401k Plan data: THE HERITAGE GROUP DISABILITY BENEFITS PLAN plan

THE HERITAGE GROUP DISABILITY BENEFITS PLAN 401k Plan overview

Plan Name	THE HERITAGE GROUP DISABILITY BENEFITS PLAN
Plan identification number	504

THE HERITAGE GROUP DISABILITY BENEFITS PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Temporary disability (accident and sickness) Long-term disability cover Other welfare benefit cover

401k Sponsoring company profile

THE HERITAGE GROUP has sponsored the creation of one or more 401k plans.

Company Name: THE HERITAGE GROUP

Employer identification number (EIN): 351448549

NAIC Classification: 324120

Additional information about THE HERITAGE GROUP

Jurisdiction of Incorporation: Wyoming Corporations Division

Incorporation Date: 2007-06-27

Company Identification Number: 000539962

Legal Registered Office Address: 1712 Pioneer Ave
Suite 782
Cheyenne
United States of America (USA)
82001

More information about THE HERITAGE GROUP

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THE HERITAGE GROUP DISABILITY BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
504 2022-01-01 JACKIE MOREHEAD 2023-08-01
504 2021-01-01 JACKIE MOREHEAD 2022-07-25
504 2020-01-01 R. DOUGLAS FELTON 2021-10-01
504 2019-01-01
504 2018-01-01 R. DOUGLAS FELTON
504 2017-01-01 R. DOUGLAS FELTON
504 2016-01-01 DAVID L. FRANZ
504 2015-01-01 DAVID L. FRANZ
504 2014-01-01 DAVID L. FRANZ
504 2013-01-01 DAVID FRANZ
504 2012-01-01 DAVID FRANZ
504 2011-01-01 DAVID FRANZ
504 2010-01-01 DAVID FRANZ
504 2009-01-01 DAVID FRANZ

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
504	2022-01-01	JACKIE MOREHEAD	2023-08-01
504	2021-01-01	JACKIE MOREHEAD	2022-07-25
504	2020-01-01	R. DOUGLAS FELTON	2021-10-01
504	2019-01-01
504	2018-01-01	R. DOUGLAS FELTON
504	2017-01-01	R. DOUGLAS FELTON
504	2016-01-01	DAVID L. FRANZ
504	2015-01-01	DAVID L. FRANZ
504	2014-01-01	DAVID L. FRANZ
504	2013-01-01	DAVID FRANZ
504	2012-01-01	DAVID FRANZ
504	2011-01-01	DAVID FRANZ
504	2010-01-01	DAVID FRANZ
504	2009-01-01	DAVID FRANZ

Plan Statistics for THE HERITAGE GROUP DISABILITY BENEFITS PLAN

401k plan membership statisitcs for THE HERITAGE GROUP DISABILITY BENEFITS PLAN

Measure Date Value
2022: THE HERITAGE GROUP DISABILITY BENEFITS PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 3,118
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 3,509
Total of all active and inactive participants 2022-01-01 3,509
Total participants 2022-01-01 3,509
2021: THE HERITAGE GROUP DISABILITY BENEFITS PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 3,067
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 3,118
Total of all active and inactive participants 2021-01-01 3,118
Total participants 2021-01-01 3,118
2020: THE HERITAGE GROUP DISABILITY BENEFITS PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 2,996
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 3,067
Total of all active and inactive participants 2020-01-01 3,067
Total participants 2020-01-01 3,067
2019: THE HERITAGE GROUP DISABILITY BENEFITS PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 2,778
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 2,996
Total of all active and inactive participants 2019-01-01 2,996
Total participants 2019-01-01 2,996
2018: THE HERITAGE GROUP DISABILITY BENEFITS PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 2,378
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 2,778
Total of all active and inactive participants 2018-01-01 2,778
Total participants 2018-01-01 2,778
2017: THE HERITAGE GROUP DISABILITY BENEFITS PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 2,019
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 2,378
Total of all active and inactive participants 2017-01-01 2,378
Total participants 2017-01-01 2,378
2016: THE HERITAGE GROUP DISABILITY BENEFITS PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 2,305
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 2,019
Total of all active and inactive participants 2016-01-01 2,019
Total participants 2016-01-01 2,019
2015: THE HERITAGE GROUP DISABILITY BENEFITS PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 2,270
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 2,305
Total of all active and inactive participants 2015-01-01 2,305
Total participants 2015-01-01 0
2014: THE HERITAGE GROUP DISABILITY BENEFITS PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 1,154
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 2,270
Total of all active and inactive participants 2014-01-01 2,270
Total participants 2014-01-01 0
2013: THE HERITAGE GROUP DISABILITY BENEFITS PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 1,000
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 1,154
Total of all active and inactive participants 2013-01-01 1,154
Total participants 2013-01-01 0
2012: THE HERITAGE GROUP DISABILITY BENEFITS PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 878
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 1,000
Total of all active and inactive participants 2012-01-01 1,000
Total participants 2012-01-01 0
2011: THE HERITAGE GROUP DISABILITY BENEFITS PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 889
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 878
Total of all active and inactive participants 2011-01-01 878
Total participants 2011-01-01 878
2010: THE HERITAGE GROUP DISABILITY BENEFITS PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 961
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 889
Total of all active and inactive participants 2010-01-01 889
Total participants 2010-01-01 889
2009: THE HERITAGE GROUP DISABILITY BENEFITS PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 957
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 961
Total of all active and inactive participants 2009-01-01 961
Total participants 2009-01-01 961

