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ARMSTRONG COUNTY MEMORIAL HOSPITAL LIFE INSURANCE & LONG-TERM DISABILITY PLAN 401k Plan overview

Plan NameARMSTRONG COUNTY MEMORIAL HOSPITAL LIFE INSURANCE & LONG-TERM DISABILITY PLAN
Plan identification number 503

ARMSTRONG COUNTY MEMORIAL HOSPITAL LIFE INSURANCE & LONG-TERM DISABILITY PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover

401k Sponsoring company profile

ARMSTRONG COUNTY MEMORIAL HOSPITAL has sponsored the creation of one or more 401k plans.

Company Name:ARMSTRONG COUNTY MEMORIAL HOSPITAL
Employer identification number (EIN):250965237
NAIC Classification:622000
NAIC Description: Hospitals

Additional information about ARMSTRONG COUNTY MEMORIAL HOSPITAL

Jurisdiction of Incorporation: COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF STATE
Incorporation Date:
Company Identification Number: 18374

More information about ARMSTRONG COUNTY MEMORIAL HOSPITAL

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ARMSTRONG COUNTY MEMORIAL HOSPITAL LIFE INSURANCE & LONG-TERM DISABILITY PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5032022-07-01
5032021-07-01
5032020-07-01
5032019-07-01
5032018-07-01
5032017-07-01ANNE REMALEY
5032016-07-01ANNE REMALEY
5032015-07-01ANNE REMALEY ANNE REMALEY2016-10-13
5032014-07-01ANNE REMALEY
5032013-07-01ANNE REMALEY
5032012-07-01ANNE REMALEY
5032011-07-01ANNE REMALEY
5032010-07-01ANNE REMALEY
5032009-07-01ANNE REMALEY

Plan Statistics for ARMSTRONG COUNTY MEMORIAL HOSPITAL LIFE INSURANCE & LONG-TERM DISABILITY PLAN

401k plan membership statisitcs for ARMSTRONG COUNTY MEMORIAL HOSPITAL LIFE INSURANCE & LONG-TERM DISABILITY PLAN

