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GROUP LIFE AD&D AND SUPPLEMENTAL LIFE PLAN FOR THE EMPLOYEES OF PCI 401k Plan overview

Plan NameGROUP LIFE AD&D AND SUPPLEMENTAL LIFE PLAN FOR THE EMPLOYEES OF PCI
Plan identification number 504

GROUP LIFE AD&D AND SUPPLEMENTAL LIFE PLAN FOR THE EMPLOYEES OF PCI Benefits

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

401k Sponsoring company profile

PROPERTY CASUALTY INSURERS ASSOCIATION OF AMERICA has sponsored the creation of one or more 401k plans.

Company Name:PROPERTY CASUALTY INSURERS ASSOCIATION OF AMERICA
Employer identification number (EIN):200487810
NAIC Classification:813000
NAIC Description: Religious, Grantmaking, Civic, Professional, and Similar Organizations

Additional information about PROPERTY CASUALTY INSURERS ASSOCIATION OF AMERICA

Jurisdiction of Incorporation: Texas Secretary of State
Incorporation Date: 2004-06-28
Company Identification Number: 0800361515
Legal Registered Office Address: 8700 W BRYN MAWR AVE STE 1200S

CHICAGO
United States of America (USA)
60631

More information about PROPERTY CASUALTY INSURERS ASSOCIATION OF AMERICA

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GROUP LIFE AD&D AND SUPPLEMENTAL LIFE PLAN FOR THE EMPLOYEES OF PCI

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5042022-01-01MARK WACHHOLZ2023-10-11
5042021-01-01MARK WACHHOLZ2022-09-27
5042020-01-01MARK D WACHHOLZ2021-10-04
5042019-01-01MARK D WACHHOLZ2020-10-13
5042018-01-01MARK D. WACHHOLZ2019-10-14
5042017-01-01MARK WACHHOLZ MARK WACHHOLZ2018-10-12
5042016-01-01MARK WACHHOLZ MARK WACHHOLZ2017-10-10
5042015-01-01MARK WACHHOLZ MARK WACHHOLZ2016-09-08
5042014-01-01MARK WACHHOLZ MARK WACHHOLZ2015-10-09
5042013-01-01DEBORAH WENSEL DEBORAH WENSEL2014-09-15
5042012-01-01DEBORAH WENSEL DEBORAH WENSEL2013-07-31
5042011-01-01DANA KALAFUT ELYSA ROBIN2012-10-10
5042010-01-01GRACE SZPAJER ELYSA ROBIN2011-10-13
5042009-01-01GRACE SZPAJER ELYSA ROBIN2010-10-13

Plan Statistics for GROUP LIFE AD&D AND SUPPLEMENTAL LIFE PLAN FOR THE EMPLOYEES OF PCI

401k plan membership statisitcs for GROUP LIFE AD&D AND SUPPLEMENTAL LIFE PLAN FOR THE EMPLOYEES OF PCI