Measure	Date	Value
2022: THE HERITAGE GROUP DISABILITY BENEFITS PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	3,118
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	3,509
Total of all active and inactive participants	2022-01-01	3,509
Total participants	2022-01-01	3,509
2021: THE HERITAGE GROUP DISABILITY BENEFITS PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	3,067
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	3,118
Total of all active and inactive participants	2021-01-01	3,118
Total participants	2021-01-01	3,118
2020: THE HERITAGE GROUP DISABILITY BENEFITS PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	2,996
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	3,067
Total of all active and inactive participants	2020-01-01	3,067
Total participants	2020-01-01	3,067
2019: THE HERITAGE GROUP DISABILITY BENEFITS PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	2,778
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	2,996
Total of all active and inactive participants	2019-01-01	2,996
Total participants	2019-01-01	2,996
2018: THE HERITAGE GROUP DISABILITY BENEFITS PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	2,378
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	2,778
Total of all active and inactive participants	2018-01-01	2,778
Total participants	2018-01-01	2,778
2017: THE HERITAGE GROUP DISABILITY BENEFITS PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	2,019
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	2,378
Total of all active and inactive participants	2017-01-01	2,378
Total participants	2017-01-01	2,378
2016: THE HERITAGE GROUP DISABILITY BENEFITS PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	2,305
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	2,019
Total of all active and inactive participants	2016-01-01	2,019
Total participants	2016-01-01	2,019
2015: THE HERITAGE GROUP DISABILITY BENEFITS PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	2,270
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	2,305
Total of all active and inactive participants	2015-01-01	2,305
Total participants	2015-01-01	0
2014: THE HERITAGE GROUP DISABILITY BENEFITS PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	1,154
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	2,270
Total of all active and inactive participants	2014-01-01	2,270
Total participants	2014-01-01	0
2013: THE HERITAGE GROUP DISABILITY BENEFITS PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	1,000
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	1,154
Total of all active and inactive participants	2013-01-01	1,154
Total participants	2013-01-01	0
2012: THE HERITAGE GROUP DISABILITY BENEFITS PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	878
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	1,000
Total of all active and inactive participants	2012-01-01	1,000
Total participants	2012-01-01	0
2011: THE HERITAGE GROUP DISABILITY BENEFITS PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	889
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	878
Total of all active and inactive participants	2011-01-01	878
Total participants	2011-01-01	878
2010: THE HERITAGE GROUP DISABILITY BENEFITS PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	961
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	889
Total of all active and inactive participants	2010-01-01	889
Total participants	2010-01-01	889
2009: THE HERITAGE GROUP DISABILITY BENEFITS PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	957
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	961
Total of all active and inactive participants	2009-01-01	961
Total participants	2009-01-01	961

