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PARK NATIONAL CORPORATION LONG TERM DISABILITY BENEFITS PLAN 401k Plan overview

Plan NamePARK NATIONAL CORPORATION LONG TERM DISABILITY BENEFITS PLAN
Plan identification number 590

PARK NATIONAL CORPORATION LONG TERM DISABILITY BENEFITS PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Temporary disability (accident and sickness)
  • Long-term disability cover

401k Sponsoring company profile

PARK NATIONAL CORPORATION has sponsored the creation of one or more 401k plans.

Company Name:PARK NATIONAL CORPORATION
Employer identification number (EIN):311123010
NAIC Classification:522110
NAIC Description:Commercial Banking

Additional information about PARK NATIONAL CORPORATION

Jurisdiction of Incorporation: Ohio Secretary of State Business Services Division
Incorporation Date: 1992-03-24
Company Identification Number: 815582
Legal Registered Office Address: 50 N 3RD ST
-
NEWARK
United States of America (USA)
43055

More information about PARK NATIONAL CORPORATION

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PARK NATIONAL CORPORATION LONG TERM DISABILITY BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5902021-12-01
5902020-12-01
5902019-12-01
5902018-12-01
5902017-12-01
5902016-12-01JILL S. EVANS JILL S. EVANS2018-06-25
5902015-12-01JILL S. EVANS JILL S. EVANS2017-06-28
5902014-12-01JILL S. EVANS JILL S. EVANS2016-06-27
5902013-12-01JILL S. EVANS JILL S. EVANS2015-09-12
5902012-12-01JILL S. EVANS JILL S. EVANS2014-09-15
5902011-12-01JILL S. EVANS JILL S. EVANS2013-05-23
5902010-12-01JILL S. EVANS JILL S. EVANS2012-06-15
5902009-12-01JILL S. EVANS JILL S. EVANS2011-07-21
5902008-12-01JILL S. EVANS JILL S. EVANS2010-06-10
5902008-12-01JILL S. EVANS JILL S. EVANS2010-03-01
5902007-12-01JILL S. EVANS

Plan Statistics for PARK NATIONAL CORPORATION LONG TERM DISABILITY BENEFITS PLAN

401k plan membership statisitcs for PARK NATIONAL CORPORATION LONG TERM DISABILITY BENEFITS PLAN

