FOOD MANAGEMENT INVESTORS, INC. DBA CULTIVATE SOLUTIONS has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan FMI, INC.
401k plan membership statisitcs for FMI, INC.
| Measure | Date | Value |
|---|
| 2022: FMI, INC. 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-08-01 | 184 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-08-01 | 187 |
| Total of all active and inactive participants | 2022-08-01 | 187 |
| Number of employers contributing to the scheme | 2022-08-01 | 8 |
| 2021: FMI, INC. 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-08-01 | 167 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-08-01 | 184 |
| Total of all active and inactive participants | 2021-08-01 | 184 |
| Number of employers contributing to the scheme | 2021-08-01 | 7 |
| 2020: FMI, INC. 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-08-01 | 145 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-08-01 | 167 |
| Total of all active and inactive participants | 2020-08-01 | 167 |
| 2019: FMI, INC. 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-08-01 | 97 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-08-01 | 145 |
| Total of all active and inactive participants | 2019-08-01 | 145 |
| Number of employers contributing to the scheme | 2019-08-01 | 5 |
| 2018: FMI, INC. 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-08-01 | 117 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-08-01 | 97 |
| Total of all active and inactive participants | 2018-08-01 | 97 |
| Number of employers contributing to the scheme | 2018-08-01 | 5 |
| 2017: FMI, INC. 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-08-01 | 132 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-08-01 | 117 |
| Total of all active and inactive participants | 2017-08-01 | 117 |
| 2016: FMI, INC. 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-08-01 | 176 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-08-01 | 132 |
| Total of all active and inactive participants | 2016-08-01 | 132 |
| Number of employers contributing to the scheme | 2016-08-01 | 4 |
| 2015: FMI, INC. 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-08-01 | 178 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-08-01 | 176 |
| Total of all active and inactive participants | 2015-08-01 | 176 |
| Number of employers contributing to the scheme | 2015-08-01 | 4 |
| 2014: FMI, INC. 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-08-01 | 122 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-08-01 | 178 |
| Total of all active and inactive participants | 2014-08-01 | 178 |
| Number of employers contributing to the scheme | 2014-08-01 | 8 |
| 2013: FMI, INC. 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-08-01 | 167 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-08-01 | 122 |
| Total of all active and inactive participants | 2013-08-01 | 122 |
| Number of employers contributing to the scheme | 2013-08-01 | 8 |
| 2012: FMI, INC. 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-08-01 | 188 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-08-01 | 167 |
| Total of all active and inactive participants | 2012-08-01 | 167 |
| Number of employers contributing to the scheme | 2012-08-01 | 8 |
| 2011: FMI, INC. 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-08-01 | 155 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-08-01 | 188 |
| Total of all active and inactive participants | 2011-08-01 | 188 |
| Number of employers contributing to the scheme | 2011-08-01 | 8 |
| 2009: FMI, INC. 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-08-01 | 196 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-08-01 | 196 |
| Total of all active and inactive participants | 2009-08-01 | 196 |
| Number of employers contributing to the scheme | 2009-08-01 | 8 |
| 2022: FMI, INC. 2022 form 5500 responses |
|---|
| 2022-08-01 | Type of plan entity | Multi-employer plan |
| 2022-08-01 | Plan is a collectively bargained plan | Yes |
| 2022-08-01 | Plan funding arrangement – Insurance | Yes |
| 2022-08-01 | Plan benefit arrangement – Insurance | Yes |
| 2021: FMI, INC. 2021 form 5500 responses |
|---|
