THE ROCKEFELLER UNIVERSITY has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan VOLUNTARY ACCIDENTAL DEATH AND DISMEMBERMENT
Measure | Date | Value |
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2022: VOLUNTARY ACCIDENTAL DEATH AND DISMEMBERMENT 2022 401k membership |
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Total participants, beginning-of-year | 2022-02-01 | 267 |
Total number of active participants reported on line 7a of the Form 5500 | 2022-02-01 | 275 |
Number of retired or separated participants receiving benefits | 2022-02-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2022-02-01 | 0 |
Total of all active and inactive participants | 2022-02-01 | 275 |
Total participants | 2022-02-01 | 275 |
2021: VOLUNTARY ACCIDENTAL DEATH AND DISMEMBERMENT 2021 401k membership |
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Total participants, beginning-of-year | 2021-02-01 | 283 |
Total number of active participants reported on line 7a of the Form 5500 | 2021-02-01 | 269 |
Number of retired or separated participants receiving benefits | 2021-02-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2021-02-01 | 0 |
Total of all active and inactive participants | 2021-02-01 | 269 |
Total participants | 2021-02-01 | 269 |
2020: VOLUNTARY ACCIDENTAL DEATH AND DISMEMBERMENT 2020 401k membership |
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Total participants, beginning-of-year | 2020-02-01 | 281 |
Total number of active participants reported on line 7a of the Form 5500 | 2020-02-01 | 283 |
Number of retired or separated participants receiving benefits | 2020-02-01 | 0 |
Total of all active and inactive participants | 2020-02-01 | 283 |
Total participants | 2020-02-01 | 283 |
2019: VOLUNTARY ACCIDENTAL DEATH AND DISMEMBERMENT 2019 401k membership |
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Total participants, beginning-of-year | 2019-02-01 | 278 |
Total number of active participants reported on line 7a of the Form 5500 | 2019-02-01 | 285 |
Total of all active and inactive participants | 2019-02-01 | 285 |
Total participants | 2019-02-01 | 285 |
2018: VOLUNTARY ACCIDENTAL DEATH AND DISMEMBERMENT 2018 401k membership |
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Total participants, beginning-of-year | 2018-02-01 | 284 |
Total number of active participants reported on line 7a of the Form 5500 | 2018-02-01 | 280 |
Total of all active and inactive participants | 2018-02-01 | 280 |
Total participants | 2018-02-01 | 280 |
2017: VOLUNTARY ACCIDENTAL DEATH AND DISMEMBERMENT 2017 401k membership |
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Total participants, beginning-of-year | 2017-02-01 | 288 |
Total number of active participants reported on line 7a of the Form 5500 | 2017-02-01 | 284 |
Total of all active and inactive participants | 2017-02-01 | 284 |
Total participants | 2017-02-01 | 284 |
2016: VOLUNTARY ACCIDENTAL DEATH AND DISMEMBERMENT 2016 401k membership |
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Total participants, beginning-of-year | 2016-02-01 | 277 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-02-01 | 288 |
Total of all active and inactive participants | 2016-02-01 | 288 |
Total participants | 2016-02-01 | 288 |
2015: VOLUNTARY ACCIDENTAL DEATH AND DISMEMBERMENT 2015 401k membership |
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Total participants, beginning-of-year | 2015-02-01 | 266 |
Total number of active participants reported on line 7a of the Form 5500 | 2015-02-01 | 277 |
Total of all active and inactive participants | 2015-02-01 | 277 |
Total participants | 2015-02-01 | 277 |
2014: VOLUNTARY ACCIDENTAL DEATH AND DISMEMBERMENT 2014 401k membership |
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Total participants, beginning-of-year | 2014-02-01 | 262 |
Total number of active participants reported on line 7a of the Form 5500 | 2014-02-01 | 266 |
Total of all active and inactive participants | 2014-02-01 | 266 |
Total participants | 2014-02-01 | 266 |
2013: VOLUNTARY ACCIDENTAL DEATH AND DISMEMBERMENT 2013 401k membership |
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Total participants, beginning-of-year | 2013-02-01 | 267 |
Total number of active participants reported on line 7a of the Form 5500 | 2013-02-01 | 272 |
Number of retired or separated participants receiving benefits | 2013-02-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2013-02-01 | 0 |
Total of all active and inactive participants | 2013-02-01 | 272 |
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2013-02-01 | 0 |
Total participants | 2013-02-01 | 272 |
2012: VOLUNTARY ACCIDENTAL DEATH AND DISMEMBERMENT 2012 401k membership |