Measure Date Value
2021: PARK NATIONAL CORPORATION LONG TERM DISABILITY BENEFITS PLAN 2021 401k membership
Total participants, beginning-of-year2021-12-011,556
Total number of active participants reported on line 7a of the Form 55002021-12-011,600
Total of all active and inactive participants2021-12-011,600
2020: PARK NATIONAL CORPORATION LONG TERM DISABILITY BENEFITS PLAN 2020 401k membership
Total participants, beginning-of-year2020-12-011,612
Total number of active participants reported on line 7a of the Form 55002020-12-011,556
Total of all active and inactive participants2020-12-011,556
2019: PARK NATIONAL CORPORATION LONG TERM DISABILITY BENEFITS PLAN 2019 401k membership
Total participants, beginning-of-year2019-12-011,662
Total number of active participants reported on line 7a of the Form 55002019-12-011,612
Total of all active and inactive participants2019-12-011,612
2018: PARK NATIONAL CORPORATION LONG TERM DISABILITY BENEFITS PLAN 2018 401k membership
Total participants, beginning-of-year2018-12-011,562
Total number of active participants reported on line 7a of the Form 55002018-12-011,662
Total of all active and inactive participants2018-12-011,662
2017: PARK NATIONAL CORPORATION LONG TERM DISABILITY BENEFITS PLAN 2017 401k membership
Total participants, beginning-of-year2017-12-011,623
Total number of active participants reported on line 7a of the Form 55002017-12-011,562
Total of all active and inactive participants2017-12-011,562
2016: PARK NATIONAL CORPORATION LONG TERM DISABILITY BENEFITS PLAN 2016 401k membership
Total participants, beginning-of-year2016-12-011,564
Total number of active participants reported on line 7a of the Form 55002016-12-011,623
Total of all active and inactive participants2016-12-011,623
2015: PARK NATIONAL CORPORATION LONG TERM DISABILITY BENEFITS PLAN 2015 401k membership
Total participants, beginning-of-year2015-12-011,624
Total number of active participants reported on line 7a of the Form 55002015-12-011,564
Total of all active and inactive participants2015-12-011,564
2014: PARK NATIONAL CORPORATION LONG TERM DISABILITY BENEFITS PLAN 2014 401k membership
Total participants, beginning-of-year2014-12-011,605
Total number of active participants reported on line 7a of the Form 55002014-12-011,624
Total of all active and inactive participants2014-12-011,624
2013: PARK NATIONAL CORPORATION LONG TERM DISABILITY BENEFITS PLAN 2013 401k membership
Total participants, beginning-of-year2013-12-011,616
Total number of active participants reported on line 7a of the Form 55002013-12-011,605
Total of all active and inactive participants2013-12-011,605
2012: PARK NATIONAL CORPORATION LONG TERM DISABILITY BENEFITS PLAN 2012 401k membership
Total participants, beginning-of-year2012-12-011,586
Total number of active participants reported on line 7a of the Form 55002012-12-011,616
Total of all active and inactive participants2012-12-011,616
2011: PARK NATIONAL CORPORATION LONG TERM DISABILITY BENEFITS PLAN 2011 401k membership
Total participants, beginning-of-year2011-12-011,672
Total number of active participants reported on line 7a of the Form 55002011-12-011,586
Total of all active and inactive participants2011-12-011,586
2010: PARK NATIONAL CORPORATION LONG TERM DISABILITY BENEFITS PLAN 2010 401k membership
Total participants, beginning-of-year2010-12-011,716
Total number of active participants reported on line 7a of the Form 55002010-12-011,672
Total of all active and inactive participants2010-12-011,672
2009: PARK NATIONAL CORPORATION LONG TERM DISABILITY BENEFITS PLAN 2009 401k membership
Total participants, beginning-of-year2009-12-011,735
Total number of active participants reported on line 7a of the Form 55002009-12-011,716
Total of all active and inactive participants2009-12-011,716
2008: PARK NATIONAL CORPORATION LONG TERM DISABILITY BENEFITS PLAN 2008 401k membership
Total participants, beginning-of-year2008-12-011,729
Total number of active participants reported on line 7a of the Form 55002008-12-011,735
Total of all active and inactive participants2008-12-011,735
2007: PARK NATIONAL CORPORATION LONG TERM DISABILITY BENEFITS PLAN 2007 401k membership
Total participants, beginning-of-year2007-12-011,704
Total number of active participants reported on line 7a of the Form 55002007-12-011,729
Total of all active and inactive participants2007-12-011,729

Form 5500 Responses for PARK NATIONAL CORPORATION LONG TERM DISABILITY BENEFITS PLAN