Measure Date Value
2022: ARMSTRONG COUNTY MEMORIAL HOSPITAL LIFE INSURANCE & LONG-TERM DISABILITY PLAN 2022 401k membership
Total participants, beginning-of-year2022-07-01909
Total number of active participants reported on line 7a of the Form 55002022-07-01894
Number of retired or separated participants receiving benefits2022-07-010
Number of other retired or separated participants entitled to future benefits2022-07-010
Total of all active and inactive participants2022-07-01894
2021: ARMSTRONG COUNTY MEMORIAL HOSPITAL LIFE INSURANCE & LONG-TERM DISABILITY PLAN 2021 401k membership
Total participants, beginning-of-year2021-07-01909
Total number of active participants reported on line 7a of the Form 55002021-07-01901
Number of retired or separated participants receiving benefits2021-07-010
Number of other retired or separated participants entitled to future benefits2021-07-010
Total of all active and inactive participants2021-07-01901
2020: ARMSTRONG COUNTY MEMORIAL HOSPITAL LIFE INSURANCE & LONG-TERM DISABILITY PLAN 2020 401k membership
Total participants, beginning-of-year2020-07-01908
Total number of active participants reported on line 7a of the Form 55002020-07-01911
Number of retired or separated participants receiving benefits2020-07-010
Number of other retired or separated participants entitled to future benefits2020-07-010
Total of all active and inactive participants2020-07-01911
2019: ARMSTRONG COUNTY MEMORIAL HOSPITAL LIFE INSURANCE & LONG-TERM DISABILITY PLAN 2019 401k membership
Total participants, beginning-of-year2019-07-01897
Total number of active participants reported on line 7a of the Form 55002019-07-01910
Number of retired or separated participants receiving benefits2019-07-010
Number of other retired or separated participants entitled to future benefits2019-07-010
Total of all active and inactive participants2019-07-01910
2018: ARMSTRONG COUNTY MEMORIAL HOSPITAL LIFE INSURANCE & LONG-TERM DISABILITY PLAN 2018 401k membership
Total participants, beginning-of-year2018-07-01905
Total number of active participants reported on line 7a of the Form 55002018-07-01902
Number of retired or separated participants receiving benefits2018-07-010
Number of other retired or separated participants entitled to future benefits2018-07-010
Total of all active and inactive participants2018-07-01902
2017: ARMSTRONG COUNTY MEMORIAL HOSPITAL LIFE INSURANCE & LONG-TERM DISABILITY PLAN 2017 401k membership
Total participants, beginning-of-year2017-07-01912
Total number of active participants reported on line 7a of the Form 55002017-07-01902
Number of retired or separated participants receiving benefits2017-07-010
Total of all active and inactive participants2017-07-01902
2016: ARMSTRONG COUNTY MEMORIAL HOSPITAL LIFE INSURANCE & LONG-TERM DISABILITY PLAN 2016 401k membership
Total participants, beginning-of-year2016-07-01955
Total number of active participants reported on line 7a of the Form 55002016-07-01919
Number of retired or separated participants receiving benefits2016-07-010
Number of other retired or separated participants entitled to future benefits2016-07-010
Total of all active and inactive participants2016-07-01919
2015: ARMSTRONG COUNTY MEMORIAL HOSPITAL LIFE INSURANCE & LONG-TERM DISABILITY PLAN 2015 401k membership
Total participants, beginning-of-year2015-07-01943
Total number of active participants reported on line 7a of the Form 55002015-07-01954
Number of retired or separated participants receiving benefits2015-07-010
Number of other retired or separated participants entitled to future benefits2015-07-010
Total of all active and inactive participants2015-07-01954
2014: ARMSTRONG COUNTY MEMORIAL HOSPITAL LIFE INSURANCE & LONG-TERM DISABILITY PLAN 2014 401k membership
Total participants, beginning-of-year2014-07-01955
Total number of active participants reported on line 7a of the Form 55002014-07-01945
Number of retired or separated participants receiving benefits2014-07-010
Number of other retired or separated participants entitled to future benefits2014-07-010
Total of all active and inactive participants2014-07-01945
2013: ARMSTRONG COUNTY MEMORIAL HOSPITAL LIFE INSURANCE & LONG-TERM DISABILITY PLAN 2013 401k membership
Total participants, beginning-of-year2013-07-01970
Total number of active participants reported on line 7a of the Form 55002013-07-01960
Number of retired or separated participants receiving benefits2013-07-010
Number of other retired or separated participants entitled to future benefits2013-07-010
Total of all active and inactive participants2013-07-01960
2012: ARMSTRONG COUNTY MEMORIAL HOSPITAL LIFE INSURANCE & LONG-TERM DISABILITY PLAN 2012 401k membership
Total participants, beginning-of-year2012-07-01956
Total number of active participants reported on line 7a of the Form 55002012-07-01971
Number of retired or separated participants receiving benefits2012-07-010
Number of other retired or separated participants entitled to future benefits2012-07-010
Total of all active and inactive participants2012-07-01971
2011: ARMSTRONG COUNTY MEMORIAL HOSPITAL LIFE INSURANCE & LONG-TERM DISABILITY PLAN 2011 401k membership
Total participants, beginning-of-year2011-07-01956
Total number of active participants reported on line 7a of the Form 55002011-07-01953
Number of retired or separated participants receiving benefits2011-07-010
Number of other retired or separated participants entitled to future benefits2011-07-010
Total of all active and inactive participants2011-07-01953
2010: ARMSTRONG COUNTY MEMORIAL HOSPITAL LIFE INSURANCE & LONG-TERM DISABILITY PLAN 2010 401k membership
Total participants, beginning-of-year2010-07-01914
Total number of active participants reported on line 7a of the Form 55002010-07-01957
Number of retired or separated participants receiving benefits2010-07-010
Number of other retired or separated participants entitled to future benefits2010-07-010
Total of all active and inactive participants2010-07-01957
2009: ARMSTRONG COUNTY MEMORIAL HOSPITAL LIFE INSURANCE & LONG-TERM DISABILITY PLAN 2009 401k membership
Total participants, beginning-of-year2009-07-01900
Total number of active participants reported on line 7a of the Form 55002009-07-01918
Number of retired or separated participants receiving benefits2009-07-010
Number of other retired or separated participants entitled to future benefits2009-07-010
Total of all active and inactive participants2009-07-01918

