HALLSTAR SERVICES CORPORATION has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan THE HALLSTAR SERVICES LONG-TERM DISABILITY PLAN
401k plan membership statisitcs for THE HALLSTAR SERVICES LONG-TERM DISABILITY PLAN
| Measure | Date | Value |
|---|
| 2017: THE HALLSTAR SERVICES LONG-TERM DISABILITY PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-10-01 | 139 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-10-01 | 133 |
| Number of retired or separated participants receiving benefits | 2017-10-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2017-10-01 | 0 |
| Total of all active and inactive participants | 2017-10-01 | 133 |
| 2016: THE HALLSTAR SERVICES LONG-TERM DISABILITY PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-10-01 | 149 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-10-01 | 139 |
| Number of retired or separated participants receiving benefits | 2016-10-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2016-10-01 | 0 |
| Total of all active and inactive participants | 2016-10-01 | 139 |
| 2015: THE HALLSTAR SERVICES LONG-TERM DISABILITY PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-10-01 | 147 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-10-01 | 149 |
| Number of retired or separated participants receiving benefits | 2015-10-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2015-10-01 | 0 |
| Total of all active and inactive participants | 2015-10-01 | 149 |
| 2014: THE HALLSTAR SERVICES LONG-TERM DISABILITY PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-10-01 | 142 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-10-01 | 147 |
| Number of retired or separated participants receiving benefits | 2014-10-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2014-10-01 | 0 |
| Total of all active and inactive participants | 2014-10-01 | 147 |
| 2013: THE HALLSTAR SERVICES LONG-TERM DISABILITY PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-10-01 | 129 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-10-01 | 142 |
| Number of retired or separated participants receiving benefits | 2013-10-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2013-10-01 | 0 |
| Total of all active and inactive participants | 2013-10-01 | 142 |
| 2012: THE HALLSTAR SERVICES LONG-TERM DISABILITY PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-10-01 | 132 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-10-01 | 129 |
| Number of retired or separated participants receiving benefits | 2012-10-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2012-10-01 | 0 |
| Total of all active and inactive participants | 2012-10-01 | 129 |
| 2011: THE HALLSTAR SERVICES LONG-TERM DISABILITY PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-10-01 | 126 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-10-01 | 132 |
| Number of retired or separated participants receiving benefits | 2011-10-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2011-10-01 | 0 |
| Total of all active and inactive participants | 2011-10-01 | 132 |
| 2010: THE HALLSTAR SERVICES LONG-TERM DISABILITY PLAN 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-10-01 | 114 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-10-01 | 126 |
| Number of retired or separated participants receiving benefits | 2010-10-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2010-10-01 | 0 |
| Total of all active and inactive participants | 2010-10-01 | 126 |
| 2009: THE HALLSTAR SERVICES LONG-TERM DISABILITY PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-10-01 | 117 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-10-01 | 114 |
| Number of retired or separated participants receiving benefits | 2009-10-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2009-10-01 | 0 |
| Total of all active and inactive participants | 2009-10-01 | 114 |
| Measure | Date | Value |
|---|
| 2017 : THE HALLSTAR SERVICES LONG-TERM DISABILITY PLAN 2017 401k financial data |
|---|
| Total income from all sources | 2017-09-30 | $28,117 |
| Expenses. Total of all expenses incurred | 2017-09-30 | $28,117 |
| Benefits paid (including direct rollovers) | 2017-09-30 | $24,234 |
| Value of fidelity bond covering the plan | 2017-09-30 | $5,000,000 |
| Expenses. Other expenses not covered elsewhere | 2017-09-30 | $3,883 |
| Net income (gross income less expenses) | 2017-09-30 | $0 |
| Net plan assets at end of year (total assets less liabilities) | 2017-09-30 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2017-09-30 | $0 |
| Total contributions received or receivable from employer(s) | 2017-09-30 | $28,117 |
| 2016 : THE HALLSTAR SERVICES LONG-TERM DISABILITY PLAN 2016 401k financial data |
|---|
