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GROUP LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT AND DENTAL BENEFITS PLAN FOR RAPID,SONITROL,EASTERN AND INTELLITEC 401k Plan overview

Plan NameGROUP LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT AND DENTAL BENEFITS PLAN FOR RAPID,SONITROL,EASTERN AND INTELLITEC
Plan identification number 502

GROUP LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT AND DENTAL BENEFITS PLAN FOR RAPID,SONITROL,EASTERN AND INTELLITEC Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision

401k Sponsoring company profile

RAPID RESPONSE MONITORING SERVICES INC has sponsored the creation of one or more 401k plans.

Company Name:RAPID RESPONSE MONITORING SERVICES INC
Employer identification number (EIN):161432416
NAIC Classification:541990
NAIC Description:All Other Professional, Scientific, and Technical Services

Additional information about RAPID RESPONSE MONITORING SERVICES INC

Jurisdiction of Incorporation: State of Delaware Division of Corporations
Incorporation Date:
Company Identification Number: 3866593

More information about RAPID RESPONSE MONITORING SERVICES INC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GROUP LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT AND DENTAL BENEFITS PLAN FOR RAPID,SONITROL,EASTERN AND INTELLITEC

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022022-04-01MARGARET COMINSKY2023-10-16
5022021-04-01MARGARET COMINSKY2022-09-23
5022020-04-01MARGARET COMINSKY2021-09-29
5022019-04-01MARGARET COMINSKY2020-10-13
5022018-04-01MARGARET COMINSKY2019-07-31
5022017-04-01
5022016-04-01
5022015-04-01MARGARET COMINSKY
5022015-04-01MARGARET COMINSKY
5022014-04-01MARGARET COMINSKY
5022014-04-01MARGARET COMINSKY
5022013-04-01MARGARET COMINSKY
5022012-04-01MARGARET COMINSKY
5022011-04-01MARGARET COMINSKY
5022009-04-01MARGARET COMINSKY
5022009-04-01MARGARET COMINSKY

Plan Statistics for GROUP LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT AND DENTAL BENEFITS PLAN FOR RAPID,SONITROL,EASTERN AND INTELLITEC

401k plan membership statisitcs for GROUP LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT AND DENTAL BENEFITS PLAN FOR RAPID,SONITROL,EASTERN AND INTELLITEC

Measure Date Value
2022: GROUP LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT AND DENTAL BENEFITS PLAN FOR RAPID,SONITROL,EASTERN AND INTELLITEC 2022 401k membership
Total participants, beginning-of-year2022-04-01670
Total number of active participants reported on line 7a of the Form 55002022-04-01790
Total of all active and inactive participants2022-04-01790
2021: GROUP LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT AND DENTAL BENEFITS PLAN FOR RAPID,SONITROL,EASTERN AND INTELLITEC 2021 401k membership
Total participants, beginning-of-year2021-04-01659
Total number of active participants reported on line 7a of the Form 55002021-04-01670
Total of all active and inactive participants2021-04-01670
2020: GROUP LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT AND DENTAL BENEFITS PLAN FOR RAPID,SONITROL,EASTERN AND INTELLITEC 2020 401k membership
Total participants, beginning-of-year2020-04-01671
Total number of active participants reported on line 7a of the Form 55002020-04-01659
Total of all active and inactive participants2020-04-01659
2019: GROUP LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT AND DENTAL BENEFITS PLAN FOR RAPID,SONITROL,EASTERN AND INTELLITEC 2019 401k membership
Total participants, beginning-of-year2019-04-01593
