ENTRUST CORPORATION has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan GROUP TRAVEL ACCIDENT INSURANCE
| Measure | Date | Value |
|---|
| 2019: GROUP TRAVEL ACCIDENT INSURANCE 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-01-01 | 1,171 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 0 |
| Number of retired or separated participants receiving benefits | 2019-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2019-01-01 | 0 |
| Total of all active and inactive participants | 2019-01-01 | 0 |
| 2018: GROUP TRAVEL ACCIDENT INSURANCE 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-01-01 | 1,181 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 1,188 |
| Number of retired or separated participants receiving benefits | 2018-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2018-01-01 | 0 |
| Total of all active and inactive participants | 2018-01-01 | 1,188 |
| 2017: GROUP TRAVEL ACCIDENT INSURANCE 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-01-01 | 1,204 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 1,181 |
| Number of retired or separated participants receiving benefits | 2017-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2017-01-01 | 0 |
| Total of all active and inactive participants | 2017-01-01 | 1,181 |
| 2016: GROUP TRAVEL ACCIDENT INSURANCE 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-01-01 | 1,336 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 1,297 |
| Number of retired or separated participants receiving benefits | 2016-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2016-01-01 | 0 |
| Total of all active and inactive participants | 2016-01-01 | 1,297 |
| 2015: GROUP TRAVEL ACCIDENT INSURANCE 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-01-01 | 1,142 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 1,231 |
| Number of retired or separated participants receiving benefits | 2015-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2015-01-01 | 0 |
| Total of all active and inactive participants | 2015-01-01 | 1,231 |
| 2014: GROUP TRAVEL ACCIDENT INSURANCE 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-11-16 | 1,098 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-11-16 | 1,098 |
| Number of retired or separated participants receiving benefits | 2014-11-16 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2014-11-16 | 0 |
| Total of all active and inactive participants | 2014-11-16 | 1,098 |
| 2013: GROUP TRAVEL ACCIDENT INSURANCE 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-11-16 | 931 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-11-16 | 1,098 |
| Number of retired or separated participants receiving benefits | 2013-11-16 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2013-11-16 | 0 |
| Total of all active and inactive participants | 2013-11-16 | 1,098 |
| 2012: GROUP TRAVEL ACCIDENT INSURANCE 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-11-16 | 852 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-11-16 | 911 |
| Number of retired or separated participants receiving benefits | 2012-11-16 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2012-11-16 | 0 |
| Total of all active and inactive participants | 2012-11-16 | 911 |
| 2011: GROUP TRAVEL ACCIDENT INSURANCE 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-11-16 | 827 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-11-16 | 879 |
| Number of retired or separated participants receiving benefits | 2011-11-16 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2011-11-16 | 0 |
| Total of all active and inactive participants | 2011-11-16 | 879 |
| 2010: GROUP TRAVEL ACCIDENT INSURANCE 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-11-16 | 785 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-11-16 | 825 |
| Number of retired or separated participants receiving benefits | 2010-11-16 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2010-11-16 | 0 |
| Total of all active and inactive participants | 2010-11-16 | 825 |
| 2009: GROUP TRAVEL ACCIDENT INSURANCE 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-11-16 | 722 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-11-16 | 777 |
| Number of retired or separated participants receiving benefits | 2009-11-16 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2009-11-16 | 0 |
| Total of all active and inactive participants | 2009-11-16 | 777 |
| 2008: GROUP TRAVEL ACCIDENT INSURANCE 2008 401k membership |
|---|
| Total participants, beginning-of-year | 2008-11-16 | 782 |
| Total number of active participants reported on line 7a of the Form 5500 | 2008-11-16 | 723 |
| Number of retired or separated participants receiving benefits | 2008-11-16 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2008-11-16 | 0 |
| Total of all active and inactive participants | 2008-11-16 | 723 |
| 2019: GROUP TRAVEL ACCIDENT INSURANCE 2019 form 5500 responses |
|---|
| 2019-01-01 | Type of plan entity | Single employer plan |
| 2019-01-01 | Submission has been amended | No |
| 2019-01-01 | This submission is the final filing | Yes |
| 2019-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2019-01-01 | Plan is a collectively bargained plan | No |
| 2019-01-01 | Plan funding arrangement – Insurance | Yes |
| 2019-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: GROUP TRAVEL ACCIDENT INSURANCE 2018 form 5500 responses |
|---|
| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | Submission has been amended | No |
| 2018-01-01 | This submission is the final filing | No |
| 2018-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2018-01-01 | Plan is a collectively bargained plan | No |
| 2018-01-01 | Plan funding arrangement – Insurance | Yes |
| 2018-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: GROUP TRAVEL ACCIDENT INSURANCE 2017 form 5500 responses |
|---|
| 2017-01-01 | Type of plan entity | Single employer plan |
| 2017-01-01 | Submission has been amended | No |
| 2017-01-01 | This submission is the final filing | No |
| 2017-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2017-01-01 | Plan is a collectively bargained plan | No |
| 2017-01-01 | Plan funding arrangement – Insurance | Yes |
| 2017-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: GROUP TRAVEL ACCIDENT INSURANCE 2016 form 5500 responses |
|---|
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | Submission has been amended | No |
| 2016-01-01 | This submission is the final filing | No |
| 2016-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-01-01 | Plan is a collectively bargained plan | No |
| 2016-01-01 | Plan funding arrangement – Insurance | Yes |
| 2016-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: GROUP TRAVEL ACCIDENT INSURANCE 2015 form 5500 responses |
|---|
| 2015-01-01 | Type of plan entity | Single employer plan |
| 2015-01-01 | Submission has been amended | No |
| 2015-01-01 | This submission is the final filing | No |
| 2015-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-01-01 | Plan is a collectively bargained plan | No |
| 2015-01-01 | Plan funding arrangement – Insurance | Yes |
| 2015-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: GROUP TRAVEL ACCIDENT INSURANCE 2014 form 5500 responses |
|---|
| 2014-11-16 | Type of plan entity | Single employer plan |
| 2014-11-16 | Submission has been amended | No |
| 2014-11-16 | This submission is the final filing | No |
| 2014-11-16 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2014-11-16 | Plan is a collectively bargained plan | No |
| 2014-11-16 | Plan funding arrangement – Insurance | Yes |
| 2014-11-16 | Plan benefit arrangement – Insurance | Yes |
| 2013: GROUP TRAVEL ACCIDENT INSURANCE 2013 form 5500 responses |
|---|
| 2013-11-16 | Type of plan entity | Single employer plan |
| 2013-11-16 | Submission has been amended | No |
| 2013-11-16 | This submission is the final filing | No |
| 2013-11-16 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2013-11-16 | Plan is a collectively bargained plan | No |
| 2013-11-16 | Plan funding arrangement – Insurance | Yes |
| 2013-11-16 | Plan benefit arrangement – Insurance | Yes |
| 2012: GROUP TRAVEL ACCIDENT INSURANCE 2012 form 5500 responses |
|---|
| 2012-11-16 | Type of plan entity | Single employer plan |
| 2012-11-16 | Submission has been amended | No |
| 2012-11-16 | This submission is the final filing | No |
| 2012-11-16 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2012-11-16 | Plan is a collectively bargained plan | No |
| 2012-11-16 | Plan funding arrangement – Insurance | Yes |
| 2012-11-16 | Plan benefit arrangement – Insurance | Yes |
| 2011: GROUP TRAVEL ACCIDENT INSURANCE 2011 form 5500 responses |
|---|
| 2011-11-16 | Type of plan entity | Single employer plan |
| 2011-11-16 | Submission has been amended | No |
| 2011-11-16 | This submission is the final filing | No |
| 2011-11-16 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2011-11-16 | Plan is a collectively bargained plan | No |
| 2011-11-16 | Plan funding arrangement – Insurance | Yes |
| 2011-11-16 | Plan benefit arrangement – Insurance | Yes |
| 2010: GROUP TRAVEL ACCIDENT INSURANCE 2010 form 5500 responses |
|---|
| 2010-11-16 | Type of plan entity | Single employer plan |
| 2010-11-16 | Submission has been amended | No |
| 2010-11-16 | This submission is the final filing | No |
| 2010-11-16 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2010-11-16 | Plan is a collectively bargained plan | No |
| 2010-11-16 | Plan funding arrangement – Insurance | Yes |
| 2010-11-16 | Plan benefit arrangement – Insurance | Yes |
| 2009: GROUP TRAVEL ACCIDENT INSURANCE 2009 form 5500 responses |
|---|
| 2009-11-16 | Type of plan entity | Single employer plan |
| 2009-11-16 | Submission has been amended | No |
| 2009-11-16 | This submission is the final filing | No |
| 2009-11-16 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2009-11-16 | Plan is a collectively bargained plan | No |
| 2009-11-16 | Plan funding arrangement – Insurance | Yes |
| 2009-11-16 | Plan benefit arrangement – Insurance | Yes |
| 2008: GROUP TRAVEL ACCIDENT INSURANCE 2008 form 5500 responses |
|---|
| 2008-11-16 | Type of plan entity | Single employer plan |
| 2008-11-16 | Submission has been amended | No |
| 2008-11-16 | This submission is the final filing | No |
| 2008-11-16 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2008-11-16 | Plan is a collectively bargained plan | No |
| 2008-11-16 | Plan funding arrangement – Insurance | Yes |
| 2008-11-16 | Plan benefit arrangement – Insurance | Yes |
| NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 ) |
| Policy contract number | GTP0009132922A |
| Policy instance | 1 |