Form 5500 Responses for THE HERITAGE GROUP DISABILITY BENEFITS PLAN

2022: THE HERITAGE GROUP DISABILITY BENEFITS PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Mulitple employer plan
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2021: THE HERITAGE GROUP DISABILITY BENEFITS PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Mulitple employer plan
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2020: THE HERITAGE GROUP DISABILITY BENEFITS PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Mulitple employer plan
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2019: THE HERITAGE GROUP DISABILITY BENEFITS PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Mulitple employer plan
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2018: THE HERITAGE GROUP DISABILITY BENEFITS PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Mulitple employer plan
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2017: THE HERITAGE GROUP DISABILITY BENEFITS PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Mulitple employer plan
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2016: THE HERITAGE GROUP DISABILITY BENEFITS PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Mulitple employer plan
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2015: THE HERITAGE GROUP DISABILITY BENEFITS PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Mulitple employer plan
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2014: THE HERITAGE GROUP DISABILITY BENEFITS PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Mulitple employer plan
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2013: THE HERITAGE GROUP DISABILITY BENEFITS PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Mulitple employer plan
2013-01-01	Submission has been amended	Yes
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2012: THE HERITAGE GROUP DISABILITY BENEFITS PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Mulitple employer plan
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2011: THE HERITAGE GROUP DISABILITY BENEFITS PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Mulitple employer plan
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2010: THE HERITAGE GROUP DISABILITY BENEFITS PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Mulitple employer plan
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2009: THE HERITAGE GROUP DISABILITY BENEFITS PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Mulitple employer plan
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

R0710202

Policy instance

Insurance contract or identification number	R0710202
Number of Individuals Covered	3651
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $19,963
Total amount of fees paid to insurance company	USD $0
Other welfare benefits provided	GROUP CRITICAL ILLNESS
Welfare Benefit Premiums Paid to Carrier	USD $505,340
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $13,156
Insurance broker organization code?	3

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

R0711739

Policy instance

Insurance contract or identification number	R0711739
Number of Individuals Covered	2927
Insurance policy start date	2022-01-01
Insurance policy end date	2023-01-01
Total amount of commissions paid to insurance broker	USD $196,813
Total amount of fees paid to insurance company	USD $0
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	CRITICAL ILLNESS
Welfare Benefit Premiums Paid to Carrier	USD $625,380
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $170,647
Insurance broker organization code?	4

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

413317

Policy instance

Insurance contract or identification number	413317
Number of Individuals Covered	126
Insurance policy start date	2022-01-01
Insurance policy end date	2023-01-01
Total amount of commissions paid to insurance broker	USD $9,998
Total amount of fees paid to insurance company	USD $0
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $61,527
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $9,998
Insurance broker organization code?	4

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

413307

Policy instance

Insurance contract or identification number	413307
Number of Individuals Covered	3509
Insurance policy start date	2022-01-01
Insurance policy end date	2023-01-01
Total amount of commissions paid to insurance broker	USD $19,037
Total amount of fees paid to insurance company	USD $0
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,522,946
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $19,037
Insurance broker organization code?	4

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

413307

Policy instance

Insurance contract or identification number	413307
Number of Individuals Covered	3168
Insurance policy start date	2022-01-01
Insurance policy end date	2022-01-01
Total amount of commissions paid to insurance broker	USD $136,450
Total amount of fees paid to insurance company	USD $0
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,335,576
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $125,165
Insurance broker organization code?	3

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

413317

Policy instance

Insurance contract or identification number	413317
Number of Individuals Covered	124
Insurance policy start date	2021-01-01
Insurance policy end date	2022-01-01
Total amount of commissions paid to insurance broker	USD $9,846
Total amount of fees paid to insurance company	USD $0
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $60,591
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $6,566
Insurance broker organization code?	4

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

R0711739

Policy instance

Insurance contract or identification number	R0711739
Number of Individuals Covered	2577
Insurance policy start date	2021-01-01
Insurance policy end date	2022-01-01
Total amount of commissions paid to insurance broker	USD $167,159
Total amount of fees paid to insurance company	USD $0
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	CRITICAL ILLNESS
Welfare Benefit Premiums Paid to Carrier	USD $537,630
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $145,324
Insurance broker organization code?	3

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

R07110202

Policy instance

Insurance contract or identification number	R07110202
Number of Individuals Covered	3168
Insurance policy start date	2021-01-01
Insurance policy end date	2022-01-01
Total amount of commissions paid to insurance broker	USD $45,552
Total amount of fees paid to insurance company	USD $0
Other welfare benefits provided	GROUP CRITICAL ILLNESS
Welfare Benefit Premiums Paid to Carrier	USD $439,876
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $44,681
Insurance broker organization code?	3

