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GROUP LIFE INSURANCE BENEFITS FOR EMPLOYEES OF FIRST INVESTORS CORPORATION AND AFFILIATES 401k Plan overview

Plan NameGROUP LIFE INSURANCE BENEFITS FOR EMPLOYEES OF FIRST INVESTORS CORPORATION AND AFFILIATES
Plan identification number 506

GROUP LIFE INSURANCE BENEFITS FOR EMPLOYEES OF FIRST INVESTORS CORPORATION AND AFFILIATES Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover
  • Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

FORESTERS FINANCIAL has sponsored the creation of one or more 401k plans.

Company Name:FORESTERS FINANCIAL
Employer identification number (EIN):132608328
NAIC Classification:523120
NAIC Description:Securities Brokerage

Additional information about FORESTERS FINANCIAL

Jurisdiction of Incorporation: Florida Department of State Division of Corporations
Incorporation Date: 1957-06-24
Company Identification Number: 203698

More information about FORESTERS FINANCIAL

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GROUP LIFE INSURANCE BENEFITS FOR EMPLOYEES OF FIRST INVESTORS CORPORATION AND AFFILIATES

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5062020-01-01ALISON HARVEY-CHUTER2021-10-13
5062019-01-01ALISON HARVEY-CHUTER2020-10-07
5062018-01-01SANDRA JOHNSON2019-10-15
5062017-01-01
5062016-01-01
5062016-01-01SANDRA L. JOHNSON2018-12-27
5062015-01-01MARJORIE SOLOWEY
5062014-01-01MARJORIE SOLOWEY
5062013-06-01MARJORIE SOLOWEY
5062012-06-01WILLIAM LIPKUS
5062011-06-01WILLIAM LIPKUS WILLIAM LIPKUS2013-12-23
5062009-06-01WILLIAM LIPKUS WILLIAM LIPKUS2013-12-23
5062008-06-01WILLIAM LIPKUS WILLIAM LIPKUS2013-12-23
5062007-06-01WILLIAM LIPKUS WILLIAM LIPKUS2013-12-23
5062006-06-01WILLIAM LIPKUS WILLIAM LIPKUS2013-12-23
5062005-06-01WILLIAM LIPKUS WILLIAM LIPKUS2013-12-23
5062004-06-01WILLIAM LIPKUS WILLIAM LIPKUS2013-12-23

Plan Statistics for GROUP LIFE INSURANCE BENEFITS FOR EMPLOYEES OF FIRST INVESTORS CORPORATION AND AFFILIATES

401k plan membership statisitcs for GROUP LIFE INSURANCE BENEFITS FOR EMPLOYEES OF FIRST INVESTORS CORPORATION AND AFFILIATES