2021: PARK NATIONAL CORPORATION LONG TERM DISABILITY BENEFITS PLAN 2021 form 5500 responses
2021-12-01Type of plan entitySingle employer plan
2021-12-01Plan funding arrangement – InsuranceYes
2021-12-01Plan funding arrangement – General assets of the sponsorYes
2021-12-01Plan benefit arrangement – InsuranceYes
2021-12-01Plan benefit arrangement – General assets of the sponsorYes
2020: PARK NATIONAL CORPORATION LONG TERM DISABILITY BENEFITS PLAN 2020 form 5500 responses
2020-12-01Type of plan entitySingle employer plan
2020-12-01Plan funding arrangement – InsuranceYes
2020-12-01Plan funding arrangement – General assets of the sponsorYes
2020-12-01Plan benefit arrangement – InsuranceYes
2020-12-01Plan benefit arrangement – General assets of the sponsorYes
2019: PARK NATIONAL CORPORATION LONG TERM DISABILITY BENEFITS PLAN 2019 form 5500 responses
2019-12-01Type of plan entitySingle employer plan
2019-12-01Plan funding arrangement – InsuranceYes
2019-12-01Plan funding arrangement – General assets of the sponsorYes
2019-12-01Plan benefit arrangement – InsuranceYes
2019-12-01Plan benefit arrangement – General assets of the sponsorYes
2018: PARK NATIONAL CORPORATION LONG TERM DISABILITY BENEFITS PLAN 2018 form 5500 responses
2018-12-01Type of plan entitySingle employer plan
2018-12-01Plan funding arrangement – InsuranceYes
2018-12-01Plan funding arrangement – General assets of the sponsorYes
2018-12-01Plan benefit arrangement – InsuranceYes
2018-12-01Plan benefit arrangement – General assets of the sponsorYes
2017: PARK NATIONAL CORPORATION LONG TERM DISABILITY BENEFITS PLAN 2017 form 5500 responses
2017-12-01Type of plan entitySingle employer plan
2017-12-01Plan funding arrangement – InsuranceYes
2017-12-01Plan funding arrangement – General assets of the sponsorYes
2017-12-01Plan benefit arrangement – InsuranceYes
2017-12-01Plan benefit arrangement – General assets of the sponsorYes
2016: PARK NATIONAL CORPORATION LONG TERM DISABILITY BENEFITS PLAN 2016 form 5500 responses
2016-12-01Type of plan entitySingle employer plan
2016-12-01Plan funding arrangement – InsuranceYes
2016-12-01Plan funding arrangement – General assets of the sponsorYes
2016-12-01Plan benefit arrangement – InsuranceYes
2016-12-01Plan benefit arrangement – General assets of the sponsorYes
2015: PARK NATIONAL CORPORATION LONG TERM DISABILITY BENEFITS PLAN 2015 form 5500 responses
2015-12-01Type of plan entitySingle employer plan
2015-12-01Plan funding arrangement – InsuranceYes
2015-12-01Plan funding arrangement – General assets of the sponsorYes
2015-12-01Plan benefit arrangement – InsuranceYes
2015-12-01Plan benefit arrangement – General assets of the sponsorYes
2014: PARK NATIONAL CORPORATION LONG TERM DISABILITY BENEFITS PLAN 2014 form 5500 responses
2014-12-01Type of plan entitySingle employer plan
2014-12-01Plan funding arrangement – InsuranceYes
2014-12-01Plan funding arrangement – General assets of the sponsorYes
2014-12-01Plan benefit arrangement – InsuranceYes
2014-12-01Plan benefit arrangement – General assets of the sponsorYes
2013: PARK NATIONAL CORPORATION LONG TERM DISABILITY BENEFITS PLAN 2013 form 5500 responses
2013-12-01Type of plan entitySingle employer plan
2013-12-01Plan funding arrangement – InsuranceYes
2013-12-01Plan funding arrangement – General assets of the sponsorYes
2013-12-01Plan benefit arrangement – InsuranceYes
2013-12-01Plan benefit arrangement – General assets of the sponsorYes
2012: PARK NATIONAL CORPORATION LONG TERM DISABILITY BENEFITS PLAN 2012 form 5500 responses
2012-12-01Type of plan entitySingle employer plan
2012-12-01Plan funding arrangement – InsuranceYes
2012-12-01Plan funding arrangement – General assets of the sponsorYes
2012-12-01Plan benefit arrangement – InsuranceYes
2012-12-01Plan benefit arrangement – General assets of the sponsorYes
2011: PARK NATIONAL CORPORATION LONG TERM DISABILITY BENEFITS PLAN 2011 form 5500 responses
2011-12-01Type of plan entitySingle employer plan
2011-12-01Plan funding arrangement – InsuranceYes
2011-12-01Plan funding arrangement – General assets of the sponsorYes
2011-12-01Plan benefit arrangement – InsuranceYes
2011-12-01Plan benefit arrangement – General assets of the sponsorYes
2010: PARK NATIONAL CORPORATION LONG TERM DISABILITY BENEFITS PLAN 2010 form 5500 responses
2010-12-01Type of plan entitySingle employer plan
2010-12-01Plan funding arrangement – InsuranceYes
2010-12-01Plan funding arrangement – General assets of the sponsorYes
2010-12-01Plan benefit arrangement – InsuranceYes
2010-12-01Plan benefit arrangement – General assets of the sponsorYes
2009: PARK NATIONAL CORPORATION LONG TERM DISABILITY BENEFITS PLAN 2009 form 5500 responses
2009-12-01Type of plan entitySingle employer plan
2009-12-01This submission is the final filingNo
2009-12-01Plan funding arrangement – InsuranceYes
2009-12-01Plan funding arrangement – General assets of the sponsorYes
2009-12-01Plan benefit arrangement – InsuranceYes
2009-12-01Plan benefit arrangement – General assets of the sponsorYes
2008: PARK NATIONAL CORPORATION LONG TERM DISABILITY BENEFITS PLAN 2008 form 5500 responses
2008-12-01Type of plan entitySingle employer plan
2008-12-01Submission has been amendedYes
2008-12-01This submission is the final filingNo
