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GROUP LONG TERM DISABILITY, BASIC LIFE, BASIC ACCIDENTAL DEATH AND DISMEMBERMENT PLAN FOR THE EMPLOYEES OF GIBNEY, ANTHONY AND FLAHERTY LLP 401k Plan overview

Plan NameGROUP LONG TERM DISABILITY, BASIC LIFE, BASIC ACCIDENTAL DEATH AND DISMEMBERMENT PLAN FOR THE EMPLOYEES OF GIBNEY, ANTHONY AND FLAHERTY LLP
Plan identification number 501

GROUP LONG TERM DISABILITY, BASIC LIFE, BASIC ACCIDENTAL DEATH AND DISMEMBERMENT PLAN FOR THE EMPLOYEES OF GIBNEY, ANTHONY AND FLAHERTY LLP Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

GIBNEY, ANTHONY & FLAHERTY has sponsored the creation of one or more 401k plans.

Company Name:GIBNEY, ANTHONY & FLAHERTY
Employer identification number (EIN):131910984
NAIC Classification:541110
NAIC Description:Offices of Lawyers

Additional information about GIBNEY, ANTHONY & FLAHERTY

Jurisdiction of Incorporation: New York Department of State
Incorporation Date: 1994-11-30
Company Identification Number: 1871533
Legal Registered Office Address: 665 5TH AVE

NEW YORK
United States of America (USA)
10022

More information about GIBNEY, ANTHONY & FLAHERTY

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GROUP LONG TERM DISABILITY, BASIC LIFE, BASIC ACCIDENTAL DEATH AND DISMEMBERMENT PLAN FOR THE EMPLOYEES OF GIBNEY, ANTHONY AND FLAHERTY LLP

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-05-01ROBERT OKULSKI2023-12-22
5012021-05-01ROBERT V. OKULSKI2022-11-29
5012020-05-01KENNETH SACKS2021-10-12
5012019-05-01MEREDITH MAZZOLA2020-10-11
5012018-05-01KENNETH SACKS2019-11-04
5012017-05-01
5012016-05-01
5012015-05-01KENNETH SACKS KENNETH SACKS2016-08-04
5012014-05-01KENNETH SACKS KENNETH SACKS2015-08-26
5012013-11-01KENNETH SACKS KENNETH SACKS2015-08-26
5012012-11-01KENNETH SACKS KENNETH SACKS2014-04-28
5012011-11-01KENNETH SACKS KENNETH SACKS2013-05-17
5012009-11-01KENNETH SACKS

Plan Statistics for GROUP LONG TERM DISABILITY, BASIC LIFE, BASIC ACCIDENTAL DEATH AND DISMEMBERMENT PLAN FOR THE EMPLOYEES OF GIBNEY, ANTHONY AND FLAHERTY LLP

401k plan membership statisitcs for GROUP LONG TERM DISABILITY, BASIC LIFE, BASIC ACCIDENTAL DEATH AND DISMEMBERMENT PLAN FOR THE EMPLOYEES OF GIBNEY, ANTHONY AND FLAHERTY LLP

