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GROUP HEALTH & DISABILITY PLAN 401k Plan overview

Plan NameGROUP HEALTH & DISABILITY PLAN
Plan identification number 501

GROUP HEALTH & DISABILITY PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover

401k Sponsoring company profile

SEATS INCORPORATED has sponsored the creation of one or more 401k plans.

Company Name:SEATS INCORPORATED
Employer identification number (EIN):390847098
NAIC Classification:339900

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GROUP HEALTH & DISABILITY PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01
5012021-01-01
5012020-01-01
5012019-01-01
5012018-01-01ANN DEITRICH ANN DEITRICH2019-07-24
5012017-01-01LINDA BISKUPSKI
5012017-01-01
5012016-01-01LINDA BISKUPSKI LINDA BISKUPSKI2017-07-13
5012016-01-01 ANN DEITRICH2019-07-22
5012015-01-01LINDA BISKUPSKI LINDA BISKUPSKI2016-06-15
5012015-01-01 ANN DEITRICH2019-07-22
5012014-01-01LINDA BISKUPSKI LINDA BISKUPSKI2015-07-16
5012014-01-01ANN DEITRICH ANN DEITRICH2019-07-22
5012013-01-01LINDA BISKUPSKI LINDA BISKUPSKI2014-07-31
5012012-01-01LINDA BISKUPSKI LINDA BISKUPSKI2013-06-26
5012011-01-01LINDA BISKUPSKI
5012010-01-01LINDA BISKUPSKI
5012009-01-01LINDA BISKUPSKI LINDA BISKUPSKI2010-06-24
5012008-01-01LINDA BISKUPSKI LINDA BISKUPSKI2010-01-29
5012007-07-01LINDA BISKUPSKI LINDA BISKUPSKI2010-01-29
5012006-07-01LINDA BISKUPSKI LINDA BISKUPSKI2010-01-29
5012005-07-01LINDA BISKUPSKI LINDA BISKUPSKI2010-01-29
5012004-07-01LINDA BISKUPSKI LINDA BISKUPSKI2010-01-29
5012003-08-01LINDA BISKUPSKI LINDA BISKUPSKI2010-01-29