2008-12-01Plan funding arrangement – InsuranceYes
2008-12-01Plan funding arrangement – General assets of the sponsorYes
2008-12-01Plan benefit arrangement – InsuranceYes
2008-12-01Plan benefit arrangement – General assets of the sponsorYes
2007: PARK NATIONAL CORPORATION LONG TERM DISABILITY BENEFITS PLAN 2007 form 5500 responses
2007-12-01Type of plan entitySingle employer plan
2007-12-01This submission is the final filingNo
2007-12-01Plan funding arrangement – InsuranceYes
2007-12-01Plan funding arrangement – General assets of the sponsorYes
2007-12-01Plan benefit arrangement – InsuranceYes
2007-12-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberG000ARUV
Policy instance 4
Insurance contract or identification numberG000ARUV
Number of Individuals Covered199
Insurance policy start date2022-01-01
Insurance policy end date2023-01-01
Total amount of commissions paid to insurance brokerUSD $2,824
Total amount of fees paid to insurance companyUSD $795
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $18,824
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,824
Amount paid for insurance broker fees795
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000ARUV
Policy instance 3
Insurance contract or identification numberG000ARUV
Number of Individuals Covered627
Insurance policy start date2022-01-01
Insurance policy end date2023-01-01
Total amount of commissions paid to insurance brokerUSD $41,112
Total amount of fees paid to insurance companyUSD $13,017
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $256,952
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $41,112
Amount paid for insurance broker fees13017
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000ARUV
Policy instance 2
Insurance contract or identification numberG000ARUV
Number of Individuals Covered1600
Insurance policy start date2022-01-01
Insurance policy end date2023-01-01
Total amount of commissions paid to insurance brokerUSD $6,361
Total amount of fees paid to insurance companyUSD $12,787
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $222,260
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,361
Amount paid for insurance broker fees12787
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000ARUV
Policy instance 1
Insurance contract or identification numberG000ARUV
Number of Individuals Covered1511
Insurance policy start date2022-01-01
Insurance policy end date2023-01-01
Total amount of commissions paid to insurance brokerUSD $6,532
Total amount of fees paid to insurance companyUSD $14,630
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $253,213
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,532
Amount paid for insurance broker fees14630
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000ARUV
Policy instance 1
Insurance contract or identification numberG000ARUV
Number of Individuals Covered1518
Insurance policy start date2021-01-01
Insurance policy end date2022-01-01
Total amount of commissions paid to insurance brokerUSD $6,652
Total amount of fees paid to insurance companyUSD $15,000
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $265,164
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,652
Amount paid for insurance broker fees15000
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000ARUV
Policy instance 2
Insurance contract or identification numberG000ARUV
Number of Individuals Covered1556
Insurance policy start date2021-01-01
Insurance policy end date2022-01-01
Total amount of commissions paid to insurance brokerUSD $6,408
Total amount of fees paid to insurance companyUSD $15,000
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $231,631
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,408
Amount paid for insurance broker fees15000
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000ARUV
Policy instance 3
Insurance contract or identification numberG000ARUV
Number of Individuals Covered587
Insurance policy start date2021-01-01
Insurance policy end date2022-01-01
Total amount of commissions paid to insurance brokerUSD $38,016
Total amount of fees paid to insurance companyUSD $15,000
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $237,599
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $38,016
Amount paid for insurance broker fees15000
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberG000ARUV
Policy instance 4
Insurance contract or identification numberG000ARUV
Number of Individuals Covered193
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $1,789
Total amount of fees paid to insurance companyUSD $358
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $11,924
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,789
Amount paid for insurance broker fees358
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberG000ARUV
Policy instance 4
Insurance contract or identification numberG000ARUV
Number of Individuals Covered98
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $1,094
Total amount of fees paid to insurance companyUSD $225
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,297
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,094
Amount paid for insurance broker fees225
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000ARUV
Policy instance 3
Insurance contract or identification numberG000ARUV
