FARMERS UNION INDUSTRIES, LLC CENTRAL BI-PRODUCTS has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan FARMERS UNION INDUSTRIES, LLC GROUP TERM LIFE - BASIC LIFE & SUPPLEMENTAL LIFE
401k plan membership statisitcs for FARMERS UNION INDUSTRIES, LLC GROUP TERM LIFE - BASIC LIFE & SUPPLEMENTAL LIFE
| Measure | Date | Value |
|---|
| 2021: FARMERS UNION INDUSTRIES, LLC GROUP TERM LIFE - BASIC LIFE & SUPPLEMENTAL LIFE 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-10-01 | 1,051 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-10-01 | 560 |
| Number of retired or separated participants receiving benefits | 2021-10-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2021-10-01 | 0 |
| Total of all active and inactive participants | 2021-10-01 | 560 |
| 2020: FARMERS UNION INDUSTRIES, LLC GROUP TERM LIFE - BASIC LIFE & SUPPLEMENTAL LIFE 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-10-01 | 1,209 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-10-01 | 1,051 |
| Number of retired or separated participants receiving benefits | 2020-10-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2020-10-01 | 0 |
| Total of all active and inactive participants | 2020-10-01 | 1,051 |
| 2019: FARMERS UNION INDUSTRIES, LLC GROUP TERM LIFE - BASIC LIFE & SUPPLEMENTAL LIFE 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-10-01 | 1,132 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-10-01 | 1,209 |
| Number of retired or separated participants receiving benefits | 2019-10-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2019-10-01 | 0 |
| Total of all active and inactive participants | 2019-10-01 | 1,209 |
| 2018: FARMERS UNION INDUSTRIES, LLC GROUP TERM LIFE - BASIC LIFE & SUPPLEMENTAL LIFE 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-10-01 | 1,367 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-10-01 | 1,132 |
| Number of retired or separated participants receiving benefits | 2018-10-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2018-10-01 | 0 |
| Total of all active and inactive participants | 2018-10-01 | 1,132 |
| 2017: FARMERS UNION INDUSTRIES, LLC GROUP TERM LIFE - BASIC LIFE & SUPPLEMENTAL LIFE 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-10-01 | 1,029 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-10-01 | 1,367 |
| 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 | 1,367 |
| 2016: FARMERS UNION INDUSTRIES, LLC GROUP TERM LIFE - BASIC LIFE & SUPPLEMENTAL LIFE 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-10-01 | 741 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-10-01 | 1,029 |
| 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 | 1,029 |
| 2015: FARMERS UNION INDUSTRIES, LLC GROUP TERM LIFE - BASIC LIFE & SUPPLEMENTAL LIFE 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-10-01 | 604 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-10-01 | 741 |
| 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 | 741 |
| 2014: FARMERS UNION INDUSTRIES, LLC GROUP TERM LIFE - BASIC LIFE & SUPPLEMENTAL LIFE 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-10-01 | 476 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-10-01 | 604 |
| 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 | 604 |
| 2013: FARMERS UNION INDUSTRIES, LLC GROUP TERM LIFE - BASIC LIFE & SUPPLEMENTAL LIFE 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-10-01 | 493 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-10-01 | 476 |
| Total of all active and inactive participants | 2013-10-01 | 476 |
| 2012: FARMERS UNION INDUSTRIES, LLC GROUP TERM LIFE - BASIC LIFE & SUPPLEMENTAL LIFE 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-10-01 | 530 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-10-01 | 493 |
| Total of all active and inactive participants | 2012-10-01 | 493 |
| 2011: FARMERS UNION INDUSTRIES, LLC GROUP TERM LIFE - BASIC LIFE & SUPPLEMENTAL LIFE 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-10-01 | 691 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-10-01 | 530 |
| Total of all active and inactive participants | 2011-10-01 | 530 |
| 2010: FARMERS UNION INDUSTRIES, LLC GROUP TERM LIFE - BASIC LIFE & SUPPLEMENTAL LIFE 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-10-01 | 526 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-10-01 | 691 |
| Total of all active and inactive participants | 2010-10-01 | 691 |
| 2009: FARMERS UNION INDUSTRIES, LLC GROUP TERM LIFE - BASIC LIFE & SUPPLEMENTAL LIFE 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-10-01 | 546 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-10-01 | 526 |
| Total of all active and inactive participants | 2009-10-01 | 526 |
| 2021: FARMERS UNION INDUSTRIES, LLC GROUP TERM LIFE - BASIC LIFE & SUPPLEMENTAL LIFE 2021 form 5500 responses |
