 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 ) |
| Policy contract number | SA382009267201 |
| Policy instance | 1 |
| Insurance contract or identification number | SA382009267201 | | Number of Individuals Covered | 2409 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $4,183 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $47,532 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,183 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | BROKER COMMISSION | | Insurance broker organization code? | 3 | | Insurance broker name | KINLOCH CONSULTING GROUP, INC. |
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