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COLD SPRING GRANITE COMPANY GROUP TERM LIFE INSURANCE PLAN 401k Plan overview

Plan NameCOLD SPRING GRANITE COMPANY GROUP TERM LIFE INSURANCE PLAN
Plan identification number 509

COLD SPRING GRANITE COMPANY GROUP TERM LIFE INSURANCE PLAN Benefits

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

401k Sponsoring company profile

COLD SPRING GRANITE COMPANY has sponsored the creation of one or more 401k plans.

Company Name:COLD SPRING GRANITE COMPANY
Employer identification number (EIN):410197900
NAIC Classification:212310
NAIC Description: Stone Mining and Quarrying

Additional information about COLD SPRING GRANITE COMPANY

Jurisdiction of Incorporation: Texas Secretary of State
Incorporation Date: 1992-12-18
Company Identification Number: 0009366306
Legal Registered Office Address: 17482 GRANITE WEST RD

COLD SPRING
United States of America (USA)
56320

More information about COLD SPRING GRANITE COMPANY

Form 5500 Filing Information

Submission information for form 5500 for 401k plan COLD SPRING GRANITE COMPANY GROUP TERM LIFE INSURANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5092022-01-01
5092021-01-01
5092020-01-01
5092019-01-01
5092018-01-01
5092017-01-01PAM OVERLAND PAM OVERLAND2018-10-09
5092016-01-01PAM OVERLAND PAM OVERLAND2017-10-13
5092015-01-01PAM OVERLAND2016-10-07 PAM OVERLAND2016-10-07
5092014-01-01PAM OVERLAND PAM OVERLAND2015-10-13
5092013-01-01PAM OVERLAND PAM OVERLAND2014-09-30
5092012-01-01PAM OVERLAND PAM OVERLAND2013-10-07
5092011-01-01PAM OVERLAND
5092009-01-01PAM OVERLAND

Plan Statistics for COLD SPRING GRANITE COMPANY GROUP TERM LIFE INSURANCE PLAN

401k plan membership statisitcs for COLD SPRING GRANITE COMPANY GROUP TERM LIFE INSURANCE PLAN

Measure Date Value
2022: COLD SPRING GRANITE COMPANY GROUP TERM LIFE INSURANCE PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01999
Total number of active participants reported on line 7a of the Form 55002022-01-01999
Total of all active and inactive participants2022-01-01999
Total participants2022-01-01999
2021: COLD SPRING GRANITE COMPANY GROUP TERM LIFE INSURANCE PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01954
Total number of active participants reported on line 7a of the Form 55002021-01-01954
Total of all active and inactive participants2021-01-01954
Total participants2021-01-01954
2020: COLD SPRING GRANITE COMPANY GROUP TERM LIFE INSURANCE PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01941
Total number of active participants reported on line 7a of the Form 55002020-01-01941
Total of all active and inactive participants2020-01-01941
Total participants2020-01-01941
2019: COLD SPRING GRANITE COMPANY GROUP TERM LIFE INSURANCE PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01926
Total number of active participants reported on line 7a of the Form 55002019-01-01926
Total of all active and inactive participants2019-01-01926
Total participants2019-01-01926
2018: COLD SPRING GRANITE COMPANY GROUP TERM LIFE INSURANCE PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01968
Total number of active participants reported on line 7a of the Form 55002018-01-01968
Total of all active and inactive participants2018-01-01968
Total participants2018-01-01968
2017: COLD SPRING GRANITE COMPANY GROUP TERM LIFE INSURANCE PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01962
Total number of active participants reported on line 7a of the Form 55002017-01-01962
Total of all active and inactive participants2017-01-01962
Total participants2017-01-01962
2016: COLD SPRING GRANITE COMPANY GROUP TERM LIFE INSURANCE PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01964
Total number of active participants reported on line 7a of the Form 55002016-01-01964
Total of all active and inactive participants2016-01-01964
Total participants2016-01-01964
2015: COLD SPRING GRANITE COMPANY GROUP TERM LIFE INSURANCE PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01834
Total number of active participants reported on line 7a of the Form 55002015-01-01834
Total of all active and inactive participants2015-01-01834
Total participants2015-01-01834
2014: COLD SPRING GRANITE COMPANY GROUP TERM LIFE INSURANCE PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-011,027
Total number of active participants reported on line 7a of the Form 55002014-01-011,027
Total of all active and inactive participants2014-01-011,027
Total participants2014-01-011,027
2013: COLD SPRING GRANITE COMPANY GROUP TERM LIFE INSURANCE PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-011,042
Total number of active participants reported on line 7a of the Form 55002013-01-011,042
Total of all active and inactive participants2013-01-011,042
Total participants2013-01-011,042
2012: COLD SPRING GRANITE COMPANY GROUP TERM LIFE INSURANCE PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-011,061
Total number of active participants reported on line 7a of the Form 55002012-01-011,061
Total of all active and inactive participants2012-01-011,061
Total participants2012-01-011,061
2011: COLD SPRING GRANITE COMPANY GROUP TERM LIFE INSURANCE PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-011,080
Total number of active participants reported on line 7a of the Form 55002011-01-011,080
Total of all active and inactive participants2011-01-011,080
Total participants2011-01-011,080
2009: COLD SPRING GRANITE COMPANY GROUP TERM LIFE INSURANCE PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-011,164
Total number of active participants reported on line 7a of the Form 55002009-01-011,164
Total of all active and inactive participants2009-01-011,164
Total participants2009-01-011,164