Measure Date Value
2020: GROUP LIFE INSURANCE BENEFITS FOR EMPLOYEES OF FIRST INVESTORS CORPORATION AND AFFILIATES 2020 401k membership
Total participants, beginning-of-year2020-01-01285
Total number of active participants reported on line 7a of the Form 55002020-01-0134
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-0134
Number of employers contributing to the scheme2020-01-010
2019: GROUP LIFE INSURANCE BENEFITS FOR EMPLOYEES OF FIRST INVESTORS CORPORATION AND AFFILIATES 2019 401k membership
Total participants, beginning-of-year2019-01-01581
Total number of active participants reported on line 7a of the Form 55002019-01-01581
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-01581
Number of employers contributing to the scheme2019-01-010
2018: GROUP LIFE INSURANCE BENEFITS FOR EMPLOYEES OF FIRST INVESTORS CORPORATION AND AFFILIATES 2018 401k membership
Total participants, beginning-of-year2018-01-01602
Total number of active participants reported on line 7a of the Form 55002018-01-01581
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-01581
Number of employers contributing to the scheme2018-01-010
2017: GROUP LIFE INSURANCE BENEFITS FOR EMPLOYEES OF FIRST INVESTORS CORPORATION AND AFFILIATES 2017 401k membership
Total participants, beginning-of-year2017-01-01739
Total number of active participants reported on line 7a of the Form 55002017-01-01604
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-01604
2016: GROUP LIFE INSURANCE BENEFITS FOR EMPLOYEES OF FIRST INVESTORS CORPORATION AND AFFILIATES 2016 401k membership
Total participants, beginning-of-year2016-01-01689
Total number of active participants reported on line 7a of the Form 55002016-01-01739
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-01739
2015: GROUP LIFE INSURANCE BENEFITS FOR EMPLOYEES OF FIRST INVESTORS CORPORATION AND AFFILIATES 2015 401k membership
Total participants, beginning-of-year2015-01-01673
Total number of active participants reported on line 7a of the Form 55002015-01-01689
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-01689
2014: GROUP LIFE INSURANCE BENEFITS FOR EMPLOYEES OF FIRST INVESTORS CORPORATION AND AFFILIATES 2014 401k membership
Total participants, beginning-of-year2014-01-01610
Total number of active participants reported on line 7a of the Form 55002014-01-01673
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-01673
2013: GROUP LIFE INSURANCE BENEFITS FOR EMPLOYEES OF FIRST INVESTORS CORPORATION AND AFFILIATES 2013 401k membership
Total participants, beginning-of-year2013-06-01610
Total number of active participants reported on line 7a of the Form 55002013-06-01610
Number of retired or separated participants receiving benefits2013-06-010
Number of other retired or separated participants entitled to future benefits2013-06-010
Total of all active and inactive participants2013-06-01610
2012: GROUP LIFE INSURANCE BENEFITS FOR EMPLOYEES OF FIRST INVESTORS CORPORATION AND AFFILIATES 2012 401k membership
Total participants, beginning-of-year2012-06-01589
Total number of active participants reported on line 7a of the Form 55002012-06-01610
Total of all active and inactive participants2012-06-01610
Total participants2012-06-01610
2011: GROUP LIFE INSURANCE BENEFITS FOR EMPLOYEES OF FIRST INVESTORS CORPORATION AND AFFILIATES 2011 401k membership
Total participants, beginning-of-year2011-06-01584
Total number of active participants reported on line 7a of the Form 55002011-06-01589
Number of retired or separated participants receiving benefits2011-06-010
Number of other retired or separated participants entitled to future benefits2011-06-010
Total of all active and inactive participants2011-06-01589
2009: GROUP LIFE INSURANCE BENEFITS FOR EMPLOYEES OF FIRST INVESTORS CORPORATION AND AFFILIATES 2009 401k membership
Total participants, beginning-of-year2009-06-01622
Total number of active participants reported on line 7a of the Form 55002009-06-01589
Number of retired or separated participants receiving benefits2009-06-010
Number of other retired or separated participants entitled to future benefits2009-06-010
Total of all active and inactive participants2009-06-01589
Total participants2009-06-010
2008: GROUP LIFE INSURANCE BENEFITS FOR EMPLOYEES OF FIRST INVESTORS CORPORATION AND AFFILIATES 2008 401k membership
Total participants, beginning-of-year2008-06-01693
Total number of active participants reported on line 7a of the Form 55002008-06-01622
Number of retired or separated participants receiving benefits2008-06-010
Number of other retired or separated participants entitled to future benefits2008-06-010
Total of all active and inactive participants2008-06-01622
2007: GROUP LIFE INSURANCE BENEFITS FOR EMPLOYEES OF FIRST INVESTORS CORPORATION AND AFFILIATES 2007 401k membership
Total participants, beginning-of-year2007-06-01686
Total number of active participants reported on line 7a of the Form 55002007-06-01693
Number of retired or separated participants receiving benefits2007-06-010
Number of other retired or separated participants entitled to future benefits2007-06-010
Total of all active and inactive participants2007-06-01693
2006: GROUP LIFE INSURANCE BENEFITS FOR EMPLOYEES OF FIRST INVESTORS CORPORATION AND AFFILIATES 2006 401k membership
Total participants, beginning-of-year2006-06-01622
Total number of active participants reported on line 7a of the Form 55002006-06-01686
Number of retired or separated participants receiving benefits2006-06-010
Number of other retired or separated participants entitled to future benefits2006-06-010
Total of all active and inactive participants2006-06-01686
2005: GROUP LIFE INSURANCE BENEFITS FOR EMPLOYEES OF FIRST INVESTORS CORPORATION AND AFFILIATES 2005 401k membership
Total participants, beginning-of-year2005-06-01622
Total number of active participants reported on line 7a of the Form 55002005-06-01622
Number of retired or separated participants receiving benefits2005-06-010
Number of other retired or separated participants entitled to future benefits2005-06-010
Total of all active and inactive participants2005-06-01622
2004: GROUP LIFE INSURANCE BENEFITS FOR EMPLOYEES OF FIRST INVESTORS CORPORATION AND AFFILIATES 2004 401k membership
Total participants, beginning-of-year2004-06-01622
Total number of active participants reported on line 7a of the Form 55002004-06-01622
Number of retired or separated participants receiving benefits2004-06-010
Number of other retired or separated participants entitled to future benefits2004-06-010
Total of all active and inactive participants2004-06-01622