Measure Date Value
2022: GROUP LONG TERM DISABILITY, BASIC LIFE, BASIC ACCIDENTAL DEATH AND DISMEMBERMENT PLAN FOR THE EMPLOYEES OF GIBNEY, ANTHONY AND FLAHERTY LLP 2022 401k membership
Total participants, beginning-of-year2022-05-01131
Total number of active participants reported on line 7a of the Form 55002022-05-01121
Number of retired or separated participants receiving benefits2022-05-010
Number of other retired or separated participants entitled to future benefits2022-05-010
Total of all active and inactive participants2022-05-01121
Number of employers contributing to the scheme2022-05-010
2021: GROUP LONG TERM DISABILITY, BASIC LIFE, BASIC ACCIDENTAL DEATH AND DISMEMBERMENT PLAN FOR THE EMPLOYEES OF GIBNEY, ANTHONY AND FLAHERTY LLP 2021 401k membership
Total participants, beginning-of-year2021-05-01123
Total number of active participants reported on line 7a of the Form 55002021-05-01131
Number of retired or separated participants receiving benefits2021-05-010
Number of other retired or separated participants entitled to future benefits2021-05-010
Total of all active and inactive participants2021-05-01131
Number of employers contributing to the scheme2021-05-010
2020: GROUP LONG TERM DISABILITY, BASIC LIFE, BASIC ACCIDENTAL DEATH AND DISMEMBERMENT PLAN FOR THE EMPLOYEES OF GIBNEY, ANTHONY AND FLAHERTY LLP 2020 401k membership
Total participants, beginning-of-year2020-05-01119
Total number of active participants reported on line 7a of the Form 55002020-05-01123
Number of retired or separated participants receiving benefits2020-05-010
Number of other retired or separated participants entitled to future benefits2020-05-010
Total of all active and inactive participants2020-05-01123
Number of employers contributing to the scheme2020-05-010
2019: GROUP LONG TERM DISABILITY, BASIC LIFE, BASIC ACCIDENTAL DEATH AND DISMEMBERMENT PLAN FOR THE EMPLOYEES OF GIBNEY, ANTHONY AND FLAHERTY LLP 2019 401k membership
Total participants, beginning-of-year2019-05-01124
Total number of active participants reported on line 7a of the Form 55002019-05-01119
Number of retired or separated participants receiving benefits2019-05-010
Number of other retired or separated participants entitled to future benefits2019-05-010
Total of all active and inactive participants2019-05-01119
Number of employers contributing to the scheme2019-05-010
2018: GROUP LONG TERM DISABILITY, BASIC LIFE, BASIC ACCIDENTAL DEATH AND DISMEMBERMENT PLAN FOR THE EMPLOYEES OF GIBNEY, ANTHONY AND FLAHERTY LLP 2018 401k membership
Total participants, beginning-of-year2018-05-01123
Total number of active participants reported on line 7a of the Form 55002018-05-01124
Number of retired or separated participants receiving benefits2018-05-010
Number of other retired or separated participants entitled to future benefits2018-05-010
Total of all active and inactive participants2018-05-01124
Number of employers contributing to the scheme2018-05-010
2017: GROUP LONG TERM DISABILITY, BASIC LIFE, BASIC ACCIDENTAL DEATH AND DISMEMBERMENT PLAN FOR THE EMPLOYEES OF GIBNEY, ANTHONY AND FLAHERTY LLP 2017 401k membership
Total participants, beginning-of-year2017-05-01114
Total number of active participants reported on line 7a of the Form 55002017-05-01123
Number of retired or separated participants receiving benefits2017-05-010
Number of other retired or separated participants entitled to future benefits2017-05-010