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

413307

Policy instance

Insurance contract or identification number	413307
Number of Individuals Covered	3067
Insurance policy end date	2021-01-01
Total amount of commissions paid to insurance broker	USD $6,054
Total amount of fees paid to insurance company	USD $0
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,230,661
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $6,054
Insurance broker organization code?	3

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

413317 0101

Policy instance

Insurance contract or identification number	413317 0101
Number of Individuals Covered	122
Insurance policy start date	2020-01-01
Insurance policy end date	2021-01-01
Total amount of commissions paid to insurance broker	USD $14,751
Total amount of fees paid to insurance company	USD $0
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $93,655
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $14,751
Insurance broker organization code?	3

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

R0711739

Policy instance

Insurance contract or identification number	R0711739
Number of Individuals Covered	683
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $167,894
Total amount of fees paid to insurance company	USD $0
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	CRITICAL ILLNESS
Welfare Benefit Premiums Paid to Carrier	USD $464,719
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $167,894
Insurance broker organization code?	3

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

R07110202

Policy instance

Insurance contract or identification number	R07110202
Number of Individuals Covered	2878
Insurance policy start date	2020-01-01
Insurance policy end date	2021-01-01
Total amount of commissions paid to insurance broker	USD $148,175
Total amount of fees paid to insurance company	USD $0
Other welfare benefits provided	GROUP CRITICAL ILLNESS
Welfare Benefit Premiums Paid to Carrier	USD $395,749
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $148,175
Insurance broker organization code?	3

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

R07110202

Policy instance

Insurance contract or identification number	R07110202
Number of Individuals Covered	2054
Insurance policy start date	2019-01-01
Insurance policy end date	2020-01-01
Total amount of commissions paid to insurance broker	USD $107,771
Other welfare benefits provided	GROUP CRITICAL ILLNESS
Welfare Benefit Premiums Paid to Carrier	USD $278,788
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $107,771
Insurance broker organization code?	3

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

R0711739

Policy instance

Insurance contract or identification number	R0711739
Number of Individuals Covered	1721
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $152,793
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	CRITICAL ILLNESS
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $152,793
Insurance broker organization code?	3

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

413317

Policy instance

Insurance contract or identification number	413317
Number of Individuals Covered	1119
Insurance policy start date	2019-01-01
Insurance policy end date	2020-01-01
Total amount of commissions paid to insurance broker	USD $73,912
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $469,280
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $73,912
Insurance broker organization code?	3

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

413307

Policy instance

Insurance contract or identification number	413307
Number of Individuals Covered	2996
Insurance policy start date	2019-01-01
Insurance policy end date	2020-01-01
Total amount of commissions paid to insurance broker	USD $5,618
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $749,126
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,618
Insurance broker organization code?	3

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

000404002520

Policy instance

Insurance contract or identification number	000404002520
Number of Individuals Covered	588
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $3,215
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $16,100
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,895
Insurance broker organization code?	3

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

000405003403

Policy instance

Insurance contract or identification number	000405003403
Number of Individuals Covered	833
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $8,851
Other welfare benefits provided	CRITICAL ILLNESS
Welfare Benefit Premiums Paid to Carrier	USD $44,819
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $7,935
Insurance broker organization code?	3

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

R0711739

Policy instance

Insurance contract or identification number	R0711739
Number of Individuals Covered	1479
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $214,960
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	CRITICAL ILLNESS
Welfare Benefit Premiums Paid to Carrier	USD $292,407
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $214,960
Insurance broker organization code?	3

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

413317

Policy instance

Insurance contract or identification number	413317
Number of Individuals Covered	1208
Insurance policy start date	2018-01-01
Insurance policy end date	2019-01-01
Total amount of commissions paid to insurance broker	USD $82,044
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $520,913
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $82,044
Insurance broker organization code?	3

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

413307

Policy instance

Insurance contract or identification number	413307
Number of Individuals Covered	2778
Insurance policy start date	2018-01-01
Insurance policy end date	2019-01-01
Total amount of commissions paid to insurance broker	USD $5,588
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $745,074
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,588
Insurance broker organization code?	3