Form 5500 Responses for ARMSTRONG COUNTY MEMORIAL HOSPITAL LIFE INSURANCE & LONG-TERM DISABILITY PLAN

2022: ARMSTRONG COUNTY MEMORIAL HOSPITAL LIFE INSURANCE & LONG-TERM DISABILITY PLAN 2022 form 5500 responses
2022-07-01Type of plan entitySingle employer plan
2022-07-01Submission has been amendedNo
2022-07-01This submission is the final filingNo
2022-07-01This return/report is a short plan year return/report (less than 12 months)No
2022-07-01Plan is a collectively bargained planNo
2022-07-01Plan funding arrangement – InsuranceYes
2022-07-01Plan benefit arrangement – InsuranceYes
2021: ARMSTRONG COUNTY MEMORIAL HOSPITAL LIFE INSURANCE & LONG-TERM DISABILITY PLAN 2021 form 5500 responses
2021-07-01Type of plan entitySingle employer plan
2021-07-01Submission has been amendedNo
2021-07-01This submission is the final filingNo
2021-07-01This return/report is a short plan year return/report (less than 12 months)No
2021-07-01Plan is a collectively bargained planNo
2021-07-01Plan funding arrangement – InsuranceYes
2021-07-01Plan benefit arrangement – InsuranceYes
2020: ARMSTRONG COUNTY MEMORIAL HOSPITAL LIFE INSURANCE & LONG-TERM DISABILITY PLAN 2020 form 5500 responses
2020-07-01Type of plan entitySingle employer plan
2020-07-01Submission has been amendedNo
2020-07-01This submission is the final filingNo
2020-07-01This return/report is a short plan year return/report (less than 12 months)No
2020-07-01Plan is a collectively bargained planNo
2020-07-01Plan funding arrangement – InsuranceYes
2020-07-01Plan benefit arrangement – InsuranceYes
2019: ARMSTRONG COUNTY MEMORIAL HOSPITAL LIFE INSURANCE & LONG-TERM DISABILITY PLAN 2019 form 5500 responses
2019-07-01Type of plan entitySingle employer plan
2019-07-01Submission has been amendedNo
2019-07-01This submission is the final filingNo
2019-07-01This return/report is a short plan year return/report (less than 12 months)No
2019-07-01Plan is a collectively bargained planNo
2019-07-01Plan funding arrangement – InsuranceYes
2019-07-01Plan benefit arrangement – InsuranceYes
2018: ARMSTRONG COUNTY MEMORIAL HOSPITAL LIFE INSURANCE & LONG-TERM DISABILITY PLAN 2018 form 5500 responses
2018-07-01Type of plan entitySingle employer plan
2018-07-01Submission has been amendedNo
2018-07-01This submission is the final filingNo
2018-07-01This return/report is a short plan year return/report (less than 12 months)No
2018-07-01Plan is a collectively bargained planNo
2018-07-01Plan funding arrangement – InsuranceYes
2018-07-01Plan benefit arrangement – InsuranceYes
2017: ARMSTRONG COUNTY MEMORIAL HOSPITAL LIFE INSURANCE & LONG-TERM DISABILITY PLAN 2017 form 5500 responses
2017-07-01Type of plan entitySingle employer plan
2017-07-01Submission has been amendedNo
2017-07-01This submission is the final filingNo
2017-07-01This return/report is a short plan year return/report (less than 12 months)No
2017-07-01Plan is a collectively bargained planNo
2017-07-01Plan funding arrangement – InsuranceYes
2017-07-01Plan benefit arrangement – InsuranceYes
2016: ARMSTRONG COUNTY MEMORIAL HOSPITAL LIFE INSURANCE & LONG-TERM DISABILITY PLAN 2016 form 5500 responses
2016-07-01Type of plan entitySingle employer plan
2016-07-01Submission has been amendedNo
2016-07-01This submission is the final filingNo
2016-07-01This return/report is a short plan year return/report (less than 12 months)No
2016-07-01Plan is a collectively bargained planNo
2016-07-01Plan funding arrangement – InsuranceYes
2016-07-01Plan benefit arrangement – InsuranceYes
2015: ARMSTRONG COUNTY MEMORIAL HOSPITAL LIFE INSURANCE & LONG-TERM DISABILITY PLAN 2015 form 5500 responses
2015-07-01Type of plan entitySingle employer plan
2015-07-01Submission has been amendedNo
2015-07-01This submission is the final filingNo
2015-07-01This return/report is a short plan year return/report (less than 12 months)No
2015-07-01Plan is a collectively bargained planNo
2015-07-01Plan funding arrangement – InsuranceYes
2015-07-01Plan benefit arrangement – InsuranceYes
2014: ARMSTRONG COUNTY MEMORIAL HOSPITAL LIFE INSURANCE & LONG-TERM DISABILITY PLAN 2014 form 5500 responses
2014-07-01Type of plan entitySingle employer plan
2014-07-01Submission has been amendedNo
2014-07-01This submission is the final filingNo
2014-07-01This return/report is a short plan year return/report (less than 12 months)No
2014-07-01Plan is a collectively bargained planNo
2014-07-01Plan funding arrangement – InsuranceYes
2014-07-01Plan benefit arrangement – InsuranceYes
2013: ARMSTRONG COUNTY MEMORIAL HOSPITAL LIFE INSURANCE & LONG-TERM DISABILITY PLAN 2013 form 5500 responses
2013-07-01Type of plan entitySingle employer plan
2013-07-01Submission has been amendedNo
2013-07-01This submission is the final filingNo
2013-07-01This return/report is a short plan year return/report (less than 12 months)No
2013-07-01Plan is a collectively bargained planNo
2013-07-01Plan funding arrangement – InsuranceYes
2013-07-01Plan benefit arrangement – InsuranceYes
2012: ARMSTRONG COUNTY MEMORIAL HOSPITAL LIFE INSURANCE & LONG-TERM DISABILITY PLAN 2012 form 5500 responses
2012-07-01Type of plan entitySingle employer plan
2012-07-01Submission has been amendedNo
2012-07-01This submission is the final filingNo
2012-07-01This return/report is a short plan year return/report (less than 12 months)No