Measure Date Value
2022: GROUP LIFE AD&D AND SUPPLEMENTAL LIFE PLAN FOR THE EMPLOYEES OF PCI 2022 401k membership
Total participants, beginning-of-year2022-01-01155
Total number of active participants reported on line 7a of the Form 55002022-01-01148
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-01148
Number of employers contributing to the scheme2022-01-010
2021: GROUP LIFE AD&D AND SUPPLEMENTAL LIFE PLAN FOR THE EMPLOYEES OF PCI 2021 401k membership
Total participants, beginning-of-year2021-01-01158
Total number of active participants reported on line 7a of the Form 55002021-01-01155
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-01155
Number of employers contributing to the scheme2021-01-010
2020: GROUP LIFE AD&D AND SUPPLEMENTAL LIFE PLAN FOR THE EMPLOYEES OF PCI 2020 401k membership
Total participants, beginning-of-year2020-01-01158
Total number of active participants reported on line 7a of the Form 55002020-01-01158
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 participants2020-01-01158
Number of employers contributing to the scheme2020-01-010
2019: GROUP LIFE AD&D AND SUPPLEMENTAL LIFE PLAN FOR THE EMPLOYEES OF PCI 2019 401k membership
Total participants, beginning-of-year2019-01-01134
Total number of active participants reported on line 7a of the Form 55002019-01-01158
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 participants2019-01-01158
Number of employers contributing to the scheme2019-01-010
2018: GROUP LIFE AD&D AND SUPPLEMENTAL LIFE PLAN FOR THE EMPLOYEES OF PCI 2018 401k membership
Total participants, beginning-of-year2018-01-01237
Total number of active participants reported on line 7a of the Form 55002018-01-01134
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 participants2018-01-01134
Number of employers contributing to the scheme2018-01-010
2017: GROUP LIFE AD&D AND SUPPLEMENTAL LIFE PLAN FOR THE EMPLOYEES OF PCI 2017 401k membership
Total participants, beginning-of-year2017-01-01238
Total number of active participants reported on line 7a of the Form 55002017-01-01134
Number of retired or separated participants receiving benefits2017-01-01103
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-01237
2016: GROUP LIFE AD&D AND SUPPLEMENTAL LIFE PLAN FOR THE EMPLOYEES OF PCI 2016 401k membership
Total participants, beginning-of-year2016-01-01133
Total number of active participants reported on line 7a of the Form 55002016-01-01135
Number of retired or separated participants receiving benefits2016-01-01103
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-01238
2015: GROUP LIFE AD&D AND SUPPLEMENTAL LIFE PLAN FOR THE EMPLOYEES OF PCI 2015 401k membership
Total participants, beginning-of-year2015-01-01131
Total number of active participants reported on line 7a of the Form 55002015-01-01133
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 participants2015-01-01133
2014: GROUP LIFE AD&D AND SUPPLEMENTAL LIFE PLAN FOR THE EMPLOYEES OF PCI 2014 401k membership
Total participants, beginning-of-year2014-01-01139
Total number of active participants reported on line 7a of the Form 55002014-01-01131
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 participants2014-01-01131
2013: GROUP LIFE AD&D AND SUPPLEMENTAL LIFE PLAN FOR THE EMPLOYEES OF PCI 2013 401k membership
Total participants, beginning-of-year2013-01-01187
Total number of active participants reported on line 7a of the Form 55002013-01-01139
Total of all active and inactive participants2013-01-01139
2012: GROUP LIFE AD&D AND SUPPLEMENTAL LIFE PLAN FOR THE EMPLOYEES OF PCI 2012 401k membership
Total participants, beginning-of-year2012-01-01192
Total number of active participants reported on line 7a of the Form 55002012-01-01187
Total of all active and inactive participants2012-01-01187
2011: GROUP LIFE AD&D AND SUPPLEMENTAL LIFE PLAN FOR THE EMPLOYEES OF PCI 2011 401k membership
Total participants, beginning-of-year2011-01-01259
Total number of active participants reported on line 7a of the Form 55002011-01-01217
Total of all active and inactive participants2011-01-01217
2010: GROUP LIFE AD&D AND SUPPLEMENTAL LIFE PLAN FOR THE EMPLOYEES OF PCI 2010 401k membership
Total participants, beginning-of-year2010-01-01273
Total number of active participants reported on line 7a of the Form 55002010-01-01148
Number of retired or separated participants receiving benefits2010-01-01111
Number of other retired or separated participants entitled to future benefits2010-01-010
Total of all active and inactive participants2010-01-01259
2009: GROUP LIFE AD&D AND SUPPLEMENTAL LIFE PLAN FOR THE EMPLOYEES OF PCI 2009 401k membership
Total participants, beginning-of-year2009-01-01277
Total number of active participants reported on line 7a of the Form 55002009-01-01156
Number of retired or separated participants receiving benefits2009-01-01117
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-01273