Plan Statistics for GROUP HEALTH & DISABILITY PLAN

401k plan membership statisitcs for GROUP HEALTH & DISABILITY PLAN

Measure Date Value
2022: GROUP HEALTH & DISABILITY PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-011,125
Total number of active participants reported on line 7a of the Form 55002022-01-011,035
Number of retired or separated participants receiving benefits2022-01-016
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-011,041
2021: GROUP HEALTH & DISABILITY PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01647
Total number of active participants reported on line 7a of the Form 55002021-01-01729
Number of retired or separated participants receiving benefits2021-01-017
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-01736
2020: GROUP HEALTH & DISABILITY PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-011,022
Total number of active participants reported on line 7a of the Form 55002020-01-01979
Number of retired or separated participants receiving benefits2020-01-0112
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-01991
2019: GROUP HEALTH & DISABILITY PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01731
Total number of active participants reported on line 7a of the Form 55002019-01-01833
Number of retired or separated participants receiving benefits2019-01-014
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-01837
2018: GROUP HEALTH & DISABILITY PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01480
Total number of active participants reported on line 7a of the Form 55002018-01-01605
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 participants2018-01-01605
2017: GROUP HEALTH & DISABILITY PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01439
Total number of active participants reported on line 7a of the Form 55002017-01-01453
Total of all active and inactive participants2017-01-01453
Total participants2017-01-01453
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-010
2016: GROUP HEALTH & DISABILITY PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01441
Total number of active participants reported on line 7a of the Form 55002016-01-01463
Total of all active and inactive participants2016-01-01463
Total participants2016-01-01463
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-010
2015: GROUP HEALTH & DISABILITY PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01420
Total number of active participants reported on line 7a of the Form 55002015-01-01441
Total of all active and inactive participants2015-01-01441
Total participants2015-01-01441
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-010
2014: GROUP HEALTH & DISABILITY PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01374
Total number of active participants reported on line 7a of the Form 55002014-01-01420
Total of all active and inactive participants2014-01-01420
Total participants2014-01-01420
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-010
2013: GROUP HEALTH & DISABILITY PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01340
Total number of active participants reported on line 7a of the Form 55002013-01-01374
Total of all active and inactive participants2013-01-01374
Total participants2013-01-01374
2012: GROUP HEALTH & DISABILITY PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01309
Total number of active participants reported on line 7a of the Form 55002012-01-01343
Total of all active and inactive participants2012-01-01343
Total participants2012-01-01343
2011: GROUP HEALTH & DISABILITY PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01323
Total number of active participants reported on line 7a of the Form 55002011-01-01300
Number of retired or separated participants receiving benefits2011-01-019
Total of all active and inactive participants2011-01-01309
Total participants2011-01-01309
2010: GROUP HEALTH & DISABILITY PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-01320
Total number of active participants reported on line 7a of the Form 55002010-01-01314
Number of retired or separated participants receiving benefits2010-01-019
Total of all active and inactive participants2010-01-01323
Total participants2010-01-01323
2009: GROUP HEALTH & DISABILITY PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01379
Total number of active participants reported on line 7a of the Form 55002009-01-01370
Number of retired or separated participants receiving benefits2009-01-019
Total of all active and inactive participants2009-01-01379
Total participants2009-01-01379
2008: GROUP HEALTH & DISABILITY PLAN 2008 401k membership
Total participants, beginning-of-year2008-01-01407
Total number of active participants reported on line 7a of the Form 55002008-01-01374
Number of retired or separated participants receiving benefits2008-01-015
Total of all active and inactive participants2008-01-01379
Total participants2008-01-01379
2007: GROUP HEALTH & DISABILITY PLAN 2007 401k membership
Total participants, beginning-of-year2007-07-01377
Total number of active participants reported on line 7a of the Form 55002007-07-01402
Number of retired or separated participants receiving benefits2007-07-015
Total of all active and inactive participants2007-07-01407
Total participants2007-07-01407
2006: GROUP HEALTH & DISABILITY PLAN 2006 401k membership
Total participants, beginning-of-year2006-07-01401
Total number of active participants reported on line 7a of the Form 55002006-07-01372
Number of retired or separated participants receiving benefits2006-07-015
Total of all active and inactive participants2006-07-01377
Total participants2006-07-01377
2005: GROUP HEALTH & DISABILITY PLAN 2005 401k membership
Total participants, beginning-of-year2005-07-01359
Total number of active participants reported on line 7a of the Form 55002005-07-01396
Number of retired or separated participants receiving benefits2005-07-015
Total of all active and inactive participants2005-07-01401
Total participants2005-07-01401
2004: GROUP HEALTH & DISABILITY PLAN 2004 401k membership
Total participants, beginning-of-year2004-07-01325
Total number of active participants reported on line 7a of the Form 55002004-07-01349
Number of retired or separated participants receiving benefits2004-07-0110
Total of all active and inactive participants2004-07-01359
Total participants2004-07-01359
2003: GROUP HEALTH & DISABILITY PLAN 2003 401k membership
Total participants, beginning-of-year2003-08-01321
Total number of active participants reported on line 7a of the Form 55002003-08-01312
Number of retired or separated participants receiving benefits2003-08-0113
Total of all active and inactive participants2003-08-01325
Total participants2003-08-01325