Total of all active and inactive participants2017-05-01123
2016: GROUP LONG TERM DISABILITY, BASIC LIFE, BASIC ACCIDENTAL DEATH AND DISMEMBERMENT PLAN FOR THE EMPLOYEES OF GIBNEY, ANTHONY AND FLAHERTY LLP 2016 401k membership
Total participants, beginning-of-year2016-05-01115
Total number of active participants reported on line 7a of the Form 55002016-05-01114
Number of retired or separated participants receiving benefits2016-05-010
Number of other retired or separated participants entitled to future benefits2016-05-010
Total of all active and inactive participants2016-05-01114
2015: GROUP LONG TERM DISABILITY, BASIC LIFE, BASIC ACCIDENTAL DEATH AND DISMEMBERMENT PLAN FOR THE EMPLOYEES OF GIBNEY, ANTHONY AND FLAHERTY LLP 2015 401k membership
Total participants, beginning-of-year2015-05-01126
Total number of active participants reported on line 7a of the Form 55002015-05-01115
Total of all active and inactive participants2015-05-01115
Total participants2015-05-01115
2014: GROUP LONG TERM DISABILITY, BASIC LIFE, BASIC ACCIDENTAL DEATH AND DISMEMBERMENT PLAN FOR THE EMPLOYEES OF GIBNEY, ANTHONY AND FLAHERTY LLP 2014 401k membership
Total participants, beginning-of-year2014-05-01120
Total number of active participants reported on line 7a of the Form 55002014-05-01126
Total of all active and inactive participants2014-05-01126
Total participants2014-05-01126
2013: GROUP LONG TERM DISABILITY, BASIC LIFE, BASIC ACCIDENTAL DEATH AND DISMEMBERMENT PLAN FOR THE EMPLOYEES OF GIBNEY, ANTHONY AND FLAHERTY LLP 2013 401k membership
Total participants, beginning-of-year2013-11-01125
Total number of active participants reported on line 7a of the Form 55002013-11-01120
Total of all active and inactive participants2013-11-01120
Total participants2013-11-01120
2012: GROUP LONG TERM DISABILITY, BASIC LIFE, BASIC ACCIDENTAL DEATH AND DISMEMBERMENT PLAN FOR THE EMPLOYEES OF GIBNEY, ANTHONY AND FLAHERTY LLP 2012 401k membership
Total participants, beginning-of-year2012-11-01123
Total number of active participants reported on line 7a of the Form 55002012-11-01120
Number of retired or separated participants receiving benefits2012-11-010
Number of other retired or separated participants entitled to future benefits2012-11-010
Total of all active and inactive participants2012-11-01120
Total participants2012-11-01120
2011: GROUP LONG TERM DISABILITY, BASIC LIFE, BASIC ACCIDENTAL DEATH AND DISMEMBERMENT PLAN FOR THE EMPLOYEES OF GIBNEY, ANTHONY AND FLAHERTY LLP 2011 401k membership
Total participants, beginning-of-year2011-11-01119
Total number of active participants reported on line 7a of the Form 55002011-11-01123
Total of all active and inactive participants2011-11-01123
Total participants2011-11-01123
2009: GROUP LONG TERM DISABILITY, BASIC LIFE, BASIC ACCIDENTAL DEATH AND DISMEMBERMENT PLAN FOR THE EMPLOYEES OF GIBNEY, ANTHONY AND FLAHERTY LLP 2009 401k membership
Total participants, beginning-of-year2009-11-01106
Total number of active participants reported on line 7a of the Form 55002009-11-01109
Number of retired or separated participants receiving benefits2009-11-010
Number of other retired or separated participants entitled to future benefits2009-11-010
Total of all active and inactive participants2009-11-01109
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-11-010
Total participants2009-11-01109
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-11-010