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Total participants, beginning-of-year | 2012-02-01 | 280 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-02-01 | 267 |
Number of retired or separated participants receiving benefits | 2012-02-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2012-02-01 | 0 |
Total of all active and inactive participants | 2012-02-01 | 267 |
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2012-02-01 | 0 |
Total participants | 2012-02-01 | 267 |
2011: VOLUNTARY ACCIDENTAL DEATH AND DISMEMBERMENT 2011 401k membership |
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Total participants, beginning-of-year | 2011-02-01 | 289 |
Total number of active participants reported on line 7a of the Form 5500 | 2011-02-01 | 280 |
Number of retired or separated participants receiving benefits | 2011-02-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2011-02-01 | 0 |
Total of all active and inactive participants | 2011-02-01 | 280 |
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2011-02-01 | 0 |
Total participants | 2011-02-01 | 280 |
2010: VOLUNTARY ACCIDENTAL DEATH AND DISMEMBERMENT 2010 401k membership |
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Total participants, beginning-of-year | 2010-02-01 | 304 |
Total number of active participants reported on line 7a of the Form 5500 | 2010-02-01 | 289 |
Number of retired or separated participants receiving benefits | 2010-02-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2010-02-01 | 0 |
Total of all active and inactive participants | 2010-02-01 | 289 |
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2010-02-01 | 0 |
Total participants | 2010-02-01 | 289 |
2009: VOLUNTARY ACCIDENTAL DEATH AND DISMEMBERMENT 2009 401k membership |
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Total participants, beginning-of-year | 2009-02-01 | 317 |
Total number of active participants reported on line 7a of the Form 5500 | 2009-02-01 | 304 |
Number of retired or separated participants receiving benefits | 2009-02-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2009-02-01 | 0 |
Total of all active and inactive participants | 2009-02-01 | 304 |
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2009-02-01 | 0 |
Total participants | 2009-02-01 | 304 |
Number of participants with account balances | 2009-02-01 | 0 |
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2009-02-01 | 0 |
2022: VOLUNTARY ACCIDENTAL DEATH AND DISMEMBERMENT 2022 form 5500 responses |
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2022-02-01 | Type of plan entity | Single employer plan |
2022-02-01 | Submission has been amended | No |
2022-02-01 | This submission is the final filing | No |
2022-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2022-02-01 | Plan is a collectively bargained plan | No |
2022-02-01 | Plan funding arrangement – Insurance | Yes |
2022-02-01 | Plan benefit arrangement – Insurance | Yes |
2021: VOLUNTARY ACCIDENTAL DEATH AND DISMEMBERMENT 2021 form 5500 responses |
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2021-02-01 | Type of plan entity | Single employer plan |
2021-02-01 | Submission has been amended | No |
2021-02-01 | This submission is the final filing | No |
2021-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2021-02-01 | Plan is a collectively bargained plan | No |
2021-02-01 | Plan funding arrangement – Insurance | Yes |
2021-02-01 | Plan benefit arrangement – Insurance | Yes |
2020: VOLUNTARY ACCIDENTAL DEATH AND DISMEMBERMENT 2020 form 5500 responses |
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2020-02-01 | Type of plan entity | Single employer plan |
2020-02-01 | Submission has been amended | No |
2020-02-01 | This submission is the final filing | No |
2020-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2020-02-01 | Plan is a collectively bargained plan | No |
2020-02-01 | Plan funding arrangement – Insurance | Yes |
2020-02-01 | Plan benefit arrangement – Insurance | Yes |
2019: VOLUNTARY ACCIDENTAL DEATH AND DISMEMBERMENT 2019 form 5500 responses |
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2019-02-01 | Type of plan entity | Single employer plan |
2019-02-01 | Submission has been amended | No |
2019-02-01 | This submission is the final filing | No |
2019-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2019-02-01 | Plan is a collectively bargained plan | No |
2019-02-01 | Plan funding arrangement – Insurance | Yes |
2019-02-01 | Plan benefit arrangement – Insurance | Yes |
2018: VOLUNTARY ACCIDENTAL DEATH AND DISMEMBERMENT 2018 form 5500 responses |
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2018-02-01 | Type of plan entity | Single employer plan |
2018-02-01 | Submission has been amended | No |
2018-02-01 | This submission is the final filing | No |