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

413307

Policy instance

Insurance contract or identification number	413307
Number of Individuals Covered	2378
Insurance policy start date	2017-01-01
Insurance policy end date	2018-01-01
Total amount of commissions paid to insurance broker	USD $74,118
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $741,133
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $74,118
Insurance broker organization code?	3
Insurance broker name	FIRST PERSON INC

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

10055689

Policy instance

Insurance contract or identification number	10055689
Number of Individuals Covered	2305
Insurance policy start date	2014-07-01
Insurance policy end date	2015-06-30
Total amount of commissions paid to insurance broker	USD $63,244
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $421,625
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $63,244
Insurance broker organization code?	3
Insurance broker name	ASSUREDPARTNERS OF INDIANA LLC

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

10055690

Policy instance

Insurance contract or identification number	10055690
Number of Individuals Covered	904
Insurance policy start date	2014-07-01
Insurance policy end date	2015-06-30
Total amount of commissions paid to insurance broker	USD $64,142
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $427,615
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $64,142
Insurance broker organization code?	3
Insurance broker name	ASSUREDPARTNERS OF INDIANA LLC

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

10055689

Policy instance

Insurance contract or identification number	10055689
Number of Individuals Covered	2270
Insurance policy start date	2013-07-01
Insurance policy end date	2014-06-30
Total amount of commissions paid to insurance broker	USD $46,121
Total amount of fees paid to insurance company	USD $7,153
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $307,471
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $46,121
Insurance broker organization code?	3
Amount paid for insurance broker fees	7153
Additional information about fees paid to insurance broker	BROKER BONUS
Insurance broker name	TOBIAS INSURANCE GROUP, INC.

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

10055690

Policy instance

Insurance contract or identification number	10055690
Number of Individuals Covered	891
Insurance policy start date	2013-07-01
Insurance policy end date	2014-06-30
Total amount of commissions paid to insurance broker	USD $31,453
Total amount of fees paid to insurance company	USD $8,504
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $209,684
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $31,453
Insurance broker organization code?	3
Amount paid for insurance broker fees	8504
Additional information about fees paid to insurance broker	BROKER BONUS
Insurance broker name	TOBIAS INSURANCE GROUP, INC.

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

10055689

Policy instance

Insurance contract or identification number	10055689
Number of Individuals Covered	1154
Insurance policy start date	2012-07-01
Insurance policy end date	2013-06-30
Total amount of commissions paid to insurance broker	USD $28,276
Total amount of fees paid to insurance company	USD $7,830
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $188,507
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $16,257
Amount paid for insurance broker fees	7830
Additional information about fees paid to insurance broker	BROKER BONUS
Insurance broker organization code?	3
Insurance broker name	ASSUREDPARTNERS OF INDIANA LLC

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

10055690

Policy instance

Insurance contract or identification number	10055690
Number of Individuals Covered	671
Insurance policy start date	2012-07-01
Insurance policy end date	2013-06-30
Total amount of commissions paid to insurance broker	USD $30,279
Total amount of fees paid to insurance company	USD $9,511
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $201,860
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $19,150
Amount paid for insurance broker fees	9511
Additional information about fees paid to insurance broker	BROKER BONUS
Insurance broker organization code?	3
Insurance broker name	ASSUREDPARTNERS OF INDIANA LLC

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

000400003002

Policy instance

Insurance contract or identification number	000400003002
Insurance policy start date	2012-07-01
Insurance policy end date	2013-06-30
Total amount of commissions paid to insurance broker	USD $19,197
Total amount of fees paid to insurance company	USD $6,309
Other welfare benefits provided	VOL LTD
Welfare Benefit Premiums Paid to Carrier	USD $127,979
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $14,918
Amount paid for insurance broker fees	6309
Additional information about fees paid to insurance broker	BROKER BONUS
Insurance broker organization code?	3
Insurance broker name	ASSUREDPARTNERS OF INDIANA LLC

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

10055690

Policy instance

Insurance contract or identification number	10055690
Number of Individuals Covered	641
Insurance policy start date	2011-07-01
Insurance policy end date	2012-06-30
Total amount of commissions paid to insurance broker	USD $30,194
Total amount of fees paid to insurance company	USD $9,048
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $201,296
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $30,194
Amount paid for insurance broker fees	9048
Additional information about fees paid to insurance broker	BROKER BONUS
Insurance broker organization code?	3
Insurance broker name	TOBIAS INSURANCE GROUP, INC.