| Total income from all sources | 2016-09-30 | $29,031 |
| Expenses. Total of all expenses incurred | 2016-09-30 | $29,031 |
| Benefits paid (including direct rollovers) | 2016-09-30 | $25,037 |
| Value of fidelity bond covering the plan | 2016-09-30 | $3,000,000 |
| Expenses. Other expenses not covered elsewhere | 2016-09-30 | $3,994 |
| Net income (gross income less expenses) | 2016-09-30 | $0 |
| Net plan assets at end of year (total assets less liabilities) | 2016-09-30 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2016-09-30 | $0 |
| Total contributions received or receivable from employer(s) | 2016-09-30 | $29,031 |
| 2015 : THE HALLSTAR SERVICES LONG-TERM DISABILITY PLAN 2015 401k financial data |
|---|
| Total income from all sources | 2015-09-30 | $27,733 |
| Expenses. Total of all expenses incurred | 2015-09-30 | $27,733 |
| Value of fidelity bond covering the plan | 2015-09-30 | $3,000,000 |
| Expenses. Other expenses not covered elsewhere | 2015-09-30 | $27,733 |
| Net income (gross income less expenses) | 2015-09-30 | $0 |
| Net plan assets at end of year (total assets less liabilities) | 2015-09-30 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2015-09-30 | $0 |
| Total contributions received or receivable from employer(s) | 2015-09-30 | $27,733 |
| 2014 : THE HALLSTAR SERVICES LONG-TERM DISABILITY PLAN 2014 401k financial data |
|---|
| Total income from all sources | 2014-09-30 | $32,392 |
| Expenses. Total of all expenses incurred | 2014-09-30 | $32,392 |
| Benefits paid (including direct rollovers) | 2014-09-30 | $11,029 |
| Net income (gross income less expenses) | 2014-09-30 | $0 |
| Net plan assets at end of year (total assets less liabilities) | 2014-09-30 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2014-09-30 | $0 |
| Total contributions received or receivable from employer(s) | 2014-09-30 | $32,392 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2014-09-30 | $21,363 |
| 2013 : THE HALLSTAR SERVICES LONG-TERM DISABILITY PLAN 2013 401k financial data |
|---|
| Total income from all sources | 2013-09-30 | $34,861 |
| Expenses. Total of all expenses incurred | 2013-09-30 | $34,861 |
| Benefits paid (including direct rollovers) | 2013-09-30 | $3,540 |
| Net income (gross income less expenses) | 2013-09-30 | $0 |
| Net plan assets at end of year (total assets less liabilities) | 2013-09-30 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2013-09-30 | $0 |
| Total contributions received or receivable from employer(s) | 2013-09-30 | $34,861 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2013-09-30 | $31,321 |
| 2012 : THE HALLSTAR SERVICES LONG-TERM DISABILITY PLAN 2012 401k financial data |
|---|
| Total income from all sources | 2012-09-30 | $33,732 |
| Expenses. Total of all expenses incurred | 2012-09-30 | $33,732 |
| Benefits paid (including direct rollovers) | 2012-09-30 | $6,679 |
| Net income (gross income less expenses) | 2012-09-30 | $0 |
| Net plan assets at end of year (total assets less liabilities) | 2012-09-30 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2012-09-30 | $0 |
| Total contributions received or receivable from employer(s) | 2012-09-30 | $33,732 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2012-09-30 | $27,053 |
| 2011 : THE HALLSTAR SERVICES LONG-TERM DISABILITY PLAN 2011 401k financial data |
|---|
| Total income from all sources | 2011-09-30 | $31,812 |
| Expenses. Total of all expenses incurred | 2011-09-30 | $31,812 |
| Benefits paid (including direct rollovers) | 2011-09-30 | $-10,944 |
| Net income (gross income less expenses) | 2011-09-30 | $0 |
| Net plan assets at end of year (total assets less liabilities) | 2011-09-30 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2011-09-30 | $0 |
| Total contributions received or receivable from employer(s) | 2011-09-30 | $31,812 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2011-09-30 | $42,756 |
| 2017: THE HALLSTAR SERVICES LONG-TERM DISABILITY PLAN 2017 form 5500 responses |
|---|
| 2017-10-01 | Type of plan entity | Single employer plan |
| 2017-10-01 | Submission has been amended | No |
| 2017-10-01 | This submission is the final filing | No |
| 2017-10-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2017-10-01 | Plan is a collectively bargained plan | No |
| 2017-10-01 | Plan funding arrangement – Insurance | Yes |
| 2017-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: THE HALLSTAR SERVICES LONG-TERM DISABILITY PLAN 2016 form 5500 responses |
|---|
| 2016-10-01 | Type of plan entity | Single employer plan |
| 2016-10-01 | Submission has been amended | No |
| 2016-10-01 | This submission is the final filing | No |
| 2016-10-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-10-01 | Plan is a collectively bargained plan | No |