Form 5500 Responses for GROUP LIFE INSURANCE BENEFITS FOR EMPLOYEES OF FIRST INVESTORS CORPORATION AND AFFILIATES

2020: GROUP LIFE INSURANCE BENEFITS FOR EMPLOYEES OF FIRST INVESTORS CORPORATION AND AFFILIATES 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – InsuranceYes
2019: GROUP LIFE INSURANCE BENEFITS FOR EMPLOYEES OF FIRST INVESTORS CORPORATION AND AFFILIATES 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: GROUP LIFE INSURANCE BENEFITS FOR EMPLOYEES OF FIRST INVESTORS CORPORATION AND AFFILIATES 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: GROUP LIFE INSURANCE BENEFITS FOR EMPLOYEES OF FIRST INVESTORS CORPORATION AND AFFILIATES 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: GROUP LIFE INSURANCE BENEFITS FOR EMPLOYEES OF FIRST INVESTORS CORPORATION AND AFFILIATES 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 LIFE INSURANCE BENEFITS FOR EMPLOYEES OF FIRST INVESTORS CORPORATION AND AFFILIATES 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 LIFE INSURANCE BENEFITS FOR EMPLOYEES OF FIRST INVESTORS CORPORATION AND AFFILIATES 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: GROUP LIFE INSURANCE BENEFITS FOR EMPLOYEES OF FIRST INVESTORS CORPORATION AND AFFILIATES 2013 form 5500 responses
2013-06-01Type of plan entitySingle employer plan
2013-06-01Submission has been amendedNo
2013-06-01This submission is the final filingNo
2013-06-01This return/report is a short plan year return/report (less than 12 months)Yes
2013-06-01Plan is a collectively bargained planNo
2013-06-01Plan funding arrangement – InsuranceYes
2013-06-01Plan benefit arrangement – InsuranceYes
2012: GROUP LIFE INSURANCE BENEFITS FOR EMPLOYEES OF FIRST INVESTORS CORPORATION AND AFFILIATES 2012 form 5500 responses
2012-06-01Type of plan entitySingle employer plan
2012-06-01Submission has been amendedNo
2012-06-01This submission is the final filingNo
2012-06-01This return/report is a short plan year return/report (less than 12 months)No
2012-06-01Plan is a collectively bargained planNo
2012-06-01Plan funding arrangement – InsuranceYes
2012-06-01Plan benefit arrangement – InsuranceYes
2011: GROUP LIFE INSURANCE BENEFITS FOR EMPLOYEES OF FIRST INVESTORS CORPORATION AND AFFILIATES 2011 form 5500 responses
2011-06-01Type of plan entitySingle employer plan
2011-06-01Submission has been amendedNo
2011-06-01This submission is the final filingNo
2011-06-01This return/report is a short plan year return/report (less than 12 months)No
2011-06-01Plan is a collectively bargained planNo
2011-06-01Plan funding arrangement – InsuranceYes
2011-06-01Plan benefit arrangement – InsuranceYes
2009: GROUP LIFE INSURANCE BENEFITS FOR EMPLOYEES OF FIRST INVESTORS CORPORATION AND AFFILIATES 2009 form 5500 responses
2009-06-01Type of plan entitySingle employer plan
2009-06-01Submission has been amendedNo
2009-06-01This submission is the final filingNo
2009-06-01This return/report is a short plan year return/report (less than 12 months)No
2009-06-01Plan is a collectively bargained planNo
2009-06-01Plan funding arrangement – InsuranceYes
2009-06-01Plan benefit arrangement – InsuranceYes
2008: GROUP LIFE INSURANCE BENEFITS FOR EMPLOYEES OF FIRST INVESTORS CORPORATION AND AFFILIATES 2008 form 5500 responses
2008-06-01Type of plan entitySingle employer plan
2008-06-01Submission has been amendedNo
2008-06-01This submission is the final filingNo
2008-06-01This return/report is a short plan year return/report (less than 12 months)No
2008-06-01Plan is a collectively bargained planNo
2008-06-01Plan funding arrangement – InsuranceYes
2008-06-01Plan benefit arrangement – InsuranceYes
2007: GROUP LIFE INSURANCE BENEFITS FOR EMPLOYEES OF FIRST INVESTORS CORPORATION AND AFFILIATES 2007 form 5500 responses
2007-06-01Type of plan entitySingle employer plan
2007-06-01Submission has been amendedNo
2007-06-01This submission is the final filingNo
2007-06-01This return/report is a short plan year return/report (less than 12 months)No
2007-06-01Plan is a collectively bargained planNo
2007-06-01Plan funding arrangement – InsuranceYes
2007-06-01Plan benefit arrangement – InsuranceYes
2006: GROUP LIFE INSURANCE BENEFITS FOR EMPLOYEES OF FIRST INVESTORS CORPORATION AND AFFILIATES 2006 form 5500 responses
2006-06-01Type of plan entitySingle employer plan
2006-06-01Submission has been amendedNo
2006-06-01This submission is the final filingNo
2006-06-01This return/report is a short plan year return/report (less than 12 months)No
2006-06-01Plan is a collectively bargained planNo
2006-06-01Plan funding arrangement – InsuranceYes
2006-06-01Plan benefit arrangement – InsuranceYes
2005: GROUP LIFE INSURANCE BENEFITS FOR EMPLOYEES OF FIRST INVESTORS CORPORATION AND AFFILIATES 2005 form 5500 responses
2005-06-01Type of plan entitySingle employer plan
2005-06-01Submission has been amendedNo
2005-06-01This submission is the final filingNo
2005-06-01This return/report is a short plan year return/report (less than 12 months)No
2005-06-01Plan is a collectively bargained planNo
2005-06-01Plan funding arrangement – InsuranceYes
2005-06-01Plan benefit arrangement – InsuranceYes
2004: GROUP LIFE INSURANCE BENEFITS FOR EMPLOYEES OF FIRST INVESTORS CORPORATION AND AFFILIATES 2004 form 5500 responses
2004-06-01Type of plan entitySingle employer plan
2004-06-01First time form 5500 has been submittedYes
2004-06-01Submission has been amendedNo
2004-06-01This submission is the final filingNo
