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GROUP DENTAL INSURANCE AND VISION SERVICE PLAN 401k Plan overview

Plan NameGROUP DENTAL INSURANCE AND VISION SERVICE PLAN
Plan identification number 502

GROUP DENTAL INSURANCE AND VISION SERVICE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Dental
  • Vision
  • Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

THE AMERICAN SOCIETY FOR THE PREVENTION OF CRUELTY TO ANIMALS has sponsored the creation of one or more 401k plans.

Company Name:THE AMERICAN SOCIETY FOR THE PREVENTION OF CRUELTY TO ANIMALS
Employer identification number (EIN):131623829
NAIC Classification:541940
NAIC Description:Veterinary Services

Additional information about THE AMERICAN SOCIETY FOR THE PREVENTION OF CRUELTY TO ANIMALS

Jurisdiction of Incorporation: New York Department of State
Incorporation Date: 1866-01-01
Company Identification Number: 165
Legal Registered Office Address: 424 EAST 92ND STREET
New York
NEW YORK
United States of America (USA)
10128

More information about THE AMERICAN SOCIETY FOR THE PREVENTION OF CRUELTY TO ANIMALS

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GROUP DENTAL INSURANCE AND VISION SERVICE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022021-01-01
5022021-01-01
5022020-01-01
5022019-01-01
5022018-01-01
5022017-01-01PETER ACCINNO
5022016-01-01PETER ACCINNO
5022015-01-01JOHANNA RICHMAN
5022014-03-01JOHANNA RICHMAN
5022013-03-01JOHANNA RICHMAN JOHANNA RICHMAN2014-10-15
5022012-03-01MARK ABRAHAMS
5022011-03-01MARK ABRAHAMS
5022010-03-01JULIA NELSON
5022009-03-01JULIA NELSON

Plan Statistics for GROUP DENTAL INSURANCE AND VISION SERVICE PLAN

401k plan membership statisitcs for GROUP DENTAL INSURANCE AND VISION SERVICE PLAN

Measure Date Value
2021: GROUP DENTAL INSURANCE AND VISION SERVICE PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01954
Total number of active participants reported on line 7a of the Form 55002021-01-011,040
Number of retired or separated participants receiving benefits2021-01-0113
Total of all active and inactive participants2021-01-011,053
Total participants2021-01-011,053
2020: GROUP DENTAL INSURANCE AND VISION SERVICE PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01966
Total number of active participants reported on line 7a of the Form 55002020-01-01937
Number of retired or separated participants receiving benefits2020-01-0110
Total of all active and inactive participants2020-01-01947
Total participants2020-01-01947
2019: GROUP DENTAL INSURANCE AND VISION SERVICE PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01913
Total number of active participants reported on line 7a of the Form 55002019-01-01944
Number of retired or separated participants receiving benefits2019-01-0111
Total of all active and inactive participants2019-01-01955
Total participants2019-01-01955
2018: GROUP DENTAL INSURANCE AND VISION SERVICE PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01890
Total number of active participants reported on line 7a of the Form 55002018-01-01917
Number of retired or separated participants receiving benefits2018-01-0112
Total of all active and inactive participants2018-01-01929
Total participants2018-01-01929
2017: GROUP DENTAL INSURANCE AND VISION SERVICE PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01794
Total number of active participants reported on line 7a of the Form 55002017-01-01900
Number of retired or separated participants receiving benefits2017-01-019
Total of all active and inactive participants2017-01-01909
Total participants2017-01-01909
2016: GROUP DENTAL INSURANCE AND VISION SERVICE PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01706
Total number of active participants reported on line 7a of the Form 55002016-01-01772
Number of retired or separated participants receiving benefits2016-01-0111
Total of all active and inactive participants2016-01-01783
Total participants2016-01-01783
2015: GROUP DENTAL INSURANCE AND VISION SERVICE PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01679
Total number of active participants reported on line 7a of the Form 55002015-01-01701
Number of retired or separated participants receiving benefits2015-01-0110
Total of all active and inactive participants2015-01-01711
Total participants2015-01-01711
2014: GROUP DENTAL INSURANCE AND VISION SERVICE PLAN 2014 401k membership
Total participants, beginning-of-year2014-03-01674
Total number of active participants reported on line 7a of the Form 55002014-03-01658
Number of retired or separated participants receiving benefits2014-03-0113
Total of all active and inactive participants2014-03-01671
Total participants2014-03-01671
2013: GROUP DENTAL INSURANCE AND VISION SERVICE PLAN 2013 401k membership
Total participants, beginning-of-year2013-03-01638
Total number of active participants reported on line 7a of the Form 55002013-03-01632
Number of retired or separated participants receiving benefits2013-03-0123
Total of all active and inactive participants2013-03-01655
Total participants2013-03-01655
2012: GROUP DENTAL INSURANCE AND VISION SERVICE PLAN 2012 401k membership
Total participants, beginning-of-year2012-03-01570
Total number of active participants reported on line 7a of the Form 55002012-03-01624
Number of retired or separated participants receiving benefits2012-03-0114
Number of other retired or separated participants entitled to future benefits2012-03-010
Total of all active and inactive participants2012-03-01638
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-03-010
Total participants2012-03-01638
Number of participants with account balances2012-03-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-03-010
2011: GROUP DENTAL INSURANCE AND VISION SERVICE PLAN 2011 401k membership
Total participants, beginning-of-year2011-03-01477
Total number of active participants reported on line 7a of the Form 55002011-03-01536
Number of retired or separated participants receiving benefits2011-03-017
Number of other retired or separated participants entitled to future benefits2011-03-010
Total of all active and inactive participants2011-03-01543
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-03-010
Total participants2011-03-01543
Number of participants with account balances2011-03-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-03-010
2010: GROUP DENTAL INSURANCE AND VISION SERVICE PLAN 2010 401k membership
Total participants, beginning-of-year2010-03-01452
Total number of active participants reported on line 7a of the Form 55002010-03-01470
Number of retired or separated participants receiving benefits2010-03-017
Number of other retired or separated participants entitled to future benefits2010-03-010
Total of all active and inactive participants2010-03-01477
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-03-010
Total participants2010-03-01477
Number of participants with account balances2010-03-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-03-010
2009: GROUP DENTAL INSURANCE AND VISION SERVICE PLAN 2009 401k membership
Total participants, beginning-of-year2009-03-01437
Total number of active participants reported on line 7a of the Form 55002009-03-01446
Number of retired or separated participants receiving benefits2009-03-016
Number of other retired or separated participants entitled to future benefits2009-03-010
Total of all active and inactive participants2009-03-01452
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-03-010
Total participants2009-03-01452
Number of participants with account balances2009-03-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-03-010