|---|
| 2021-10-01 | Type of plan entity | Single employer plan |
| 2021-10-01 | Plan funding arrangement – Insurance | Yes |
| 2021-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2020: FARMERS UNION INDUSTRIES, LLC GROUP TERM LIFE - BASIC LIFE & SUPPLEMENTAL LIFE 2020 form 5500 responses |
|---|
| 2020-10-01 | Type of plan entity | Single employer plan |
| 2020-10-01 | Plan funding arrangement – Insurance | Yes |
| 2020-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2019: FARMERS UNION INDUSTRIES, LLC GROUP TERM LIFE - BASIC LIFE & SUPPLEMENTAL LIFE 2019 form 5500 responses |
|---|
| 2019-10-01 | Type of plan entity | Single employer plan |
| 2019-10-01 | Plan funding arrangement – Insurance | Yes |
| 2019-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: FARMERS UNION INDUSTRIES, LLC GROUP TERM LIFE - BASIC LIFE & SUPPLEMENTAL LIFE 2018 form 5500 responses |
|---|
| 2018-10-01 | Type of plan entity | Single employer plan |
| 2018-10-01 | Plan funding arrangement – Insurance | Yes |
| 2018-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: FARMERS UNION INDUSTRIES, LLC GROUP TERM LIFE - BASIC LIFE & SUPPLEMENTAL LIFE 2017 form 5500 responses |
|---|
| 2017-10-01 | Type of plan entity | Single employer plan |
| 2017-10-01 | Plan funding arrangement – Insurance | Yes |
| 2017-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: FARMERS UNION INDUSTRIES, LLC GROUP TERM LIFE - BASIC LIFE & SUPPLEMENTAL LIFE 2016 form 5500 responses |
|---|
| 2016-10-01 | Type of plan entity | Single employer plan |
| 2016-10-01 | Plan funding arrangement – Insurance | Yes |
| 2016-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: FARMERS UNION INDUSTRIES, LLC GROUP TERM LIFE - BASIC LIFE & SUPPLEMENTAL LIFE 2015 form 5500 responses |
|---|
| 2015-10-01 | Type of plan entity | Single employer plan |
| 2015-10-01 | Plan funding arrangement – Insurance | Yes |
| 2015-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: FARMERS UNION INDUSTRIES, LLC GROUP TERM LIFE - BASIC LIFE & SUPPLEMENTAL LIFE 2014 form 5500 responses |
|---|
| 2014-10-01 | Type of plan entity | Single employer plan |
| 2014-10-01 | Plan funding arrangement – Insurance | Yes |
| 2014-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: FARMERS UNION INDUSTRIES, LLC GROUP TERM LIFE - BASIC LIFE & SUPPLEMENTAL LIFE 2013 form 5500 responses |
|---|
| 2013-10-01 | Type of plan entity | Single employer plan |
| 2013-10-01 | Plan funding arrangement – Insurance | Yes |
| 2013-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: FARMERS UNION INDUSTRIES, LLC GROUP TERM LIFE - BASIC LIFE & SUPPLEMENTAL LIFE 2012 form 5500 responses |
|---|
| 2012-10-01 | Type of plan entity | Single employer plan |
| 2012-10-01 | Plan funding arrangement – Insurance | Yes |
| 2012-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: FARMERS UNION INDUSTRIES, LLC GROUP TERM LIFE - BASIC LIFE & SUPPLEMENTAL LIFE 2011 form 5500 responses |
|---|
| 2011-10-01 | Type of plan entity | Single employer plan |
| 2011-10-01 | Plan funding arrangement – Insurance | Yes |
| 2011-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2010: FARMERS UNION INDUSTRIES, LLC GROUP TERM LIFE - BASIC LIFE & SUPPLEMENTAL LIFE 2010 form 5500 responses |
|---|
| 2010-10-01 | Type of plan entity | Single employer plan |
| 2010-10-01 | Plan funding arrangement – Insurance | Yes |
| 2010-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: FARMERS UNION INDUSTRIES, LLC GROUP TERM LIFE - BASIC LIFE & SUPPLEMENTAL LIFE 2009 form 5500 responses |
|---|
| 2009-10-01 | Type of plan entity | Single employer plan |
| 2009-10-01 | This submission is the final filing | No |
| 2009-10-01 | Plan funding arrangement – Insurance | Yes |
| 2009-10-01 | Plan benefit arrangement – Insurance | Yes |
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 167773 |
| Policy instance | 3 |
| Insurance contract or identification number | 167773 | | Number of Individuals Covered | 172 | | Insurance policy start date | 2021-10-01 | | Insurance policy end date | 2022-09-30 | | Long Term Disability Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 167773 |
| Policy instance | 2 |
| Insurance contract or identification number | 167773 | | Number of Individuals Covered | 560 | | Insurance policy start date | 2021-10-01 | | Insurance policy end date | 2022-09-30 | | Life Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
| Policy contract number | E3611290 |
| Policy instance | 1 |