2012-07-01Plan is a collectively bargained planNo
2012-07-01Plan funding arrangement – InsuranceYes
2012-07-01Plan benefit arrangement – InsuranceYes
2011: ARMSTRONG COUNTY MEMORIAL HOSPITAL LIFE INSURANCE & LONG-TERM DISABILITY PLAN 2011 form 5500 responses
2011-07-01Type of plan entitySingle employer plan
2011-07-01Submission has been amendedNo
2011-07-01This submission is the final filingNo
2011-07-01This return/report is a short plan year return/report (less than 12 months)No
2011-07-01Plan is a collectively bargained planNo
2011-07-01Plan funding arrangement – InsuranceYes
2011-07-01Plan benefit arrangement – InsuranceYes
2010: ARMSTRONG COUNTY MEMORIAL HOSPITAL LIFE INSURANCE & LONG-TERM DISABILITY PLAN 2010 form 5500 responses
2010-07-01Type of plan entitySingle employer plan
2010-07-01Submission has been amendedNo
2010-07-01This submission is the final filingNo
2010-07-01This return/report is a short plan year return/report (less than 12 months)No
2010-07-01Plan is a collectively bargained planNo
2010-07-01Plan funding arrangement – InsuranceYes
2010-07-01Plan benefit arrangement – InsuranceYes
2009: ARMSTRONG COUNTY MEMORIAL HOSPITAL LIFE INSURANCE & LONG-TERM DISABILITY PLAN 2009 form 5500 responses
2009-07-01Type of plan entitySingle employer plan
2009-07-01First time form 5500 has been submittedYes
2009-07-01Submission has been amendedNo
2009-07-01This submission is the final filingNo
2009-07-01This return/report is a short plan year return/report (less than 12 months)No
2009-07-01Plan is a collectively bargained planNo
2009-07-01Plan funding arrangement – InsuranceYes
2009-07-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number202172
Policy instance 1
Insurance contract or identification number202172
Number of Individuals Covered913
Insurance policy start date2022-07-01
Insurance policy end date2023-06-30
Total amount of commissions paid to insurance brokerUSD $15,328
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedA D & D
Welfare Benefit Premiums Paid to CarrierUSD $338,316
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,664
Insurance broker organization code?3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number202172
Policy instance 1
Insurance contract or identification number202172
Number of Individuals Covered911
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $15,342
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedA D & D
Welfare Benefit Premiums Paid to CarrierUSD $337,700
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,671
Insurance broker organization code?3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number202172
Policy instance 1
Insurance contract or identification number202172
Number of Individuals Covered911
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $15,414
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $340,165
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,707
Insurance broker organization code?3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number202172
Policy instance 1
Insurance contract or identification number202172
Number of Individuals Covered910
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $15,333
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $331,646
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,667
Insurance broker organization code?3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number202172
Policy instance 1
Insurance contract or identification number202172
Number of Individuals Covered902
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $15,382
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $334,370
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,691
Insurance broker organization code?3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number202172
Policy instance 1
Insurance contract or identification number202172
Number of Individuals Covered902
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $12,733
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $337,889
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,035
Insurance broker organization code?3
Insurance broker nameLUCAS REED MICHAEL
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number202172
Policy instance 1
Insurance contract or identification number202172
Number of Individuals Covered954
Insurance policy start date2015-07-01
Insurance policy end date2016-06-30
Total amount of commissions paid to insurance brokerUSD $10,277
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedA D & D
Welfare Benefit Premiums Paid to CarrierUSD $356,244
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,115
Insurance broker organization code?3
Insurance broker nameSTEPHEN GOULD
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number202172
Policy instance 2
Insurance contract or identification number202172
Number of Individuals Covered737
Insurance policy start date2014-07-01
Insurance policy end date2015-06-30
Total amount of commissions paid to insurance brokerUSD $6,757
Total amount of fees paid to insurance companyUSD $0
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $275,698
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,757
Insurance broker organization code?3
Insurance broker nameRONALD MCFARLAND
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number202172