Number of Individuals Covered572
Insurance policy start date2020-01-01
Insurance policy end date2021-01-01
Total amount of commissions paid to insurance brokerUSD $38,344
Total amount of fees paid to insurance companyUSD $14,130
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $239,652
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $38,344
Amount paid for insurance broker fees14130
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000ARUV
Policy instance 2
Insurance contract or identification numberG000ARUV
Number of Individuals Covered1612
Insurance policy start date2020-01-01
Insurance policy end date2021-01-01
Total amount of commissions paid to insurance brokerUSD $6,608
Total amount of fees paid to insurance companyUSD $15,000
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $271,619
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,608
Amount paid for insurance broker fees15000
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000ARUV
Policy instance 1
Insurance contract or identification numberG000ARUV
Number of Individuals Covered1572
Insurance policy start date2020-01-01
Insurance policy end date2021-01-01
Total amount of commissions paid to insurance brokerUSD $7,153
Total amount of fees paid to insurance companyUSD $15,000
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $315,343
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,153
Amount paid for insurance broker fees15000
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000ARUV
Policy instance 1
Insurance contract or identification numberG000ARUV
Number of Individuals Covered1601
Insurance policy start date2019-01-01
Insurance policy end date2020-01-01
Total amount of commissions paid to insurance brokerUSD $7,308
Total amount of fees paid to insurance companyUSD $12,241
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $330,752
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,308
Amount paid for insurance broker fees12241
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000ARUV
Policy instance 2
Insurance contract or identification numberG000ARUV
Number of Individuals Covered1662
Insurance policy start date2019-01-01
Insurance policy end date2020-01-01
Total amount of commissions paid to insurance brokerUSD $6,668
Total amount of fees paid to insurance companyUSD $10,850
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $283,665
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,668
Amount paid for insurance broker fees10850
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000ARUV
Policy instance 3
Insurance contract or identification numberG000ARUV
Number of Individuals Covered554
Insurance policy start date2019-01-01
Insurance policy end date2020-01-01
Total amount of commissions paid to insurance brokerUSD $34,973
Total amount of fees paid to insurance companyUSD $9,244
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $218,581
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $34,973
Amount paid for insurance broker fees9244
Insurance broker organization code?4
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberG000ARUV
Policy instance 4
Insurance contract or identification numberG000ARUV
Number of Individuals Covered49
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $515
Total amount of fees paid to insurance companyUSD $0
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,435
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $515
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberG000ARUV
Policy instance 4
Insurance contract or identification numberG000ARUV
Number of Individuals Covered49
Insurance policy start date2018-10-01
Insurance policy end date2019-01-01
Total amount of commissions paid to insurance brokerUSD $855
Total amount of fees paid to insurance companyUSD $0
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,698
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 numberG000ARUV
Policy instance 3
Insurance contract or identification numberG000ARUV
Number of Individuals Covered501
Insurance policy start date2018-01-01
Insurance policy end date2019-01-01
Total amount of commissions paid to insurance brokerUSD $32,285
Total amount of fees paid to insurance companyUSD $11,877
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $201,783
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 numberG000ARUV
Policy instance 1
Insurance contract or identification numberG000ARUV
Number of Individuals Covered1501
Insurance policy start date2018-01-01
Insurance policy end date2019-01-01
Total amount of commissions paid to insurance brokerUSD $6,673
Total amount of fees paid to insurance companyUSD $15,000
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $267,282
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 numberG000ARUV
Policy instance 2
Insurance contract or identification numberG000ARUV
Number of Individuals Covered1562
Insurance policy start date2018-01-01
Insurance policy end date2019-01-01
Total amount of commissions paid to insurance brokerUSD $6,435
Total amount of fees paid to insurance companyUSD $13,023
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $236,915
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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