2018-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2018-02-01 | Plan is a collectively bargained plan | No |
2018-02-01 | Plan funding arrangement – Insurance | Yes |
2018-02-01 | Plan benefit arrangement – Insurance | Yes |
2017: VOLUNTARY ACCIDENTAL DEATH AND DISMEMBERMENT 2017 form 5500 responses |
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2017-02-01 | Type of plan entity | Single employer plan |
2017-02-01 | Submission has been amended | No |
2017-02-01 | This submission is the final filing | No |
2017-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2017-02-01 | Plan is a collectively bargained plan | No |
2017-02-01 | Plan funding arrangement – Insurance | Yes |
2017-02-01 | Plan benefit arrangement – Insurance | Yes |
2016: VOLUNTARY ACCIDENTAL DEATH AND DISMEMBERMENT 2016 form 5500 responses |
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2016-02-01 | Type of plan entity | Single employer plan |
2016-02-01 | Submission has been amended | No |
2016-02-01 | This submission is the final filing | No |
2016-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2016-02-01 | Plan is a collectively bargained plan | No |
2016-02-01 | Plan funding arrangement – Insurance | Yes |
2016-02-01 | Plan benefit arrangement – Insurance | Yes |
2015: VOLUNTARY ACCIDENTAL DEATH AND DISMEMBERMENT 2015 form 5500 responses |
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2015-02-01 | Type of plan entity | Single employer plan |
2015-02-01 | Submission has been amended | No |
2015-02-01 | This submission is the final filing | No |
2015-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2015-02-01 | Plan is a collectively bargained plan | No |
2015-02-01 | Plan funding arrangement – Insurance | Yes |
2015-02-01 | Plan benefit arrangement – Insurance | Yes |
2014: VOLUNTARY ACCIDENTAL DEATH AND DISMEMBERMENT 2014 form 5500 responses |
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2014-02-01 | Type of plan entity | Single employer plan |
2014-02-01 | Submission has been amended | No |
2014-02-01 | This submission is the final filing | No |
2014-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2014-02-01 | Plan is a collectively bargained plan | No |
2014-02-01 | Plan funding arrangement – Insurance | Yes |
2014-02-01 | Plan benefit arrangement – Insurance | Yes |
2013: VOLUNTARY ACCIDENTAL DEATH AND DISMEMBERMENT 2013 form 5500 responses |
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2013-02-01 | Type of plan entity | Single employer plan |
2013-02-01 | Submission has been amended | No |
2013-02-01 | This submission is the final filing | No |
2013-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2013-02-01 | Plan is a collectively bargained plan | No |
2013-02-01 | Plan funding arrangement – Insurance | Yes |
2013-02-01 | Plan benefit arrangement – Insurance | Yes |
2012: VOLUNTARY ACCIDENTAL DEATH AND DISMEMBERMENT 2012 form 5500 responses |
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2012-02-01 | Type of plan entity | Single employer plan |
2012-02-01 | Submission has been amended | No |
2012-02-01 | This submission is the final filing | No |
2012-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2012-02-01 | Plan is a collectively bargained plan | No |
2012-02-01 | Plan funding arrangement – Insurance | Yes |
2012-02-01 | Plan benefit arrangement – Insurance | Yes |
2011: VOLUNTARY ACCIDENTAL DEATH AND DISMEMBERMENT 2011 form 5500 responses |
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2011-02-01 | Type of plan entity | Single employer plan |
2011-02-01 | Submission has been amended | No |
2011-02-01 | This submission is the final filing | No |
2011-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2011-02-01 | Plan is a collectively bargained plan | No |
2011-02-01 | Plan funding arrangement – Insurance | Yes |
2011-02-01 | Plan benefit arrangement – Insurance | Yes |
2010: VOLUNTARY ACCIDENTAL DEATH AND DISMEMBERMENT 2010 form 5500 responses |
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2010-02-01 | Type of plan entity | Single employer plan |
2010-02-01 | Submission has been amended | No |
2010-02-01 | This submission is the final filing | No |
2010-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2010-02-01 | Plan is a collectively bargained plan | No |
2010-02-01 | Plan funding arrangement – Insurance | Yes |
2010-02-01 | Plan benefit arrangement – Insurance | Yes |
2009: VOLUNTARY ACCIDENTAL DEATH AND DISMEMBERMENT 2009 form 5500 responses |
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2009-02-01 | Type of plan entity | Single employer plan |
2009-02-01 | Submission has been amended | No |
2009-02-01 | This submission is the final filing | No |
2009-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2009-02-01 | Plan is a collectively bargained plan | No |