| Insurance contract or identification number | E3611290 | | Number of Individuals Covered | 170 | | Insurance policy start date | 2021-10-01 | | Insurance policy end date | 2022-09-30 | | Total amount of commissions paid to insurance broker | USD $15,287 | | Total amount of fees paid to insurance company | USD $180 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $159,084 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,758 | | Amount paid for insurance broker fees | 143 | | Additional information about fees paid to insurance broker | FEES | | Insurance broker organization code? | 3 |
|
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
| Policy contract number | E3611290 |
| Policy instance | 1 |
| Insurance contract or identification number | E3611290 | | Number of Individuals Covered | 213 | | Insurance policy start date | 2020-10-01 | | Insurance policy end date | 2021-09-30 | | Total amount of commissions paid to insurance broker | USD $25,624 | | Total amount of fees paid to insurance company | USD $4,375 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $200,950 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $528 | | Amount paid for insurance broker fees | 77 | | Insurance broker organization code? | 3 |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 167773 |
| Policy instance | 2 |
| Insurance contract or identification number | 167773 | | Number of Individuals Covered | 633 | | Insurance policy start date | 2020-10-01 | | Insurance policy end date | 2021-09-30 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $117,173 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 167773 |
| Policy instance | 3 |
| Insurance contract or identification number | 167773 | | Number of Individuals Covered | 205 | | Insurance policy start date | 2020-10-01 | | Insurance policy end date | 2021-09-30 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $48,829 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010194698 |
| Policy instance | 5 |
| Insurance contract or identification number | 000010194698 | | Number of Individuals Covered | 68 | | Insurance policy start date | 2019-10-01 | | Insurance policy end date | 2020-09-30 | | Total amount of fees paid to insurance company | USD $253 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $12,103 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 253 | | Additional information about fees paid to insurance broker | BROKER BONUS | | Insurance broker organization code? | 3 |
|
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
| Policy contract number | E3611290 |
| Policy instance | 4 |
| Insurance contract or identification number | E3611290 | | Number of Individuals Covered | 265 | | Insurance policy start date | 2019-10-01 | | Insurance policy end date | 2020-09-30 | | Total amount of commissions paid to insurance broker | USD $59,889 | | Total amount of fees paid to insurance company | USD $12,967 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $274,100 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $18,518 | | Amount paid for insurance broker fees | 9784 | | Insurance broker organization code? | 3 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010219365 |
| Policy instance | 3 |
| Insurance contract or identification number | 000010219365 | | Number of Individuals Covered | 152 | | Insurance policy start date | 2019-10-01 | | Insurance policy end date | 2020-09-30 | | Total amount of fees paid to insurance company | USD $846 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $43,823 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 846 | | Additional information about fees paid to insurance broker | BROKER BONUS | | Insurance broker organization code? | 3 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000400194699 |
| Policy instance | 2 |
| Insurance contract or identification number | 000400194699 | | Number of Individuals Covered | 197 | | Insurance policy start date | 2019-10-01 | | Insurance policy end date | 2020-09-30 | | Total amount of fees paid to insurance company | USD $987 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $50,337 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 987 | | Additional information about fees paid to insurance broker | BROKER BONUS | | Insurance broker organization code? | 3 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010194697 |
| Policy instance | 1 |
| Insurance contract or identification number | 000010194697 | | Number of Individuals Covered | 527 | | Insurance policy start date | 2019-10-01 | | Insurance policy end date | 2020-09-30 | | Total amount of fees paid to insurance company | USD $2,428 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH | | Welfare Benefit Premiums Paid to Carrier | USD $117,822 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 2428 | | Additional information about fees paid to insurance broker | BROKER BONUS | | Insurance broker organization code? | 3 |
|
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