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

10055689

Policy instance

Insurance contract or identification number	10055689
Number of Individuals Covered	1000
Insurance policy start date	2011-07-01
Insurance policy end date	2012-06-30
Total amount of commissions paid to insurance broker	USD $25,102
Total amount of fees paid to insurance company	USD $7,375
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $167,346
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $25,102
Amount paid for insurance broker fees	7375
Additional information about fees paid to insurance broker	BROKER BONUS
Insurance broker organization code?	3
Insurance broker name	TOBIAS INSURANCE GROUP, INC.

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

000400003002

Policy instance

Insurance contract or identification number	000400003002
Number of Individuals Covered	319
Insurance policy start date	2011-07-01
Insurance policy end date	2012-06-30
Total amount of commissions paid to insurance broker	USD $20,631
Total amount of fees paid to insurance company	USD $5,557
Other welfare benefits provided	VOL LTD
Welfare Benefit Premiums Paid to Carrier	USD $137,538
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $20,631
Amount paid for insurance broker fees	5557
Additional information about fees paid to insurance broker	BROKER BONUS
Insurance broker organization code?	3
Insurance broker name	TOBIAS INSURANCE GROUP, INC.

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

10055689

Policy instance

Insurance contract or identification number	10055689
Number of Individuals Covered	878
Insurance policy start date	2010-07-01
Insurance policy end date	2011-06-30
Total amount of commissions paid to insurance broker	USD $22,831
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $152,209
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

10055690

Policy instance

Insurance contract or identification number	10055690
Number of Individuals Covered	619
Insurance policy start date	2010-07-01
Insurance policy end date	2011-06-30
Total amount of commissions paid to insurance broker	USD $27,612
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $184,079
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

000400003002

Policy instance

Insurance contract or identification number	000400003002
Number of Individuals Covered	285
Insurance policy start date	2010-07-01
Insurance policy end date	2011-06-30
Total amount of commissions paid to insurance broker	USD $16,893
Other welfare benefits provided	VOL LTD
Welfare Benefit Premiums Paid to Carrier	USD $112,623
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

000400003002

Policy instance

Insurance contract or identification number	000400003002
Number of Individuals Covered	273
Insurance policy start date	2009-07-01
Insurance policy end date	2010-06-30
Total amount of commissions paid to insurance broker	USD $16,722
Total amount of fees paid to insurance company	USD $5,516
Other welfare benefits provided	VOL LTD
Welfare Benefit Premiums Paid to Carrier	USD $111,478
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $16,722
Amount paid for insurance broker fees	5516
Additional information about fees paid to insurance broker	BROKER BONUS
Insurance broker organization code?	3
Insurance broker name	TOBIAS INSURANCE GROUP, INC.

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

10055690

Policy instance

Insurance contract or identification number	10055690
Number of Individuals Covered	610
Insurance policy start date	2009-07-01
Insurance policy end date	2010-06-30
Total amount of commissions paid to insurance broker	USD $26,376
Total amount of fees paid to insurance company	USD $9,029
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $175,843
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $26,376
Amount paid for insurance broker fees	9029
Additional information about fees paid to insurance broker	BROKER BONUS
Insurance broker organization code?	3
Insurance broker name	TOBIAS INSURANCE GROUP, INC.

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

10055689

Policy instance

Insurance contract or identification number	10055689
Number of Individuals Covered	889
Insurance policy start date	2009-07-01
Insurance policy end date	2010-06-30
Total amount of commissions paid to insurance broker	USD $20,939
Total amount of fees paid to insurance company	USD $6,798
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $139,593
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $20,939
Amount paid for insurance broker fees	6798
Additional information about fees paid to insurance broker	BROKER BONUS
Insurance broker organization code?	3
Insurance broker name	TOBIAS INSURANCE GROUP, INC.

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Company Name:	THE HERITAGE GROUP
Employer identification number (EIN):	351448549
NAIC Classification:	324120

Jurisdiction of Incorporation:	Wyoming Corporations Division
Incorporation Date:	2007-06-27
Company Identification Number:	000539962
Legal Registered Office Address:	1712 Pioneer Ave Suite 782 Cheyenne United States of America (USA) 82001