Form 5500 Responses for GROUP DENTAL INSURANCE AND VISION SERVICE PLAN

2021: GROUP DENTAL INSURANCE AND VISION SERVICE PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingYes
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – InsuranceYes
2020: GROUP DENTAL INSURANCE AND VISION SERVICE PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – InsuranceYes
2019: GROUP DENTAL INSURANCE AND VISION SERVICE PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: GROUP DENTAL INSURANCE AND VISION SERVICE PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: GROUP DENTAL INSURANCE AND VISION SERVICE PLAN 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: GROUP DENTAL INSURANCE AND VISION SERVICE PLAN 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: GROUP DENTAL INSURANCE AND VISION SERVICE PLAN 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: GROUP DENTAL INSURANCE AND VISION SERVICE PLAN 2014 form 5500 responses
2014-03-01Type of plan entitySingle employer plan
2014-03-01Submission has been amendedNo
2014-03-01This submission is the final filingNo
2014-03-01This return/report is a short plan year return/report (less than 12 months)Yes
2014-03-01Plan is a collectively bargained planNo
2014-03-01Plan funding arrangement – InsuranceYes
2014-03-01Plan benefit arrangement – InsuranceYes
2013: GROUP DENTAL INSURANCE AND VISION SERVICE PLAN 2013 form 5500 responses
2013-03-01Type of plan entitySingle employer plan
2013-03-01Submission has been amendedNo
2013-03-01This submission is the final filingNo
2013-03-01This return/report is a short plan year return/report (less than 12 months)No
2013-03-01Plan is a collectively bargained planNo
2013-03-01Plan funding arrangement – InsuranceYes
2013-03-01Plan benefit arrangement – InsuranceYes
2012: GROUP DENTAL INSURANCE AND VISION SERVICE PLAN 2012 form 5500 responses
2012-03-01Type of plan entitySingle employer plan
2012-03-01Submission has been amendedNo
2012-03-01This submission is the final filingNo
2012-03-01This return/report is a short plan year return/report (less than 12 months)No
2012-03-01Plan is a collectively bargained planNo
2012-03-01Plan funding arrangement – InsuranceYes
2012-03-01Plan benefit arrangement – InsuranceYes
2011: GROUP DENTAL INSURANCE AND VISION SERVICE PLAN 2011 form 5500 responses
2011-03-01Type of plan entitySingle employer plan
2011-03-01Submission has been amendedNo
2011-03-01This submission is the final filingNo
2011-03-01This return/report is a short plan year return/report (less than 12 months)No
2011-03-01Plan is a collectively bargained planNo
2011-03-01Plan funding arrangement – InsuranceYes
2011-03-01Plan benefit arrangement – InsuranceYes
2010: GROUP DENTAL INSURANCE AND VISION SERVICE PLAN 2010 form 5500 responses
2010-03-01Type of plan entitySingle employer plan
2010-03-01Submission has been amendedNo
2010-03-01This submission is the final filingNo
2010-03-01This return/report is a short plan year return/report (less than 12 months)No
2010-03-01Plan is a collectively bargained planNo
2010-03-01Plan funding arrangement – InsuranceYes
2010-03-01Plan benefit arrangement – InsuranceYes
2009: GROUP DENTAL INSURANCE AND VISION SERVICE PLAN 2009 form 5500 responses
2009-03-01Type of plan entitySingle employer plan
2009-03-01Submission has been amendedNo
2009-03-01This submission is the final filingNo
2009-03-01This return/report is a short plan year return/report (less than 12 months)No
2009-03-01Plan is a collectively bargained planNo
2009-03-01Plan funding arrangement – InsuranceYes
2009-03-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00476154
Policy instance 1
Insurance contract or identification number00476154
Number of Individuals Covered1053
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of fees paid to insurance companyUSD $12,731
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 BenefitYes
Vision Insurance Welfare BenefitYes
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 $895,845
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees12731
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00476154
Policy instance 1
Insurance contract or identification number00476154
Number of Individuals Covered947
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of fees paid to insurance companyUSD $6,408
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 BenefitYes
Vision Insurance Welfare BenefitYes
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 $915,280
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees6408
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00476154
Policy instance 1
Insurance contract or identification number00476154
Number of Individuals Covered960
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $43,147