2009-02-01 | Plan funding arrangement – Insurance | Yes |
2009-02-01 | Plan benefit arrangement – Insurance | Yes |
NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 ) |
Policy contract number | PAI0009133323B |
Policy instance | 1 |
Insurance contract or identification number | PAI0009133323B | Number of Individuals Covered | 275 | Insurance policy start date | 2022-02-01 | Insurance policy end date | 2023-01-31 | Total amount of commissions paid to insurance broker | USD $4,670 | 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 | No | 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 | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | 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 $23,230 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,667 | Insurance broker organization code? | 3 |
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NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 ) |
Policy contract number | PAI0009133323B |
Policy instance | 1 |
Insurance contract or identification number | PAI0009133323B | Number of Individuals Covered | 269 | Insurance policy start date | 2021-02-01 | Insurance policy end date | 2022-02-01 | Total amount of commissions paid to insurance broker | USD $4,667 | 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 | No | 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 | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | 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 $23,336 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,667 | Insurance broker organization code? | 3 |
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NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 ) |
Policy contract number | PAI0009133323B |
Policy instance | 1 |
Insurance contract or identification number | PAI0009133323B | Number of Individuals Covered | 283 | Insurance policy start date | 2020-02-01 | Insurance policy end date | 2021-01-31 | Total amount of commissions paid to insurance broker | USD $4,635 | 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 | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | 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 $23,176 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,635 | Insurance broker organization code? | 3 |
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NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 ) |
Policy contract number | PAI0009133323A |
Policy instance | 1 |
Insurance contract or identification number | PAI0009133323A | Number of Individuals Covered | 285 | Insurance policy start date | 2019-02-01 | Insurance policy end date | 2020-01-31 | Total amount of commissions paid to insurance broker | USD $4,820 | 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 | No | 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 | Other welfare benefits provided | VOLUNTARY ACCIDENTAL DEATH & DISMEMBERMENT | 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 $21,953 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,820 | Insurance broker organization code? | 3 |
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NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 ) |
Policy contract number | PAI0009133323A |
Policy instance | 1 |
Insurance contract or identification number | PAI0009133323A | Number of Individuals Covered | 280 | Insurance policy start date | 2018-02-01 | Insurance policy end date | 2019-01-31 | Total amount of commissions paid to insurance broker | USD $5,057 | 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 | No | 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 | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | 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 $25,286 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 5057 | Insurance broker organization code? | 3 |
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NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 ) |
Policy contract number | PAI0009133323A |
Policy instance | 1 |
Insurance contract or identification number | PAI0009133323A | Number of Individuals Covered | 284 | Insurance policy start date | 2017-02-01 | Insurance policy end date | 2018-01-31 | Total amount of commissions paid to insurance broker | USD $4,823 | 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 | No | 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 | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | 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 $24,114 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,823 | Insurance broker organization code? | 3 | Insurance broker name | WILLIS OF NEW YORK, INC. |
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