Policy instance 1
Insurance contract or identification number202172
Number of Individuals Covered945
Insurance policy start date2014-07-01
Insurance policy end date2015-06-30
Total amount of commissions paid to insurance brokerUSD $3,482
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $76,602
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,482
Insurance broker organization code?3
Insurance broker nameRONALD MCFARLAND
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number202172
Policy instance 2
Insurance contract or identification number202172
Number of Individuals Covered747
Insurance policy start date2013-07-01
Insurance policy end date2014-06-30
Total amount of commissions paid to insurance brokerUSD $6,765
Total amount of fees paid to insurance companyUSD $0
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $276,378
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,765
Insurance broker organization code?3
Insurance broker nameRONALD MCFARLAND
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number202172
Policy instance 1
Insurance contract or identification number202172
Number of Individuals Covered960
Insurance policy start date2013-07-01
Insurance policy end date2014-06-30
Total amount of commissions paid to insurance brokerUSD $3,541
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $79,445
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,541
Insurance broker organization code?3
Insurance broker nameRONALD MCFARLAND
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number202172
Policy instance 1
Insurance contract or identification number202172
Number of Individuals Covered971
Insurance policy start date2012-07-01
Insurance policy end date2013-06-30
Total amount of commissions paid to insurance brokerUSD $3,524
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $78,703
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,524
Insurance broker organization code?3
Insurance broker nameRONALD MCFARLAND
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number202172
Policy instance 2
Insurance contract or identification number202172
Number of Individuals Covered759
Insurance policy start date2012-07-01
Insurance policy end date2013-06-30
Total amount of commissions paid to insurance brokerUSD $6,686
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $268,651
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,686
Insurance broker organization code?3
Insurance broker nameRONALD MCFARLAND
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number202172
Policy instance 1
Insurance contract or identification number202172
Number of Individuals Covered738
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
Total amount of commissions paid to insurance brokerUSD $6,569
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $256,834
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 number202172
Policy instance 2
Insurance contract or identification number202172
Number of Individuals Covered953
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
Total amount of commissions paid to insurance brokerUSD $3,366
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $70,798
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 number202172
Policy instance 2
Insurance contract or identification number202172
Number of Individuals Covered741
Insurance policy start date2010-07-01
Insurance policy end date2011-06-30
Total amount of commissions paid to insurance brokerUSD $6,500
Total amount of fees paid to insurance companyUSD $0
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $250,023
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,500
Insurance broker organization code?3
Insurance broker nameRONALD MCFARLAND
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number202172
Policy instance 1
Insurance contract or identification number202172
Number of Individuals Covered957
Insurance policy start date2010-07-01
Insurance policy end date2011-06-30
Total amount of commissions paid to insurance brokerUSD $3,349
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $69,945
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,349
Insurance broker organization code?3
Insurance broker nameRONALD MCFARLAND
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number202172
Policy instance 2
Insurance contract or identification number202172
Number of Individuals Covered918
Insurance policy start date2009-07-01
Insurance policy end date2010-06-30
Total amount of commissions paid to insurance brokerUSD $3,364
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $70,702
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,364
Insurance broker organization code?3
Insurance broker nameRONALD MCFARLAND
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number202172
Policy instance 1
Insurance contract or identification number202172
Number of Individuals Covered711
Insurance policy start date2009-07-01
Insurance policy end date2010-06-30
Total amount of commissions paid to insurance brokerUSD $6,316
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $231,581
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,316
Insurance broker organization code?3
Insurance broker nameRONALD MCFARLAND

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