| 2016-10-01 | Plan funding arrangement – Insurance | Yes |
| 2016-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: THE HALLSTAR SERVICES LONG-TERM DISABILITY PLAN 2015 form 5500 responses |
|---|
| 2015-10-01 | Type of plan entity | Single employer plan |
| 2015-10-01 | Submission has been amended | No |
| 2015-10-01 | This submission is the final filing | No |
| 2015-10-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-10-01 | Plan is a collectively bargained plan | No |
| 2015-10-01 | Plan funding arrangement – Insurance | Yes |
| 2015-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: THE HALLSTAR SERVICES LONG-TERM DISABILITY PLAN 2014 form 5500 responses |
|---|
| 2014-10-01 | Type of plan entity | Single employer plan |
| 2014-10-01 | Submission has been amended | No |
| 2014-10-01 | This submission is the final filing | No |
| 2014-10-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2014-10-01 | Plan is a collectively bargained plan | No |
| 2014-10-01 | Plan funding arrangement – Insurance | Yes |
| 2014-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: THE HALLSTAR SERVICES LONG-TERM DISABILITY PLAN 2013 form 5500 responses |
|---|
| 2013-10-01 | Type of plan entity | Single employer plan |
| 2013-10-01 | Submission has been amended | No |
| 2013-10-01 | This submission is the final filing | No |
| 2013-10-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2013-10-01 | Plan is a collectively bargained plan | No |
| 2013-10-01 | Plan funding arrangement – Insurance | Yes |
| 2013-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: THE HALLSTAR SERVICES LONG-TERM DISABILITY PLAN 2012 form 5500 responses |
|---|
| 2012-10-01 | Type of plan entity | Single employer plan |
| 2012-10-01 | Submission has been amended | No |
| 2012-10-01 | This submission is the final filing | No |
| 2012-10-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2012-10-01 | Plan is a collectively bargained plan | No |
| 2012-10-01 | Plan funding arrangement – Insurance | Yes |
| 2012-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: THE HALLSTAR SERVICES LONG-TERM DISABILITY PLAN 2011 form 5500 responses |
|---|
| 2011-10-01 | Type of plan entity | Single employer plan |
| 2011-10-01 | Submission has been amended | No |
| 2011-10-01 | This submission is the final filing | No |
| 2011-10-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2011-10-01 | Plan is a collectively bargained plan | No |
| 2011-10-01 | Plan funding arrangement – Insurance | Yes |
| 2011-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2010: THE HALLSTAR SERVICES LONG-TERM DISABILITY PLAN 2010 form 5500 responses |
|---|
| 2010-10-01 | Type of plan entity | Single employer plan |
| 2010-10-01 | Submission has been amended | Yes |
| 2010-10-01 | This submission is the final filing | No |
| 2010-10-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2010-10-01 | Plan is a collectively bargained plan | No |
| 2010-10-01 | Plan funding arrangement – Insurance | Yes |
| 2010-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: THE HALLSTAR SERVICES LONG-TERM DISABILITY PLAN 2009 form 5500 responses |
|---|
| 2009-10-01 | Type of plan entity | Single employer plan |
| 2009-10-01 | Submission has been amended | No |
| 2009-10-01 | This submission is the final filing | No |
| 2009-10-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2009-10-01 | Plan is a collectively bargained plan | No |
| 2009-10-01 | Plan funding arrangement – Insurance | Yes |
| 2009-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2008: THE HALLSTAR SERVICES LONG-TERM DISABILITY PLAN 2008 form 5500 responses |
|---|
| 2008-10-01 | Type of plan entity | Single employer plan |
| 2008-10-01 | Submission has been amended | No |
| 2008-10-01 | This submission is the final filing | No |
| 2008-10-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2008-10-01 | Plan is a collectively bargained plan | No |
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | KM05945407 |
| Policy instance | 1 |
| Insurance contract or identification number | KM05945407 | | Number of Individuals Covered | 279 | | Insurance policy start date | 2017-10-01 | | Insurance policy end date | 2018-09-30 | | Total amount of commissions paid to insurance broker | USD $3,661 | | Total amount of fees paid to insurance company | USD $483 | | Are there contracts with allocated funds for individual policies? | 0 | | Are there contracts with allocated funds for group deferred annuity? | No | | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | Yes | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $25,542 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 237097 |
