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GROUP LONG TERM DISABILITY INSURANCE PLAN FOR THE EMPLOYEES OF THE MEDICAL COLLEGE OF WISCONSIN, INC. 401k Plan overview

Plan NameGROUP LONG TERM DISABILITY INSURANCE PLAN FOR THE EMPLOYEES OF THE MEDICAL COLLEGE OF WISCONSIN, INC.
Plan identification number 503

GROUP LONG TERM DISABILITY INSURANCE PLAN FOR THE EMPLOYEES OF THE MEDICAL COLLEGE OF WISCONSIN, INC. Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Long-term disability cover

401k Sponsoring company profile

THE MEDICAL COLLEGE OF WISCONSIN, INC. has sponsored the creation of one or more 401k plans.

Company Name:THE MEDICAL COLLEGE OF WISCONSIN, INC.
Employer identification number (EIN):390806261
NAIC Classification:611000

Additional information about THE MEDICAL COLLEGE OF WISCONSIN, INC.

Jurisdiction of Incorporation: Texas Secretary of State
Incorporation Date: 2020-04-15
Company Identification Number: 0803593406
Legal Registered Office Address: 8701 WATERTOWN PLANK RD

MILWAUKEE
United States of America (USA)
53226

More information about THE MEDICAL COLLEGE OF WISCONSIN, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GROUP LONG TERM DISABILITY INSURANCE PLAN FOR THE EMPLOYEES OF THE MEDICAL COLLEGE OF WISCONSIN, INC.

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5032022-01-01
5032021-01-01
5032020-01-01
5032019-01-01
5032018-01-01SHERRI DUCHARME WHITE
5032017-01-01SHERRI DUCHARME WHITE
5032016-01-01SHERRI DUCHARME WHITE
5032015-01-01SHERRI DUCHARME WHITE
5032014-01-01SHERRI DUCHARME-WHITE
5032013-01-01G. ALLEN BOLTON, JR.
5032012-01-01G. ALLEN BOLTON, JR.
5032011-01-01G. ALLEN BOLTON, JR.
5032010-01-01SHERRI DUCHARME-WHITE
5032009-01-01MARJORIE M. SPENCER

Plan Statistics for GROUP LONG TERM DISABILITY INSURANCE PLAN FOR THE EMPLOYEES OF THE MEDICAL COLLEGE OF WISCONSIN, INC.

401k plan membership statisitcs for GROUP LONG TERM DISABILITY INSURANCE PLAN FOR THE EMPLOYEES OF THE MEDICAL COLLEGE OF WISCONSIN, INC.

