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GROUP TERM LIFE INSURANCE 401k Plan overview

Plan NameGROUP TERM LIFE INSURANCE
Plan identification number 504

GROUP TERM LIFE INSURANCE Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance

401k Sponsoring company profile

MARSHFIELD CLINIC, INC. has sponsored the creation of one or more 401k plans.

Company Name:MARSHFIELD CLINIC, INC.
Employer identification number (EIN):390452970
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Additional information about MARSHFIELD CLINIC, INC.

Jurisdiction of Incorporation: Michigan Department of Licensing & Regulatory Affairs
Incorporation Date:
Company Identification Number: 90083H

More information about MARSHFIELD CLINIC, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GROUP TERM LIFE INSURANCE

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5042015-01-01STEVEN CHRISTIANSON
5042014-01-01STEVEN CHRISTIANSON
5042013-01-01STEVEN CHRISTIANSON
5042012-01-01STEVEN CHRISTIANSON
5042011-01-01STEVEN CHRISTIANSON
5042009-01-01STEVEN CHRISTIANSON

Plan Statistics for GROUP TERM LIFE INSURANCE

401k plan membership statisitcs for GROUP TERM LIFE INSURANCE

Measure Date Value
2015: GROUP TERM LIFE INSURANCE 2015 401k membership
Total participants, beginning-of-year2015-01-016,799
Total number of active participants reported on line 7a of the Form 55002015-01-016,920
Total of all active and inactive participants2015-01-016,920
Total participants2015-01-016,920
2014: GROUP TERM LIFE INSURANCE 2014 401k membership
Total participants, beginning-of-year2014-01-017,479
Total number of active participants reported on line 7a of the Form 55002014-01-016,835
Total of all active and inactive participants2014-01-016,835
Total participants2014-01-016,835
2013: GROUP TERM LIFE INSURANCE 2013 401k membership
Total participants, beginning-of-year2013-01-017,559
Total number of active participants reported on line 7a of the Form 55002013-01-017,479
Total of all active and inactive participants2013-01-017,479
Total participants2013-01-017,479
2012: GROUP TERM LIFE INSURANCE 2012 401k membership
Total participants, beginning-of-year2012-01-017,684
Total number of active participants reported on line 7a of the Form 55002012-01-017,559
Total of all active and inactive participants2012-01-017,559
Total participants2012-01-017,559
2011: GROUP TERM LIFE INSURANCE 2011 401k membership
Total participants, beginning-of-year2011-01-017,441
Total number of active participants reported on line 7a of the Form 55002011-01-017,684
Total of all active and inactive participants2011-01-017,684
Total participants2011-01-017,684
2009: GROUP TERM LIFE INSURANCE 2009 401k membership
Total participants, beginning-of-year2009-01-017,297
Total number of active participants reported on line 7a of the Form 55002009-01-017,291
Total of all active and inactive participants2009-01-017,291
Total participants2009-01-017,291

Form 5500 Responses for GROUP TERM LIFE INSURANCE

2015: GROUP TERM LIFE INSURANCE 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: GROUP TERM LIFE INSURANCE 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: GROUP TERM LIFE INSURANCE 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: GROUP TERM LIFE INSURANCE 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: GROUP TERM LIFE INSURANCE 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2009: GROUP TERM LIFE INSURANCE 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number676354G
Policy instance 1
Insurance contract or identification number676354G
Number of Individuals Covered6920
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $61,666
Total amount of fees paid to insurance companyUSD $120,905
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $2,055,517
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $61,666
Amount paid for insurance broker fees120905
Additional information about fees paid to insurance brokerALLOCATION OF CONTINGENT COMPENSATION
Insurance broker organization code?3
Insurance broker nameLOCKTON COMPANIES LLC
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number676354G
Policy instance 1
Insurance contract or identification number676354G
Number of Individuals Covered6835
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $53,393
Total amount of fees paid to insurance companyUSD $94,308
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,965,797
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $53,393
Amount paid for insurance broker fees94308
Additional information about fees paid to insurance brokerALLOCATION OF CONTINGENT COMPENSATION
Insurance broker organization code?3
Insurance broker nameLOCKTON COMPANY
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number676354G
Policy instance 1
Insurance contract or identification number676354G
Number of Individuals Covered7479
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $160,924
Total amount of fees paid to insurance companyUSD $101,174
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $2,298,401
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $26,052
Amount paid for insurance broker fees2327
Insurance broker organization code?3
Additional information about fees paid to insurance brokerALLOCATION OF CONTINGENT COMPENSATION
Insurance broker nameBPC CLIENT SERVICES
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number676354G
Policy instance 1
Insurance contract or identification number676354G
Number of Individuals Covered7559
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $160,759
Total amount of fees paid to insurance companyUSD $96,946
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,111,039
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $160,759
Amount paid for insurance broker fees67755
Additional information about fees paid to insurance brokerALLOCATION OF CONTINGENT COMPENSATION
Insurance broker organization code?3
Insurance broker nameBPC CLIENT SERVICES
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number676354G
Policy instance 1
Insurance contract or identification number676354G
Number of Individuals Covered7684
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $155,691
Total amount of fees paid to insurance companyUSD $125,926
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,229,869
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number676354G
Policy instance 1
Insurance contract or identification number676354G
Number of Individuals Covered7441
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $164,783
Total amount of fees paid to insurance companyUSD $181,833
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,105,322
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $164,783
Amount paid for insurance broker fees123147
Additional information about fees paid to insurance brokerALLOCATION OF CONTINGENT COMPENSATION
Insurance broker organization code?3
Insurance broker nameBPC CLIENT SERVICES

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