| Policy instance | 1 |
| Insurance contract or identification number | 237097 | | Number of Individuals Covered | 149 | | Insurance policy start date | 2015-10-01 | | Insurance policy end date | 2016-09-30 | | Total amount of commissions paid to insurance broker | USD $3,994 | | Total amount of fees paid to insurance company | USD $0 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | Yes | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $29,031 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,994 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | FEES | | Insurance broker organization code? | 3 | | Insurance broker name | EBCG LLC |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 237097 |
| Policy instance | 1 |
| Insurance contract or identification number | 237097 | | Number of Individuals Covered | 147 | | Insurance policy start date | 2014-10-01 | | Insurance policy end date | 2015-09-30 | | Total amount of commissions paid to insurance broker | USD $5,514 | | Total amount of fees paid to insurance company | USD $0 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | Yes | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $27,733 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,514 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | FEES | | Insurance broker organization code? | 3 | | Insurance broker name | EBCG LLC |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | GLTD 54V4 |
| Policy instance | 1 |
| Insurance contract or identification number | GLTD 54V4 | | Number of Individuals Covered | 127 | | Insurance policy start date | 2013-10-01 | | Insurance policy end date | 2014-07-01 | | Total amount of commissions paid to insurance broker | USD $953 | | Total amount of fees paid to insurance company | USD $0 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | Yes | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $25,768 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $953 | | Insurance broker organization code? | 4 | | Insurance broker name | EMPLOYEE BENEFITS CONSULTING |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 237097 |
| Policy instance | 2 |
| Insurance contract or identification number | 237097 | | Number of Individuals Covered | 142 | | Insurance policy start date | 2014-07-01 | | Insurance policy end date | 2014-09-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | Yes | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $6,624 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $0 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | FEES | | Insurance broker organization code? | 3 | | Insurance broker name | EBCG LLC |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | GLTD 54V4 |
| Policy instance | 1 |
| Insurance contract or identification number | GLTD 54V4 | | Number of Individuals Covered | 129 | | Insurance policy start date | 2012-10-01 | | Insurance policy end date | 2013-09-30 | | Total amount of commissions paid to insurance broker | USD $3,754 | | Total amount of fees paid to insurance company | USD $0 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | Yes | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $34,861 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,754 | | Insurance broker organization code? | 4 | | Insurance broker name | EMPLOYEE BENEFITS CONSULTING |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | GLTD 54V4 |
| Policy instance | 1 |
| Insurance contract or identification number | GLTD 54V4 | | Number of Individuals Covered | 132 | | Insurance policy start date | 2011-10-01 | | Insurance policy end date | 2012-09-30 | | Total amount of commissions paid to insurance broker | USD $3,704 | | Total amount of fees paid to insurance company | USD $0 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | Yes | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $33,732 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | GLTD 54V4 |
| Policy instance | 1 |
| Insurance contract or identification number | GLTD 54V4 | | Number of Individuals Covered | 126 | | Insurance policy start date | 2010-10-01 | | Insurance policy end date | 2011-09-30 | | Total amount of commissions paid to insurance broker | USD $3,701 | | Total amount of fees paid to insurance company | USD $0 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | | Health Insurance Welfare Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | Yes | | Unemployment Insurance Welfare Benefit | No | | Were dividends or retroactive rate refunds paid in cash? | No | | Were dividends or retroactive rate refunds paid as a credit? | No | | Welfare Benefit Premiums Paid to Carrier | USD $31,812 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