Form 5500 Responses for GROUP LONG TERM DISABILITY, BASIC LIFE, BASIC ACCIDENTAL DEATH AND DISMEMBERMENT PLAN FOR THE EMPLOYEES OF GIBNEY, ANTHONY AND FLAHERTY LLP

2022: GROUP LONG TERM DISABILITY, BASIC LIFE, BASIC ACCIDENTAL DEATH AND DISMEMBERMENT PLAN FOR THE EMPLOYEES OF GIBNEY, ANTHONY AND FLAHERTY LLP 2022 form 5500 responses
2022-05-01Type of plan entitySingle employer plan
2022-05-01Plan funding arrangement – InsuranceYes
2022-05-01Plan benefit arrangement – InsuranceYes
2021: GROUP LONG TERM DISABILITY, BASIC LIFE, BASIC ACCIDENTAL DEATH AND DISMEMBERMENT PLAN FOR THE EMPLOYEES OF GIBNEY, ANTHONY AND FLAHERTY LLP 2021 form 5500 responses
2021-05-01Type of plan entitySingle employer plan
2021-05-01Plan funding arrangement – InsuranceYes
2021-05-01Plan benefit arrangement – InsuranceYes
2020: GROUP LONG TERM DISABILITY, BASIC LIFE, BASIC ACCIDENTAL DEATH AND DISMEMBERMENT PLAN FOR THE EMPLOYEES OF GIBNEY, ANTHONY AND FLAHERTY LLP 2020 form 5500 responses
2020-05-01Type of plan entitySingle employer plan
2020-05-01Plan funding arrangement – InsuranceYes
2020-05-01Plan benefit arrangement – InsuranceYes
2019: GROUP LONG TERM DISABILITY, BASIC LIFE, BASIC ACCIDENTAL DEATH AND DISMEMBERMENT PLAN FOR THE EMPLOYEES OF GIBNEY, ANTHONY AND FLAHERTY LLP 2019 form 5500 responses
2019-05-01Type of plan entitySingle employer plan
2019-05-01Plan funding arrangement – InsuranceYes
2019-05-01Plan benefit arrangement – InsuranceYes
2018: GROUP LONG TERM DISABILITY, BASIC LIFE, BASIC ACCIDENTAL DEATH AND DISMEMBERMENT PLAN FOR THE EMPLOYEES OF GIBNEY, ANTHONY AND FLAHERTY LLP 2018 form 5500 responses
2018-05-01Type of plan entitySingle employer plan
2018-05-01Plan funding arrangement – InsuranceYes
2018-05-01Plan benefit arrangement – InsuranceYes
2017: GROUP LONG TERM DISABILITY, BASIC LIFE, BASIC ACCIDENTAL DEATH AND DISMEMBERMENT PLAN FOR THE EMPLOYEES OF GIBNEY, ANTHONY AND FLAHERTY LLP 2017 form 5500 responses
2017-05-01Type of plan entitySingle employer plan
2017-05-01Plan funding arrangement – InsuranceYes
2017-05-01Plan benefit arrangement – InsuranceYes
2016: GROUP LONG TERM DISABILITY, BASIC LIFE, BASIC ACCIDENTAL DEATH AND DISMEMBERMENT PLAN FOR THE EMPLOYEES OF GIBNEY, ANTHONY AND FLAHERTY LLP 2016 form 5500 responses
2016-05-01Type of plan entitySingle employer plan
2016-05-01Submission has been amendedNo
2016-05-01This submission is the final filingNo
2016-05-01This return/report is a short plan year return/report (less than 12 months)No
2016-05-01Plan is a collectively bargained planNo
2016-05-01Plan funding arrangement – InsuranceYes
2016-05-01Plan benefit arrangement – InsuranceYes
2015: GROUP LONG TERM DISABILITY, BASIC LIFE, BASIC ACCIDENTAL DEATH AND DISMEMBERMENT PLAN FOR THE EMPLOYEES OF GIBNEY, ANTHONY AND FLAHERTY LLP 2015 form 5500 responses
2015-05-01Type of plan entitySingle employer plan
2015-05-01Submission has been amendedNo
2015-05-01This submission is the final filingNo
2015-05-01This return/report is a short plan year return/report (less than 12 months)No
2015-05-01Plan is a collectively bargained planNo
2015-05-01Plan funding arrangement – InsuranceYes
2015-05-01Plan benefit arrangement – InsuranceYes
2014: GROUP LONG TERM DISABILITY, BASIC LIFE, BASIC ACCIDENTAL DEATH AND DISMEMBERMENT PLAN FOR THE EMPLOYEES OF GIBNEY, ANTHONY AND FLAHERTY LLP 2014 form 5500 responses
2014-05-01Type of plan entitySingle employer plan
2014-05-01Submission has been amendedNo
2014-05-01This submission is the final filingNo
2014-05-01This return/report is a short plan year return/report (less than 12 months)No
2014-05-01Plan is a collectively bargained planNo
2014-05-01Plan funding arrangement – InsuranceYes
2014-05-01Plan benefit arrangement – InsuranceYes
2013: GROUP LONG TERM DISABILITY, BASIC LIFE, BASIC ACCIDENTAL DEATH AND DISMEMBERMENT PLAN FOR THE EMPLOYEES OF GIBNEY, ANTHONY AND FLAHERTY LLP 2013 form 5500 responses
2013-11-01Type of plan entitySingle employer plan
2013-11-01Submission has been amendedYes
2013-11-01This submission is the final filingNo
2013-11-01This return/report is a short plan year return/report (less than 12 months)Yes
2013-11-01Plan is a collectively bargained planNo
2013-11-01Plan funding arrangement – InsuranceYes
2013-11-01Plan benefit arrangement – InsuranceYes
2012: GROUP LONG TERM DISABILITY, BASIC LIFE, BASIC ACCIDENTAL DEATH AND DISMEMBERMENT PLAN FOR THE EMPLOYEES OF GIBNEY, ANTHONY AND FLAHERTY LLP 2012 form 5500 responses
2012-11-01Type of plan entitySingle employer plan
2012-11-01Submission has been amendedNo
2012-11-01This submission is the final filingNo