Total number of active participants reported on line 7a of the Form 55002019-04-01671
Total of all active and inactive participants2019-04-01671
2018: GROUP LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT AND DENTAL BENEFITS PLAN FOR RAPID,SONITROL,EASTERN AND INTELLITEC 2018 401k membership
Total participants, beginning-of-year2018-04-01650
Total number of active participants reported on line 7a of the Form 55002018-04-01593
Total of all active and inactive participants2018-04-01593
2017: GROUP LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT AND DENTAL BENEFITS PLAN FOR RAPID,SONITROL,EASTERN AND INTELLITEC 2017 401k membership
Total participants, beginning-of-year2017-04-01659
Total number of active participants reported on line 7a of the Form 55002017-04-01650
Total of all active and inactive participants2017-04-01650
2016: GROUP LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT AND DENTAL BENEFITS PLAN FOR RAPID,SONITROL,EASTERN AND INTELLITEC 2016 401k membership
Total participants, beginning-of-year2016-04-01536
Total number of active participants reported on line 7a of the Form 55002016-04-01659
Total of all active and inactive participants2016-04-01659
2015: GROUP LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT AND DENTAL BENEFITS PLAN FOR RAPID,SONITROL,EASTERN AND INTELLITEC 2015 401k membership
Total participants, beginning-of-year2015-04-01484
Total number of active participants reported on line 7a of the Form 55002015-04-01536
Total of all active and inactive participants2015-04-01536
Total participants2015-04-01536
2014: GROUP LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT AND DENTAL BENEFITS PLAN FOR RAPID,SONITROL,EASTERN AND INTELLITEC 2014 401k membership
Total participants, beginning-of-year2014-04-01369
Total number of active participants reported on line 7a of the Form 55002014-04-01344
Total of all active and inactive participants2014-04-01344
Total participants2014-04-01344
2013: GROUP LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT AND DENTAL BENEFITS PLAN FOR RAPID,SONITROL,EASTERN AND INTELLITEC 2013 401k membership
Total participants, beginning-of-year2013-04-01450
Total number of active participants reported on line 7a of the Form 55002013-04-01455
Total of all active and inactive participants2013-04-01455
Total participants2013-04-01455
2012: GROUP LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT AND DENTAL BENEFITS PLAN FOR RAPID,SONITROL,EASTERN AND INTELLITEC 2012 401k membership
Total participants, beginning-of-year2012-04-01364
Total number of active participants reported on line 7a of the Form 55002012-04-01356
Total of all active and inactive participants2012-04-01356
Total participants2012-04-01356
2011: GROUP LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT AND DENTAL BENEFITS PLAN FOR RAPID,SONITROL,EASTERN AND INTELLITEC 2011 401k membership
Total participants, beginning-of-year2011-04-01362
Total number of active participants reported on line 7a of the Form 55002011-04-01364
Total of all active and inactive participants2011-04-01364
Total participants2011-04-01364
2009: GROUP LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT AND DENTAL BENEFITS PLAN FOR RAPID,SONITROL,EASTERN AND INTELLITEC 2009 401k membership
Total participants, beginning-of-year2009-04-01327
Total number of active participants reported on line 7a of the Form 55002009-04-01324
Total of all active and inactive participants2009-04-01324
Total participants2009-04-01324