2004-06-01This return/report is a short plan year return/report (less than 12 months)No
2004-06-01Plan is a collectively bargained planNo
2004-06-01Plan funding arrangement – InsuranceYes
2004-06-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX967360
Policy instance 1
Insurance contract or identification numberFLX967360
Number of Individuals Covered581
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $10,903
Total amount of fees paid to insurance companyUSD $6,255
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 BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $145,069
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $10,903
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerSALES AND SERVICES
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX967361
Policy instance 3
Insurance contract or identification numberFLX967361
Number of Individuals Covered581
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $22,459
Total amount of fees paid to insurance companyUSD $11,230
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $224,594
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $22,459
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerSALES AND SERVICE
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberOK968878
Policy instance 2
Insurance contract or identification numberOK968878
Number of Individuals Covered581
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $377
Total amount of fees paid to insurance companyUSD $377
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $7,542
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees377
Additional information about fees paid to insurance brokerSALES AND SERVICE
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX967360
Policy instance 1
Insurance contract or identification numberFLX967360
Number of Individuals Covered581
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $1,257
Total amount of fees paid to insurance companyUSD $1,257
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $25,140
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees1257
Additional information about fees paid to insurance brokerSALES AND SERVICE
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX967360
Policy instance 1
Insurance contract or identification numberFLX967360
Number of Individuals Covered581
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $29,861
Total amount of fees paid to insurance companyUSD $21,924
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 BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $302,553
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $28,544
Amount paid for insurance broker fees8113
Additional information about fees paid to insurance brokerOVERRIDE
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX967360
Policy instance 1
Insurance contract or identification numberFLX967360
Number of Individuals Covered604
Insurance policy start date2016-07-01
Insurance policy end date2017-06-30
Total amount of commissions paid to insurance brokerUSD $1,063
Total amount of fees paid to insurance companyUSD $1,063
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $21,254
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees1063
Additional information about fees paid to insurance brokerSALES AND SERVICE
Insurance broker organization code?3
Insurance broker nameUSI INSURANCE SERVICES LLC
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX967361
Policy instance 3
Insurance contract or identification numberFLX967361
Number of Individuals Covered604
Insurance policy start date2016-07-01
Insurance policy end date2017-06-30
Total amount of commissions paid to insurance brokerUSD $21,686
Total amount of fees paid to insurance companyUSD $10,843
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $216,860
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $21,686
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerSALES AND SERVICE
Insurance broker nameEMERSON REID, LLC
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberOK968878
Policy instance 2
Insurance contract or identification numberOK968878
Number of Individuals Covered604
Insurance policy start date2016-07-01
Insurance policy end date2017-06-30
Total amount of commissions paid to insurance brokerUSD $319
Total amount of fees paid to insurance companyUSD $319
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $6,372
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees319
Additional information about fees paid to insurance brokerSALES AND SERVICE
Insurance broker organization code?3
Insurance broker nameUSI INSURANCE SERVICES LLC
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number889991
Policy instance 1
Insurance contract or identification number889991
Number of Individuals Covered689
Insurance policy start date2014-06-01
Insurance policy end date2015-05-31
Total amount of commissions paid to insurance brokerUSD $22,244
Total amount of fees paid to insurance companyUSD $4,150
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 BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND 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 CarrierUSD $255,857
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $22,244
Amount paid for insurance broker fees4150
Additional information about fees paid to insurance brokerMM P3 BONUS
Insurance broker organization code?3
Insurance broker name