2012-11-01This return/report is a short plan year return/report (less than 12 months)No
2012-11-01Plan is a collectively bargained planNo
2012-11-01Plan funding arrangement – InsuranceYes
2012-11-01Plan benefit arrangement – InsuranceYes
2011: GROUP LONG TERM DISABILITY, BASIC LIFE, BASIC ACCIDENTAL DEATH AND DISMEMBERMENT PLAN FOR THE EMPLOYEES OF GIBNEY, ANTHONY AND FLAHERTY LLP 2011 form 5500 responses
2011-11-01Type of plan entitySingle employer plan
2011-11-01Submission has been amendedNo
2011-11-01This submission is the final filingNo
2011-11-01This return/report is a short plan year return/report (less than 12 months)No
2011-11-01Plan is a collectively bargained planNo
2011-11-01Plan funding arrangement – InsuranceYes
2011-11-01Plan benefit arrangement – InsuranceYes
2009: GROUP LONG TERM DISABILITY, BASIC LIFE, BASIC ACCIDENTAL DEATH AND DISMEMBERMENT PLAN FOR THE EMPLOYEES OF GIBNEY, ANTHONY AND FLAHERTY LLP 2009 form 5500 responses
2009-11-01Type of plan entitySingle employer plan
2009-11-01First time form 5500 has been submittedYes
2009-11-01Submission has been amendedNo
2009-11-01This submission is the final filingNo
2009-11-01This return/report is a short plan year return/report (less than 12 months)No
2009-11-01Plan is a collectively bargained planNo
2009-11-01Plan funding arrangement – InsuranceYes
2009-11-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )
Policy contract number6276
Policy instance 1
Insurance contract or identification number6276
Number of Individuals Covered121
Insurance policy start date2021-11-01
Insurance policy end date2022-10-31
Total amount of commissions paid to insurance brokerUSD $3,619
Total amount of fees paid to insurance companyUSD $3,073
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $43,141
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $3,619
Amount paid for insurance broker fees928
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )
Policy contract number6276
Policy instance 1
Insurance contract or identification number6276
Number of Individuals Covered131
Insurance policy start date2020-11-01
Insurance policy end date2021-10-31
Total amount of commissions paid to insurance brokerUSD $6,351
Total amount of fees paid to insurance companyUSD $1,718
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $42,863
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $4,292
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerFEES
AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )
Policy contract number6276
Policy instance 1
Insurance contract or identification number6276
Number of Individuals Covered123
Insurance policy start date2019-11-01
Insurance policy end date2020-10-31
Total amount of commissions paid to insurance brokerUSD $3,750
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $37,497
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $3,750
Amount paid for insurance broker fees0
Insurance broker organization code?3
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract number935103
Policy instance 1
Insurance contract or identification number935103
Number of Individuals Covered119
Insurance policy start date2019-05-01
Insurance policy end date2019-10-31
Total amount of commissions paid to insurance brokerUSD $3,415
Total amount of fees paid to insurance companyUSD $126
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $28,500
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,684
Amount paid for insurance broker fees126
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract number935103
Policy instance 1
Insurance contract or identification number935103
Number of Individuals Covered124
Insurance policy start date2018-05-01
Insurance policy end date2019-04-30
Total amount of commissions paid to insurance brokerUSD $6,739
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $73,046
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,739
Amount paid for insurance broker fees0
Insurance broker organization code?3
FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )
Policy contract number935103
Policy instance 2
Insurance contract or identification number935103
Number of Individuals Covered123
Insurance policy start date2017-11-01
Insurance policy end date2018-04-30
Total amount of commissions paid to insurance brokerUSD $3,440
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $34,401
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,440
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameVERTICAL FOX, LLC
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract number818761