Form 5500 Responses for GROUP LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT AND DENTAL BENEFITS PLAN FOR RAPID,SONITROL,EASTERN AND INTELLITEC

2022: GROUP LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT AND DENTAL BENEFITS PLAN FOR RAPID,SONITROL,EASTERN AND INTELLITEC 2022 form 5500 responses
2022-04-01Type of plan entitySingle employer plan
2022-04-01Plan funding arrangement – InsuranceYes
2022-04-01Plan benefit arrangement – InsuranceYes
2021: GROUP LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT AND DENTAL BENEFITS PLAN FOR RAPID,SONITROL,EASTERN AND INTELLITEC 2021 form 5500 responses
2021-04-01Type of plan entitySingle employer plan
2021-04-01Plan funding arrangement – InsuranceYes
2021-04-01Plan benefit arrangement – InsuranceYes
2020: GROUP LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT AND DENTAL BENEFITS PLAN FOR RAPID,SONITROL,EASTERN AND INTELLITEC 2020 form 5500 responses
2020-04-01Type of plan entitySingle employer plan
2020-04-01Plan funding arrangement – InsuranceYes
2020-04-01Plan benefit arrangement – InsuranceYes
2019: GROUP LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT AND DENTAL BENEFITS PLAN FOR RAPID,SONITROL,EASTERN AND INTELLITEC 2019 form 5500 responses
2019-04-01Type of plan entitySingle employer plan
2019-04-01Plan funding arrangement – InsuranceYes
2019-04-01Plan benefit arrangement – InsuranceYes
2018: GROUP LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT AND DENTAL BENEFITS PLAN FOR RAPID,SONITROL,EASTERN AND INTELLITEC 2018 form 5500 responses
2018-04-01Type of plan entitySingle employer plan
2018-04-01Plan funding arrangement – InsuranceYes
2018-04-01Plan benefit arrangement – InsuranceYes
2017: GROUP LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT AND DENTAL BENEFITS PLAN FOR RAPID,SONITROL,EASTERN AND INTELLITEC 2017 form 5500 responses
2017-04-01Type of plan entitySingle employer plan
2017-04-01Plan funding arrangement – InsuranceYes
2017-04-01Plan benefit arrangement – InsuranceYes
2016: GROUP LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT AND DENTAL BENEFITS PLAN FOR RAPID,SONITROL,EASTERN AND INTELLITEC 2016 form 5500 responses
2016-04-01Type of plan entitySingle employer plan
2016-04-01Plan funding arrangement – InsuranceYes
2016-04-01Plan benefit arrangement – InsuranceYes
2015: GROUP LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT AND DENTAL BENEFITS PLAN FOR RAPID,SONITROL,EASTERN AND INTELLITEC 2015 form 5500 responses
2015-04-01Type of plan entitySingle employer plan
2015-04-01Submission has been amendedNo
2015-04-01This submission is the final filingNo
2015-04-01This return/report is a short plan year return/report (less than 12 months)No
2015-04-01Plan is a collectively bargained planNo
2015-04-01Plan funding arrangement – InsuranceYes
2015-04-01Plan benefit arrangement – InsuranceYes
2014: GROUP LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT AND DENTAL BENEFITS PLAN FOR RAPID,SONITROL,EASTERN AND INTELLITEC 2014 form 5500 responses
2014-04-01Type of plan entitySingle employer plan
2014-04-01Submission has been amendedNo
2014-04-01This submission is the final filingNo
2014-04-01This return/report is a short plan year return/report (less than 12 months)No
2014-04-01Plan is a collectively bargained planNo
2014-04-01Plan funding arrangement – InsuranceYes
2014-04-01Plan funding arrangement – General assets of the sponsorYes
2014-04-01Plan benefit arrangement – InsuranceYes
2014-04-01Plan benefit arrangement – General assets of the sponsorYes
2013: GROUP LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT AND DENTAL BENEFITS PLAN FOR RAPID,SONITROL,EASTERN AND INTELLITEC 2013 form 5500 responses
2013-04-01Type of plan entitySingle employer plan
2013-04-01Submission has been amendedNo
2013-04-01This submission is the final filingNo
2013-04-01This return/report is a short plan year return/report (less than 12 months)No
2013-04-01Plan is a collectively bargained planNo
2013-04-01Plan funding arrangement – InsuranceYes
2013-04-01Plan benefit arrangement – InsuranceYes
2012: GROUP LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT AND DENTAL BENEFITS PLAN FOR RAPID,SONITROL,EASTERN AND INTELLITEC 2012 form 5500 responses
2012-04-01Type of plan entitySingle employer plan
2012-04-01Submission has been amendedNo
2012-04-01This submission is the final filingNo
2012-04-01This return/report is a short plan year return/report (less than 12 months)No
2012-04-01Plan is a collectively bargained planNo
2012-04-01Plan funding arrangement – InsuranceYes
2012-04-01Plan funding arrangement – General assets of the sponsorYes
2012-04-01Plan benefit arrangement – InsuranceYes
2012-04-01Plan benefit arrangement – General assets of the sponsorYes
2011: GROUP LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT AND DENTAL BENEFITS PLAN FOR RAPID,SONITROL,EASTERN AND INTELLITEC 2011 form 5500 responses
2011-04-01Type of plan entitySingle employer plan
2011-04-01Submission has been amendedNo
2011-04-01This submission is the final filingNo
2011-04-01This return/report is a short plan year return/report (less than 12 months)No
2011-04-01Plan is a collectively bargained planNo
2011-04-01Plan funding arrangement – InsuranceYes
2011-04-01Plan funding arrangement – General assets of the sponsorYes
2011-04-01Plan benefit arrangement – InsuranceYes
2011-04-01Plan benefit arrangement – General assets of the sponsorYes
2009: GROUP LIFE, ACCIDENTAL DEATH AND DISMEMBERMENT AND DENTAL BENEFITS PLAN FOR RAPID,SONITROL,EASTERN AND INTELLITEC 2009 form 5500 responses
2009-04-01Type of plan entitySingle employer plan
2009-04-01Submission has been amendedNo
2009-04-01This submission is the final filingNo
2009-04-01This return/report is a short plan year return/report (less than 12 months)No
2009-04-01Plan is a collectively bargained planNo
2009-04-01Plan funding arrangement – InsuranceYes
2009-04-01Plan funding arrangement – General assets of the sponsorYes
2009-04-01Plan benefit arrangement – InsuranceYes
2009-04-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