Measure Date Value
2022: GROUP LONG TERM DISABILITY INSURANCE PLAN FOR THE EMPLOYEES OF THE MEDICAL COLLEGE OF WISCONSIN, INC. 2022 401k membership
Total participants, beginning-of-year2022-01-015,067
Total number of active participants reported on line 7a of the Form 55002022-01-015,087
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-015,087
2021: GROUP LONG TERM DISABILITY INSURANCE PLAN FOR THE EMPLOYEES OF THE MEDICAL COLLEGE OF WISCONSIN, INC. 2021 401k membership
Total participants, beginning-of-year2021-01-015,075
Total number of active participants reported on line 7a of the Form 55002021-01-015,067
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-015,067
2020: GROUP LONG TERM DISABILITY INSURANCE PLAN FOR THE EMPLOYEES OF THE MEDICAL COLLEGE OF WISCONSIN, INC. 2020 401k membership
Total participants, beginning-of-year2020-01-014,972
Total number of active participants reported on line 7a of the Form 55002020-01-015,075
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-015,075
2019: GROUP LONG TERM DISABILITY INSURANCE PLAN FOR THE EMPLOYEES OF THE MEDICAL COLLEGE OF WISCONSIN, INC. 2019 401k membership
Total participants, beginning-of-year2019-01-014,840
Total number of active participants reported on line 7a of the Form 55002019-01-014,972
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-014,972
2018: GROUP LONG TERM DISABILITY INSURANCE PLAN FOR THE EMPLOYEES OF THE MEDICAL COLLEGE OF WISCONSIN, INC. 2018 401k membership
Total participants, beginning-of-year2018-01-014,642
Total number of active participants reported on line 7a of the Form 55002018-01-014,784
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-014,784
2017: GROUP LONG TERM DISABILITY INSURANCE PLAN FOR THE EMPLOYEES OF THE MEDICAL COLLEGE OF WISCONSIN, INC. 2017 401k membership
Total participants, beginning-of-year2017-01-014,684
Total number of active participants reported on line 7a of the Form 55002017-01-014,619
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-014,619
2016: GROUP LONG TERM DISABILITY INSURANCE PLAN FOR THE EMPLOYEES OF THE MEDICAL COLLEGE OF WISCONSIN, INC. 2016 401k membership
Total participants, beginning-of-year2016-01-014,108
Total number of active participants reported on line 7a of the Form 55002016-01-014,282
Number of retired or separated participants receiving benefits2016-01-014
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-014,286
2015: GROUP LONG TERM DISABILITY INSURANCE PLAN FOR THE EMPLOYEES OF THE MEDICAL COLLEGE OF WISCONSIN, INC. 2015 401k membership
Total participants, beginning-of-year2015-01-014,120
Total number of active participants reported on line 7a of the Form 55002015-01-014,125
Number of retired or separated participants receiving benefits2015-01-014
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-014,129
2014: GROUP LONG TERM DISABILITY INSURANCE PLAN FOR THE EMPLOYEES OF THE MEDICAL COLLEGE OF WISCONSIN, INC. 2014 401k membership
Total participants, beginning-of-year2014-01-014,385
Total number of active participants reported on line 7a of the Form 55002014-01-014,104
Number of retired or separated participants receiving benefits2014-01-0131
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-014,135
2013: GROUP LONG TERM DISABILITY INSURANCE PLAN FOR THE EMPLOYEES OF THE MEDICAL COLLEGE OF WISCONSIN, INC. 2013 401k membership
Total participants, beginning-of-year2013-01-014,361
Total number of active participants reported on line 7a of the Form 55002013-01-014,355
Number of retired or separated participants receiving benefits2013-01-0130
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-014,385
2012: GROUP LONG TERM DISABILITY INSURANCE PLAN FOR THE EMPLOYEES OF THE MEDICAL COLLEGE OF WISCONSIN, INC. 2012 401k membership
Total participants, beginning-of-year2012-01-014,412
Total number of active participants reported on line 7a of the Form 55002012-01-014,338
Number of retired or separated participants receiving benefits2012-01-0123
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-014,361
2011: GROUP LONG TERM DISABILITY INSURANCE PLAN FOR THE EMPLOYEES OF THE MEDICAL COLLEGE OF WISCONSIN, INC. 2011 401k membership
Total participants, beginning-of-year2011-01-014,286
Total number of active participants reported on line 7a of the Form 55002011-01-014,391
Number of retired or separated participants receiving benefits2011-01-0121
Number of other retired or separated participants entitled to future benefits2011-01-010
Total of all active and inactive participants2011-01-014,412
2010: GROUP LONG TERM DISABILITY INSURANCE PLAN FOR THE EMPLOYEES OF THE MEDICAL COLLEGE OF WISCONSIN, INC. 2010 401k membership
Total participants, beginning-of-year2010-01-014,195
Total number of active participants reported on line 7a of the Form 55002010-01-014,262
Number of retired or separated participants receiving benefits2010-01-0124
Number of other retired or separated participants entitled to future benefits2010-01-010
Total of all active and inactive participants2010-01-014,286
2009: GROUP LONG TERM DISABILITY INSURANCE PLAN FOR THE EMPLOYEES OF THE MEDICAL COLLEGE OF WISCONSIN, INC. 2009 401k membership
Total participants, beginning-of-year2009-01-014,049
Total number of active participants reported on line 7a of the Form 55002009-01-014,162
Number of retired or separated participants receiving benefits2009-01-0133
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-014,195
Total participants2009-01-014,195

Form 5500 Responses for GROUP LONG TERM DISABILITY INSURANCE PLAN FOR THE EMPLOYEES OF THE MEDICAL COLLEGE OF WISCONSIN, INC.