Policy instance 1
Insurance contract or identification number818761
Number of Individuals Covered109
Insurance policy start date2017-05-01
Insurance policy end date2017-10-31
Total amount of commissions paid to insurance brokerUSD $3,530
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $35,301
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,530
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameVERTICAL FOX, LLC
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract number818761
Policy instance 1
Insurance contract or identification number818761
Number of Individuals Covered115
Insurance policy start date2015-05-01
Insurance policy end date2016-04-30
Total amount of commissions paid to insurance brokerUSD $6,941
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
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 $75,356
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,941
Insurance broker organization code?3
Insurance broker nameGALLAGHER BENEFIT SERVICES INC.
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract number818761
Policy instance 1
Insurance contract or identification number818761
Number of Individuals Covered126
Total amount of commissions paid to insurance brokerUSD $7,561
Total amount of fees paid to insurance companyUSD $1,397
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
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 $69,659
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,560
Insurance broker organization code?3
Amount paid for insurance broker fees1397
Additional information about fees paid to insurance brokerBONUSES
Insurance broker nameGALLAGHER BENEFIT SERVICES
SUN LIFE INSURANCE AND ANNUITY COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract number811845
Policy instance 1
Insurance contract or identification number811845
Number of Individuals Covered126
Insurance policy start date2013-11-01
Insurance policy end date2014-04-30
Total amount of commissions paid to insurance brokerUSD $3,498
Total amount of fees paid to insurance companyUSD $1,397
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
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 $34,983
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,498
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerBONUSES
Insurance broker nameGALLAGHER BENEFIT SERVICES INC
SUN LIFE INSURANCE AND ANNUITY COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract number811845
Policy instance 1
Insurance contract or identification number811845
Number of Individuals Covered126
Insurance policy start date2013-11-01
Insurance policy end date2014-10-31
Total amount of commissions paid to insurance brokerUSD $3,498
Total amount of fees paid to insurance companyUSD $1,397
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
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 $34,983
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract number869920G
Policy instance 1
Insurance contract or identification number869920G
Number of Individuals Covered120
Insurance policy start date2012-10-31
Insurance policy end date2013-11-01
Total amount of commissions paid to insurance brokerUSD $7,817
Total amount of fees paid to insurance companyUSD $3,909
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
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 $78,174
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,817
Amount paid for insurance broker fees3909
Additional information about fees paid to insurance brokerADMINISTRATIVE
Insurance broker organization code?3
Insurance broker nameEMERSON REID & CO INC
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract number869920G
Policy instance 1
Insurance contract or identification number869920G
Number of Individuals Covered123
Insurance policy start date2011-11-01
Insurance policy end date2012-10-31
Total amount of commissions paid to insurance brokerUSD $7,184
Total amount of fees paid to insurance companyUSD $3,592
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $71,836
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract number869920G
Policy instance 1
Insurance contract or identification number869920G
Number of Individuals Covered119
Insurance policy start date2010-11-01
Insurance policy end date2011-10-31
Total amount of commissions paid to insurance brokerUSD $6,724
Total amount of fees paid to insurance companyUSD $3,283
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $65,666
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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