AMERITAS LIFE INSURANCE CORP OF NY (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number#026-202603
Policy instance 2
Insurance contract or identification number#026-202603
Number of Individuals Covered1738
Insurance policy start date2022-04-01
Insurance policy end date2023-03-31
Total amount of commissions paid to insurance brokerUSD $16,980
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $215,698
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,980
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00394800
Policy instance 1
Insurance contract or identification number00394800
Number of Individuals Covered756
Insurance policy start date2022-04-01
Insurance policy end date2023-03-31
Total amount of commissions paid to insurance brokerUSD $24,652
Total amount of fees paid to insurance companyUSD $3,394
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $260,281
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $24,652
Amount paid for insurance broker fees3394
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00394800
Policy instance 1
Insurance contract or identification number00394800
Number of Individuals Covered670
Insurance policy start date2021-04-01
Insurance policy end date2022-03-31
Total amount of commissions paid to insurance brokerUSD $26,948
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $485,511
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $26,948
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00394800
Policy instance 1
Insurance contract or identification number00394800
Number of Individuals Covered659
Insurance policy start date2020-04-01
Insurance policy end date2021-03-31
Total amount of commissions paid to insurance brokerUSD $26,194
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $481,847
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $26,194
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00394800
Policy instance 1
Insurance contract or identification number00394800
Number of Individuals Covered671
Insurance policy start date2019-04-01
Insurance policy end date2020-03-31
Total amount of commissions paid to insurance brokerUSD $24,624
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $445,607
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $24,624
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00394800
Policy instance 1
Insurance contract or identification number00394800
Number of Individuals Covered650
Insurance policy start date2017-04-01
Insurance policy end date2018-03-31
Total amount of commissions paid to insurance brokerUSD $19,941
Total amount of fees paid to insurance companyUSD $13,856
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $372,418
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $19,941
Amount paid for insurance broker fees13856
Insurance broker organization code?3
Insurance broker nameENV INSURANCE AGENCY
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00394800
Policy instance 1
Insurance contract or identification number00394800
Number of Individuals Covered521
Insurance policy start date2015-04-01
Insurance policy end date2016-03-31
Total amount of commissions paid to insurance brokerUSD $17,811
Total amount of fees paid to insurance companyUSD $11,333
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare 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 $306,890
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17,811
Amount paid for insurance broker fees11333
Additional information about fees paid to insurance brokerBONUS COMPENSATION
Insurance broker organization code?3
Insurance broker nameENV INSURANCE AGENCY
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00394800
Policy instance 1
Insurance contract or identification number00394800
Number of Individuals Covered461
Insurance policy start date2014-04-01
Insurance policy end date2015-03-31
Total amount of commissions paid to insurance brokerUSD $16,519
Total amount of fees paid to insurance companyUSD $7,756
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare 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 $23,405
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HM LIFE INSURANCE COMPANY OF NY (National Association of Insurance Commissioners NAIC id number: 60213 )
Policy contract number404618 0010 SSL
Policy instance 1
Insurance contract or identification number404618 0010 SSL
Number of Individuals Covered345
Insurance policy start date2014-04-01
Insurance policy end date2015-03-31
Total amount of commissions paid to insurance brokerUSD $31,053
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 BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $207,021
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $31,053
Insurance broker organization code?3
Insurance broker nameENV INS AGENCY LLC
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00394800
Policy instance 1
Insurance contract or identification number00394800
Number of Individuals Covered448
Insurance policy start date2013-04-01
Insurance policy end date2014-03-31
Total amount of commissions paid to insurance brokerUSD $15,559
Total amount of fees paid to insurance companyUSD $10,803
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare 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 $256,177
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,559
Amount paid for insurance broker fees10803
Additional information about fees paid to insurance brokerBONUS COMPENSATION
Insurance broker organization code?3
Insurance broker nameENV INSURANCE AGENCY LLC
HM LIFE INSURANCE COMPANY OF NY (National Association of Insurance Commissioners NAIC id number: 60213 )
Policy contract number404618 0010 SSL
Policy instance 1
Insurance contract or identification number404618 0010 SSL
Number of Individuals Covered368
Insurance policy start date2013-04-01
Insurance policy end date2014-03-31
Total amount of commissions paid to insurance brokerUSD $29,443
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 BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $196,287
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00394800
Policy instance 1
Insurance contract or identification number00394800
Number of Individuals Covered434
Insurance policy start date2012-04-01
Insurance policy end date2013-03-31
Total amount of commissions paid to insurance brokerUSD $15,216
Total amount of fees paid to insurance companyUSD $10,665
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $257,639
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
STANDARD SECURITY LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 70939 )
Policy contract number12/032
Policy instance 1
Insurance contract or identification number12/032
Number of Individuals Covered371
Insurance policy start date2012-04-01
Insurance policy end date2013-03-31
Total amount of commissions paid to insurance brokerUSD $26,360
Welfare Benefit Premiums Paid to CarrierUSD $175,731
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $26,360
Insurance broker organization code?3
Insurance broker nameEBS RMSCO, INC.
STANDARD SECURITY LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 70939 )
Policy contract number11/652
Policy instance 1
Insurance contract or identification number11/652
Number of Individuals Covered364
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
Total amount of commissions paid to insurance brokerUSD $23,732
Welfare Benefit Premiums Paid to CarrierUSD $158,216
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 )
Policy contract numberB0080
Policy instance 1
Insurance contract or identification numberB0080
Number of Individuals Covered362
Insurance policy start date2010-04-01
Insurance policy end date2011-03-31
Total amount of commissions paid to insurance brokerUSD $16,881
Welfare Benefit Premiums Paid to CarrierUSD $112,543
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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