Form 5500 Responses for GROUP HEALTH & DISABILITY PLAN

2022: GROUP HEALTH & DISABILITY PLAN 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 funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: GROUP HEALTH & DISABILITY PLAN 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 funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: GROUP HEALTH & DISABILITY PLAN 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 funding arrangement – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes
2019: GROUP HEALTH & DISABILITY PLAN 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 funding arrangement – General assets of the sponsorYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – General assets of the sponsorYes
2018: GROUP HEALTH & DISABILITY PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01First time form 5500 has been submittedYes
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 funding arrangement – General assets of the sponsorYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – General assets of the sponsorYes
2017: GROUP HEALTH & DISABILITY PLAN 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 – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – General assets of the sponsorYes
2016: GROUP HEALTH & DISABILITY PLAN 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 – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – General assets of the sponsorYes
2015: GROUP HEALTH & DISABILITY PLAN 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 – General assets of the sponsorYes
2015-01-01Plan benefit arrangement – General assets of the sponsorYes
2014: GROUP HEALTH & DISABILITY PLAN 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 – General assets of the sponsorYes
2014-01-01Plan benefit arrangement – General assets of the sponsorYes
2013: GROUP HEALTH & DISABILITY PLAN 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 – General assets of the sponsorYes
2013-01-01Plan benefit arrangement – General assets of the sponsorYes
2012: GROUP HEALTH & DISABILITY PLAN 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 – General assets of the sponsorYes
2012-01-01Plan benefit arrangement – General assets of the sponsorYes
2011: GROUP HEALTH & DISABILITY PLAN 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 – General assets of the sponsorYes
2011-01-01Plan benefit arrangement – General assets of the sponsorYes
2010: GROUP HEALTH & DISABILITY PLAN 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 – General assets of the sponsorYes
2010-01-01Plan benefit arrangement – General assets of the sponsorYes
2009: GROUP HEALTH & DISABILITY PLAN 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 – General assets of the sponsorYes
2009-01-01Plan benefit arrangement – General assets of the sponsorYes
2008: GROUP HEALTH & DISABILITY PLAN 2008 form 5500 responses
2008-01-01Type of plan entitySingle employer plan
2008-01-01Submission has been amendedNo
2008-01-01This submission is the final filingNo
2008-01-01This return/report is a short plan year return/report (less than 12 months)No
2008-01-01Plan is a collectively bargained planNo
2008-01-01Plan funding arrangement – General assets of the sponsorYes
2008-01-01Plan benefit arrangement – General assets of the sponsorYes
2007: GROUP HEALTH & DISABILITY PLAN 2007 form 5500 responses
2007-07-01Type of plan entitySingle employer plan
2007-07-01Submission has been amendedNo
2007-07-01This submission is the final filingNo
2007-07-01This return/report is a short plan year return/report (less than 12 months)Yes
2007-07-01Plan is a collectively bargained planNo
2007-07-01Plan funding arrangement – General assets of the sponsorYes
2007-07-01Plan benefit arrangement – General assets of the sponsorYes
2006: GROUP HEALTH & DISABILITY PLAN 2006 form 5500 responses
2006-07-01Type of plan entitySingle employer plan
2006-07-01Submission has been amendedNo
2006-07-01This submission is the final filingNo
2006-07-01This return/report is a short plan year return/report (less than 12 months)No
2006-07-01Plan is a collectively bargained planNo
2006-07-01Plan funding arrangement – General assets of the sponsorYes
2006-07-01Plan benefit arrangement – General assets of the sponsorYes
2005: GROUP HEALTH & DISABILITY PLAN 2005 form 5500 responses
2005-07-01Type of plan entitySingle employer plan
2005-07-01Submission has been amendedNo
2005-07-01This submission is the final filingNo
2005-07-01This return/report is a short plan year return/report (less than 12 months)No
2005-07-01Plan is a collectively bargained planNo
2005-07-01Plan funding arrangement – General assets of the sponsorYes
2005-07-01Plan benefit arrangement – General assets of the sponsorYes
2004: GROUP HEALTH & DISABILITY PLAN 2004 form 5500 responses
2004-07-01Type of plan entitySingle employer plan
2004-07-01Submission has been amendedNo
2004-07-01This submission is the final filingNo
2004-07-01This return/report is a short plan year return/report (less than 12 months)No
2004-07-01Plan is a collectively bargained planNo
2004-07-01Plan funding arrangement – General assets of the sponsorYes
2004-07-01Plan benefit arrangement – General assets of the sponsorYes
2003: GROUP HEALTH & DISABILITY PLAN 2003 form 5500 responses
2003-08-01Type of plan entitySingle employer plan
2003-08-01Submission has been amendedNo
2003-08-01This submission is the final filingNo
2003-08-01This return/report is a short plan year return/report (less than 12 months)No
2003-08-01Plan is a collectively bargained planNo
2003-08-01Plan funding arrangement – General assets of the sponsorYes
2003-08-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number168416
Policy instance 1
Insurance contract or identification number168416
Number of Individuals Covered946
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $36,057
Total amount of fees paid to insurance companyUSD $0
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 BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT, VOL. LIFE/AD&D
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $36,057
Insurance broker organization code?3
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number168416
Policy instance 1
Insurance contract or identification number168416
Number of Individuals Covered919
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $53,440
Total amount of fees paid to insurance companyUSD $0
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 BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $53,440
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number602861
Policy instance 1
Insurance contract or identification number602861
Number of Individuals Covered791
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $27,638
Total amount of fees paid to insurance companyUSD $5,584
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 BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
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 $254,698
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $27,638
Amount paid for insurance broker fees5584
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION PAID
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number602861
Policy instance 1
Insurance contract or identification number602861
Number of Individuals Covered839
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $26,255
Total amount of fees paid to insurance companyUSD $4,401
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 BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
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 $284,562
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $20,875
Amount paid for insurance broker fees4401
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION PAID
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number602861
Policy instance 1
Insurance contract or identification number602861
Number of Individuals Covered511
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $21,726
Total amount of fees paid to insurance companyUSD $0
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 BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
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 $189,414
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $18,925
Insurance broker organization code?3

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