Total amount of fees paid to insurance companyUSD $14,337
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 BenefitYes
Vision Insurance Welfare BenefitYes
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 $935,972
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $43,147
Amount paid for insurance broker fees14337
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00476154
Policy instance 1
Insurance contract or identification number00476154
Number of Individuals Covered929
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $48,148
Total amount of fees paid to insurance companyUSD $9,888
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 BenefitYes
Vision Insurance Welfare BenefitYes
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 $962,968
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $48,148
Amount paid for insurance broker fees9888
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00476154
Policy instance 1
Insurance contract or identification number00476154
Number of Individuals Covered909
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $40,479
Total amount of fees paid to insurance companyUSD $8,848
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 BenefitYes
Vision Insurance Welfare BenefitYes
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 $809,585
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $40,479
Amount paid for insurance broker fees8848
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
Insurance broker nameGA SOLUTIONS LLC
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00476154
Policy instance 1
Insurance contract or identification number00476154
Number of Individuals Covered701
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $43,464
Total amount of fees paid to insurance companyUSD $7,201
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $590,976
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $43,464
Amount paid for insurance broker fees7201
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
Insurance broker nameGA SOLUTIONS LLC
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00476154
Policy instance 1
Insurance contract or identification number00476154
Number of Individuals Covered658
Insurance policy start date2014-03-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $29,415
Total amount of fees paid to insurance companyUSD $9,580
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $391,135
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $29,415
Amount paid for insurance broker fees9580
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
Insurance broker nameGA SOLUTIONS LLC
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00476154
Policy instance 1
Insurance contract or identification number00476154
Number of Individuals Covered655
Insurance policy start date2013-03-01
Insurance policy end date2014-02-28
Total amount of commissions paid to insurance brokerUSD $26,948
Total amount of fees paid to insurance companyUSD $8,132
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $350,124
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $26,948
Amount paid for insurance broker fees8132
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
Insurance broker nameGA SOLUTIONS LLC
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00476154
Policy instance 1
Insurance contract or identification number00476154
Number of Individuals Covered638
Insurance policy start date2012-03-01
Insurance policy end date2013-02-28
Total amount of commissions paid to insurance brokerUSD $29,499
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $423,069
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $29,499
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameGA SOLUTIONS LLC
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberTS05402569
Policy instance 1
Insurance contract or identification numberTS05402569
Number of Individuals Covered996
Insurance policy start date2011-03-01
Insurance policy end date2012-02-29
Total amount of commissions paid to insurance brokerUSD $25,705
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $385,442
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberTS05402569
Policy instance 1
Insurance contract or identification numberTS05402569
Number of Individuals Covered871
Insurance policy start date2010-03-01
Insurance policy end date2011-02-28
Total amount of commissions paid to insurance brokerUSD $23,668
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $335,567
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $23,668
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker namePROFESSIONAL GROUP MARKETING INC

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