| Policy contract number | E3611290 |
| Policy instance | 4 |
| Insurance contract or identification number | E3611290 | | Number of Individuals Covered | 260 | | Insurance policy start date | 2018-10-01 | | Insurance policy end date | 2019-09-30 | | Total amount of commissions paid to insurance broker | USD $47,346 | | Total amount of fees paid to insurance company | USD $11,626 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $210,822 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $14,871 | | Amount paid for insurance broker fees | 8707 | | Insurance broker organization code? | 3 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010219365 |
| Policy instance | 3 |
| Insurance contract or identification number | 000010219365 | | Number of Individuals Covered | 148 | | Insurance policy start date | 2018-10-01 | | Insurance policy end date | 2019-09-30 | | Total amount of fees paid to insurance company | USD $1,164 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $37,981 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 1164 | | Additional information about fees paid to insurance broker | BROKER BONUS | | Insurance broker organization code? | 3 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000400194699 |
| Policy instance | 2 |
| Insurance contract or identification number | 000400194699 | | Number of Individuals Covered | 197 | | Insurance policy start date | 2018-10-01 | | Insurance policy end date | 2019-09-30 | | Total amount of fees paid to insurance company | USD $1,457 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $46,384 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 1457 | | Additional information about fees paid to insurance broker | BROKER BONUS | | Insurance broker organization code? | 3 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010194697 |
| Policy instance | 1 |
| Insurance contract or identification number | 000010194697 | | Number of Individuals Covered | 527 | | Insurance policy start date | 2018-10-01 | | Insurance policy end date | 2019-09-30 | | Total amount of fees paid to insurance company | USD $4,722 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH | | Welfare Benefit Premiums Paid to Carrier | USD $115,509 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 4722 | | Additional information about fees paid to insurance broker | BROKER BONUS | | Insurance broker organization code? | 3 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010194698 |
| Policy instance | 2 |
| Insurance contract or identification number | 000010194698 | | Number of Individuals Covered | 71 | | Insurance policy start date | 2017-10-01 | | Insurance policy end date | 2018-09-30 | | Total amount of commissions paid to insurance broker | USD $213 | | Total amount of fees paid to insurance company | USD $443 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $10,517 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000400194699 |
| Policy instance | 3 |
| Insurance contract or identification number | 000400194699 | | Number of Individuals Covered | 327 | | Insurance policy start date | 2017-10-01 | | Insurance policy end date | 2018-09-30 | | Total amount of fees paid to insurance company | USD $1,393 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $26,126 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010219365 |
| Policy instance | 4 |
| Insurance contract or identification number | 000010219365 | | Number of Individuals Covered | 160 | | Insurance policy start date | 2017-10-01 | | Insurance policy end date | 2018-09-30 | | Total amount of fees paid to insurance company | USD $912 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $21,008 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
| Policy contract number | E3611290 |
| Policy instance | 5 |
| Insurance contract or identification number | E3611290 | | Number of Individuals Covered | 270 | | Insurance policy start date | 2017-10-01 | | Insurance policy end date | 2018-09-30 | | Total amount of commissions paid to insurance broker | USD $39,666 | | Total amount of fees paid to insurance company | USD $10,007 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $160,600 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010194697 |
| Policy instance | 1 |
| Insurance contract or identification number | 000010194697 | | Number of Individuals Covered | 539 | | Insurance policy start date | 2017-10-01 | | Insurance policy end date | 2018-09-30 | | Total amount of fees paid to insurance company | USD $3,719 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH | | Welfare Benefit Premiums Paid to Carrier | USD $93,902 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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