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number889991
Policy instance 1
Insurance contract or identification number889991
Number of Individuals Covered673
Insurance policy start date2013-06-01
Insurance policy end date2014-05-31
Total amount of commissions paid to insurance brokerUSD $20,236
Total amount of fees paid to insurance companyUSD $141
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 BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND 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 CarrierUSD $221,899
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,710
Insurance broker organization code?3
Amount paid for insurance broker fees141
Additional information about fees paid to insurance brokerINDIRECT COMPENSATION
Insurance broker nameUSI INSURANCE SERVICES, LLC
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number889991
Policy instance 1
Insurance contract or identification number889991
Number of Individuals Covered610
Insurance policy start date2012-06-01
Insurance policy end date2013-05-31
Total amount of commissions paid to insurance brokerUSD $17,500
Total amount of fees paid to insurance companyUSD $50
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 BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND 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 CarrierUSD $200,045
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17,500
Insurance broker organization code?3
Amount paid for insurance broker fees50
Additional information about fees paid to insurance brokerINDIRECT COMPENSATION
Insurance broker nameUSI INSURANCE SERVICES, LLC
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number889991
Policy instance 1
Insurance contract or identification number889991
Number of Individuals Covered610
Insurance policy start date2012-06-01
Insurance policy end date2013-05-31
Total amount of commissions paid to insurance brokerUSD $17,500
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $200,045
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17,500
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameUSI INSURANCE SERVICES LLC
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number889991
Policy instance 1
Insurance contract or identification number889991
Number of Individuals Covered589
Insurance policy start date2011-06-01
Insurance policy end date2012-05-31
Total amount of commissions paid to insurance brokerUSD $16,932
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $188,615
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number889991
Policy instance 1
Insurance contract or identification number889991
Number of Individuals Covered584
Insurance policy start date2010-06-01
Insurance policy end date2011-05-31
Total amount of commissions paid to insurance brokerUSD $16,486
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $183,449
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number889991
Policy instance 1
Insurance contract or identification number889991
Number of Individuals Covered622
Insurance policy start date2008-06-01
Insurance policy end date2009-05-31
Total amount of commissions paid to insurance brokerUSD $16,275
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $184,107
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,275
Insurance broker organization code?3
Insurance broker namePROGRESSIVE PLAN ADMINISTRATORS
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number889991
Policy instance 1
Insurance contract or identification number889991
Number of Individuals Covered693
Insurance policy start date2007-06-01
Insurance policy end date2008-05-31
Total amount of commissions paid to insurance brokerUSD $14,496
Total amount of fees paid to insurance companyUSD $2,368
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $165,445
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,496
Amount paid for insurance broker fees2368
Additional information about fees paid to insurance broker2007 MID MKT RETENTION BONUS - TERM LIFE ($537.00) & SUPP LIFE ($1,831.00)
Insurance broker organization code?3
Insurance broker namePROGRESSIVE PLAN ADMINISTRATORS
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number889991
Policy instance 1
Insurance contract or identification number889991
Number of Individuals Covered686
Insurance policy start date2006-06-01
Insurance policy end date2007-05-31
Total amount of commissions paid to insurance brokerUSD $13,128
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $148,540
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,128
Insurance broker organization code?3
Insurance broker namePROGRESSIVE PLAN ADMINISTRATORS
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number889991
Policy instance 1
Insurance contract or identification number889991
Insurance policy start date2005-06-01
Insurance policy end date2006-05-31
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number889991-ERG
Policy instance 1
Insurance contract or identification number889991-ERG
Number of Individuals Covered622
Insurance policy start date2004-06-01
Insurance policy end date2005-05-31
Total amount of commissions paid to insurance brokerUSD $10,405
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $122,869
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,405
Insurance broker organization code?3
Insurance broker namePROGRESSIVE PLAN ADMINISTRATORS INC

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