2022: GROUP LONG TERM DISABILITY INSURANCE PLAN FOR THE EMPLOYEES OF THE MEDICAL COLLEGE OF WISCONSIN, INC. 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – InsuranceYes
2021: GROUP LONG TERM DISABILITY INSURANCE PLAN FOR THE EMPLOYEES OF THE MEDICAL COLLEGE OF WISCONSIN, INC. 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – InsuranceYes
2020: GROUP LONG TERM DISABILITY INSURANCE PLAN FOR THE EMPLOYEES OF THE MEDICAL COLLEGE OF WISCONSIN, INC. 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – InsuranceYes
2019: GROUP LONG TERM DISABILITY INSURANCE PLAN FOR THE EMPLOYEES OF THE MEDICAL COLLEGE OF WISCONSIN, INC. 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: GROUP LONG TERM DISABILITY INSURANCE PLAN FOR THE EMPLOYEES OF THE MEDICAL COLLEGE OF WISCONSIN, INC. 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: GROUP LONG TERM DISABILITY INSURANCE PLAN FOR THE EMPLOYEES OF THE MEDICAL COLLEGE OF WISCONSIN, INC. 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: GROUP LONG TERM DISABILITY INSURANCE PLAN FOR THE EMPLOYEES OF THE MEDICAL COLLEGE OF WISCONSIN, INC. 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: GROUP LONG TERM DISABILITY INSURANCE PLAN FOR THE EMPLOYEES OF THE MEDICAL COLLEGE OF WISCONSIN, INC. 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 LONG TERM DISABILITY INSURANCE PLAN FOR THE EMPLOYEES OF THE MEDICAL COLLEGE OF WISCONSIN, INC. 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 LONG TERM DISABILITY INSURANCE PLAN FOR THE EMPLOYEES OF THE MEDICAL COLLEGE OF WISCONSIN, INC. 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 LONG TERM DISABILITY INSURANCE PLAN FOR THE EMPLOYEES OF THE MEDICAL COLLEGE OF WISCONSIN, INC. 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 LONG TERM DISABILITY INSURANCE PLAN FOR THE EMPLOYEES OF THE MEDICAL COLLEGE OF WISCONSIN, INC. 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
2010: GROUP LONG TERM DISABILITY INSURANCE PLAN FOR THE EMPLOYEES OF THE MEDICAL COLLEGE OF WISCONSIN, INC. 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – InsuranceYes
2009: GROUP LONG TERM DISABILITY INSURANCE PLAN FOR THE EMPLOYEES OF THE MEDICAL COLLEGE OF WISCONSIN, INC. 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

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number603731
Policy instance 1
Insurance contract or identification number603731
Number of Individuals Covered3332
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $27,812
Are there contracts with allocated funds for individual policies?0
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 BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
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 $2,224,967
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees27812
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number603731
Policy instance 1
Insurance contract or identification number603731
Number of Individuals Covered3225
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $27,373
Are there contracts with allocated funds for individual policies?0
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 BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
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 $2,079,636
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees27373
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number603731
Policy instance 1
Insurance contract or identification number603731
Number of Individuals Covered5075
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $39,514
Are there contracts with allocated funds for individual policies?0
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 BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
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 $1,977,148
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees39514
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number603731
Policy instance 1
Insurance contract or identification number603731
Number of Individuals Covered4944
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $13,821
Are there contracts with allocated funds for individual policies?0
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 BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
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 $1,478,811
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees13821
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number603731
Policy instance 1
Insurance contract or identification number603731
Number of Individuals Covered4784
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $13,268
Are there contracts with allocated funds for individual policies?0
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 BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
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 $1,527,797
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees13268
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number603731
Policy instance 1
Insurance contract or identification number603731
Number of Individuals Covered4636
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $21,165
Are there contracts with allocated funds for individual policies?0
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 BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
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 $1,218,923
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees21165
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
Insurance broker nameTHE BENEFIT SERVICES GROUP INC
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number603731
Policy instance 1
Insurance contract or identification number603731
Number of Individuals Covered4918
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $26,191
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 BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
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 $1,047,641
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees26191
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
Insurance broker nameTHE BENEFIT SERVICES GROUP INC
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010038512
Policy instance 1
Insurance contract or identification number000010038512
Number of Individuals Covered4104
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
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 BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
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 $1,071,213
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 number000010038512
Policy instance 1
Insurance contract or identification number000010038512
Number of Individuals Covered4355
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $44,230
Total amount of fees paid to insurance companyUSD $618
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 BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
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 $1,174,336
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $44,230
Insurance broker organization code?3
Amount paid for insurance broker fees618
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker nameWILLIS OF ARIZONA INC
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010038512
Policy instance 1
Insurance contract or identification number000010038512
Number of Individuals Covered4361
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $57,396
Total amount of fees paid to insurance companyUSD $4,767
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 BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
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 $1,147,924
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $57,396
Insurance broker organization code?3
Amount paid for insurance broker fees4767
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker nameWILLIS OF ARIZONA INC
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010038512
Policy instance 1
Insurance contract or identification number000010038512
Number of Individuals Covered4412
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $55,843
Total amount of fees paid to insurance companyUSD $7,800
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 BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
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 $1,116,859
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 number000010038512
Policy instance 1
Insurance contract or identification number000010038512
Number of Individuals Covered4286
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $46,534
Total amount of fees paid to insurance companyUSD $5,998
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 BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
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 $930,684
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $46,534
Amount paid for insurance broker fees5998
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
Insurance broker nameWILLIS OF WI INC

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