Form 5500 Responses for GROUP LIFE AD&D AND SUPPLEMENTAL LIFE PLAN FOR THE EMPLOYEES OF PCI

2022: GROUP LIFE AD&D AND SUPPLEMENTAL LIFE PLAN FOR THE EMPLOYEES OF PCI 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – InsuranceYes
2021: GROUP LIFE AD&D AND SUPPLEMENTAL LIFE PLAN FOR THE EMPLOYEES OF PCI 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – InsuranceYes
2020: GROUP LIFE AD&D AND SUPPLEMENTAL LIFE PLAN FOR THE EMPLOYEES OF PCI 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 AD&D AND SUPPLEMENTAL LIFE PLAN FOR THE EMPLOYEES OF PCI 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 AD&D AND SUPPLEMENTAL LIFE PLAN FOR THE EMPLOYEES OF PCI 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 AD&D AND SUPPLEMENTAL LIFE PLAN FOR THE EMPLOYEES OF PCI 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 AD&D AND SUPPLEMENTAL LIFE PLAN FOR THE EMPLOYEES OF PCI 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: GROUP LIFE AD&D AND SUPPLEMENTAL LIFE PLAN FOR THE EMPLOYEES OF PCI 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: GROUP LIFE AD&D AND SUPPLEMENTAL LIFE PLAN FOR THE EMPLOYEES OF PCI 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: GROUP LIFE AD&D AND SUPPLEMENTAL LIFE PLAN FOR THE EMPLOYEES OF PCI 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: GROUP LIFE AD&D AND SUPPLEMENTAL LIFE PLAN FOR THE EMPLOYEES OF PCI 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: GROUP LIFE AD&D AND SUPPLEMENTAL LIFE PLAN FOR THE EMPLOYEES OF PCI 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2010: GROUP LIFE AD&D AND SUPPLEMENTAL LIFE PLAN FOR THE EMPLOYEES OF PCI 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – InsuranceYes
2009: GROUP LIFE AD&D AND SUPPLEMENTAL LIFE PLAN FOR THE EMPLOYEES OF PCI 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan 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 numberFLX965237
Policy instance 1
Insurance contract or identification numberFLX965237
Number of Individuals Covered148
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $3,593
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 $213,637
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees3593
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 numberFLX965237
Policy instance 1
Insurance contract or identification numberFLX965237
Number of Individuals Covered155
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $1,909
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 $278,354
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees1909
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 numberFLX965237
Policy instance 1
Insurance contract or identification numberFLX965237
Number of Individuals Covered153
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $3,276
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 $156,814
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees3276
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 numberFLX965237
Policy instance 1
Insurance contract or identification numberFLX965237
Number of Individuals Covered158
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $2,205
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 $226,119
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 fees2205
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 numberFLX965237
Policy instance 1
Insurance contract or identification numberFLX965237
Number of Individuals Covered237
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
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 $133,231
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX965237
Policy instance 1
Insurance contract or identification numberFLX965237
Number of Individuals Covered281
Insurance policy start date2017-01-01
Insurance policy end date2018-01-01
Total amount of fees paid to insurance companyUSD $2,549
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $190,045
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees2549
Additional information about fees paid to insurance brokerOVERRIDE
Insurance broker organization code?3
Insurance broker nameLOCKTON COMPANIES, LLC
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberOK 966829
Policy instance 2
Insurance contract or identification numberOK 966829
Number of Individuals Covered135
Insurance policy start date2017-01-01
Insurance policy end date2018-01-01
Total amount of fees paid to insurance companyUSD $45
Other welfare benefits providedACCIDENTAL DEATH
Welfare Benefit Premiums Paid to CarrierUSD $3,351
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees45
Additional information about fees paid to insurance brokerOVERRIDE
Insurance broker organization code?3
Insurance broker nameLOCKTON COMPANIES, LLC

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