Form 5500 Responses for COLD SPRING GRANITE COMPANY GROUP TERM LIFE INSURANCE PLAN

2022: COLD SPRING GRANITE COMPANY GROUP TERM LIFE INSURANCE 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 benefit arrangement – InsuranceYes
2021: COLD SPRING GRANITE COMPANY GROUP TERM LIFE INSURANCE 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 benefit arrangement – InsuranceYes
2020: COLD SPRING GRANITE COMPANY GROUP TERM LIFE INSURANCE 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 benefit arrangement – InsuranceYes
2019: COLD SPRING GRANITE COMPANY GROUP TERM LIFE INSURANCE 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 benefit arrangement – InsuranceYes
2018: COLD SPRING GRANITE COMPANY GROUP TERM LIFE INSURANCE PLAN 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: COLD SPRING GRANITE COMPANY GROUP TERM LIFE INSURANCE 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 – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: COLD SPRING GRANITE COMPANY GROUP TERM LIFE INSURANCE 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 – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: COLD SPRING GRANITE COMPANY GROUP TERM LIFE INSURANCE 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 – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: COLD SPRING GRANITE COMPANY GROUP TERM LIFE INSURANCE 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 – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: COLD SPRING GRANITE COMPANY GROUP TERM LIFE INSURANCE 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 – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: COLD SPRING GRANITE COMPANY GROUP TERM LIFE INSURANCE 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 – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: COLD SPRING GRANITE COMPANY GROUP TERM LIFE INSURANCE 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 – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2009: COLD SPRING GRANITE COMPANY GROUP TERM LIFE INSURANCE 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 – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX966563
Policy instance 1
Insurance contract or identification numberFLX966563
Number of Individuals Covered999
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $20,664
Total amount of fees paid to insurance companyUSD $3,688
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 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 $280,715
Commission paid to Insurance BrokerUSD $20,664
Amount paid for insurance broker fees3688
Additional information about fees paid to insurance brokerOVERRIDE
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX966563
Policy instance 1
Insurance contract or identification numberFLX966563
Number of Individuals Covered954
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $23,105
Total amount of fees paid to insurance companyUSD $4,317
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 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 $266,313
Commission paid to Insurance BrokerUSD $21,305
Amount paid for insurance broker fees4317
Additional information about fees paid to insurance brokerOVERRIDE
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX966563
Policy instance 1
Insurance contract or identification numberFLX966563
Number of Individuals Covered941
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $12,278
Total amount of fees paid to insurance companyUSD $2,471
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 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 $153,481
Commission paid to Insurance BrokerUSD $12,278
Amount paid for insurance broker fees271
Additional information about fees paid to insurance brokerOVERRIDE
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX966563
Policy instance 1
Insurance contract or identification numberFLX966563
Number of Individuals Covered926
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $25,766
Total amount of fees paid to insurance companyUSD $1,930
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 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 $322,071
Commission paid to Insurance BrokerUSD $25,766
Amount paid for insurance broker fees1930
Additional information about fees paid to insurance brokerOVERRIDE
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX966563
Policy instance 1
Insurance contract or identification numberFLX966563
Number of Individuals Covered968
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $16,243
Total amount of fees paid to insurance companyUSD $3,036
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 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 $203,037
Commission paid to Insurance BrokerUSD $16,243
Amount paid for insurance broker fees3036
Additional information about fees paid to insurance brokerOVERRIDE
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX966563
Policy instance 1
Insurance contract or identification numberFLX966563
Number of Individuals Covered962
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $19,420
Total amount of fees paid to insurance companyUSD $4,925
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 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 $242,757
Commission paid to Insurance BrokerUSD $19,420
Amount paid for insurance broker fees4925
Additional information about fees paid to insurance brokerOVERRIDE
Insurance broker organization code?3
Insurance broker nameGALLAGHER BENEFIT SERVICE
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX966563
Policy instance 1
Insurance contract or identification numberFLX966563
Number of Individuals Covered834
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
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 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 $211,097
Commission paid to Insurance BrokerUSD $16,888
Amount paid for insurance broker fees8125
Insurance broker organization code?3
Insurance broker nameGALLAGHER BENEFIT SERVICE INC
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010147497
Policy instance 1
Insurance contract or identification number000010147497
Number of Individuals Covered1027
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 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 $64,832
Commission paid to Insurance BrokerUSD $331,184
Insurance broker organization code?3
Insurance broker nameGALLAGHER BENEFIT SERVICE INC
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010147497
Policy instance 1
Insurance contract or identification number000010147497
Number of Individuals Covered1061
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
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 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 $63,964
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010147497
Policy instance 1
Insurance contract or identification number000010147497
Number of Individuals Covered1061
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Welfare Benefit Premiums Paid to CarrierUSD $75,212
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number150375
Policy instance 1
Insurance contract or identification number150375
Number of Individuals Covered1080
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $71,353
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number150375
Policy instance 1
Insurance contract or identification number150375
Number of Individuals Covered1090
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $1,627
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $79,278
Commission paid to Insurance BrokerUSD $165
Insurance broker organization code?3
Insurance broker nameGALLAGHER BENEFIT SVSC INC OF

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