| Insurance contract or identification number | GTP0009132922A | | Number of Individuals Covered | 1295 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $4,967 | | Total amount of fees paid to insurance company | USD $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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | BUSINESS TRAVEL ACCIDENT | | 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 Carrier | USD $19,868 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,967 | | Insurance broker organization code? | 3 |
|
| NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 ) |
| Policy contract number | GTP0009132922A |
| Policy instance | 1 |
| Insurance contract or identification number | GTP0009132922A | | Number of Individuals Covered | 1188 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $4,278 | | Total amount of fees paid to insurance company | USD $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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | BUSINESS TRAVEL ACCIDENT | | 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 Carrier | USD $17,111 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,278 | | Insurance broker organization code? | 3 |
|
| NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 ) |
| Policy contract number | GTP0009132922A |
| Policy instance | 1 |
| Insurance contract or identification number | GTP0009132922A | | Number of Individuals Covered | 1181 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $4,278 | | Total amount of fees paid to insurance company | USD $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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | BUSINESS TRAVEL ACCIDENT | | 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 Carrier | USD $17,111 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,278 | | Insurance broker organization code? | 3 | | Insurance broker name | MERCER HEALTH AND BENEFITS, LLC |
|
| NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 ) |
| Policy contract number | GTP 0009132922 |
| Policy instance | 1 |
| Insurance contract or identification number | GTP 0009132922 | | Number of Individuals Covered | 1231 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $3,255 | | Total amount of fees paid to insurance company | USD $0 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | BUSINESS TRAVEL ACCIDENT | | 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 Carrier | USD $13,020 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,255 | | Insurance broker organization code? | 3 | | Insurance broker name | MERCER HEALTH AND BENEFITS, LLC |
|
| NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 ) |
| Policy contract number | GTP 0009132922 |
| Policy instance | 1 |
| Insurance contract or identification number | GTP 0009132922 | | Number of Individuals Covered | 1098 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $3,255 | | Total amount of fees paid to insurance company | USD $0 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | BUSINESS TRAVEL ACCIDENT | | 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 Carrier | USD $13,020 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,255 | | Insurance broker organization code? | 3 | | Insurance broker name | MERCER HEALTH AND BENEFITS, LLC |
|
| NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 ) |
| Policy contract number | GTP 0009132922 |
| Policy instance | 1 |
| Insurance contract or identification number | GTP 0009132922 | | Number of Individuals Covered | 1098 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $2,414 | | Total amount of fees paid to insurance company | USD $0 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | BUSINESS TRAVEL ACCIDENT | | 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 Carrier | USD $12,072 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,414 | | Insurance broker organization code? | 3 | | Insurance broker name | MERCER HEALTH AND BENEFITS, LLC |
|
| NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19745 ) |
| Policy contract number | GTP 0009132922 |
| Policy instance | 1 |
| Insurance contract or identification number | GTP 0009132922 | | Number of Individuals Covered | 911 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $1,614 | | Total amount of fees paid to insurance company | USD $0 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | BUSINESS TRAVEL ACCIDENT | | 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 Carrier | USD $8,072 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,614 | | Insurance broker organization code? | 3 | | Insurance broker name | MERCER HEALTH AND BENEFITS, LLC |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | ABL658425 |
| Policy instance | 1 |
| Insurance contract or identification number | ABL658425 | | Number of Individuals Covered | 879 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | BUSINESS TRAVEL ACCIDENT | | 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 Carrier | USD $0 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | ABL658425 |
| Policy instance | 1 |
| Insurance contract or identification number | ABL658425 | | Number of Individuals Covered | 825 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $618 | | Total amount of fees paid to insurance company | USD $26 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | BUSINESS TRAVEL ACCIDENT | | 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 Carrier | USD $3,089 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