| 2021-08-01 | Type of plan entity | Multi-employer plan |
| 2021-08-01 | Plan is a collectively bargained plan | Yes |
| 2021-08-01 | Plan funding arrangement – Insurance | Yes |
| 2021-08-01 | Plan benefit arrangement – Insurance | Yes |
| 2020: FMI, INC. 2020 form 5500 responses |
|---|
| 2020-08-01 | Type of plan entity | Multi-employer plan |
| 2020-08-01 | Plan is a collectively bargained plan | Yes |
| 2020-08-01 | Plan funding arrangement – Insurance | Yes |
| 2020-08-01 | Plan benefit arrangement – Insurance | Yes |
| 2019: FMI, INC. 2019 form 5500 responses |
|---|
| 2019-08-01 | Type of plan entity | Multi-employer plan |
| 2019-08-01 | Plan is a collectively bargained plan | Yes |
| 2019-08-01 | Plan funding arrangement – Insurance | Yes |
| 2019-08-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: FMI, INC. 2018 form 5500 responses |
|---|
| 2018-08-01 | Type of plan entity | Multi-employer plan |
| 2018-08-01 | Plan is a collectively bargained plan | Yes |
| 2018-08-01 | Plan funding arrangement – Insurance | Yes |
| 2018-08-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: FMI, INC. 2017 form 5500 responses |
|---|
| 2017-08-01 | Type of plan entity | Multi-employer plan |
| 2017-08-01 | Plan is a collectively bargained plan | Yes |
| 2017-08-01 | Plan funding arrangement – Insurance | Yes |
| 2017-08-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: FMI, INC. 2016 form 5500 responses |
|---|
| 2016-08-01 | Type of plan entity | Multi-employer plan |
| 2016-08-01 | Plan is a collectively bargained plan | Yes |
| 2016-08-01 | Plan funding arrangement – Insurance | Yes |
| 2016-08-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: FMI, INC. 2015 form 5500 responses |
|---|
| 2015-08-01 | Type of plan entity | Multi-employer plan |
| 2015-08-01 | Plan is a collectively bargained plan | Yes |
| 2015-08-01 | Plan funding arrangement – Insurance | Yes |
| 2015-08-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: FMI, INC. 2014 form 5500 responses |
|---|
| 2014-08-01 | Type of plan entity | Multi-employer plan |
| 2014-08-01 | Plan is a collectively bargained plan | Yes |
| 2014-08-01 | Plan funding arrangement – Insurance | Yes |
| 2014-08-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: FMI, INC. 2013 form 5500 responses |
|---|
| 2013-08-01 | Type of plan entity | Multi-employer plan |
| 2013-08-01 | Plan is a collectively bargained plan | Yes |
| 2013-08-01 | Plan funding arrangement – Insurance | Yes |
| 2013-08-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: FMI, INC. 2012 form 5500 responses |
|---|
| 2012-08-01 | Type of plan entity | Multi-employer plan |
| 2012-08-01 | Plan is a collectively bargained plan | Yes |
| 2012-08-01 | Plan funding arrangement – Insurance | Yes |
| 2012-08-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: FMI, INC. 2011 form 5500 responses |
|---|
| 2011-08-01 | Type of plan entity | Multi-employer plan |
| 2011-08-01 | Plan is a collectively bargained plan | Yes |
| 2011-08-01 | Plan funding arrangement – Insurance | Yes |
| 2011-08-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: FMI, INC. 2009 form 5500 responses |
|---|
| 2009-08-01 | Type of plan entity | Multi-employer plan |
| 2009-08-01 | This submission is the final filing | No |
| 2009-08-01 | Plan is a collectively bargained plan | Yes |
| 2009-08-01 | Plan funding arrangement – Insurance | Yes |
| 2009-08-01 | Plan benefit arrangement – Insurance | Yes |
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 098859 |
| Policy instance | 2 |
| Insurance contract or identification number | 098859 | | Number of Individuals Covered | 70 | | Insurance policy start date | 2022-08-01 | | Insurance policy end date | 2023-08-01 | | Total amount of commissions paid to insurance broker | USD $4,900 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH | | Welfare Benefit Premiums Paid to Carrier | USD $28,823 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,900 | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 295860 |
| Policy instance | 1 |
| Insurance contract or identification number | 295860 | | Number of Individuals Covered | 183 | | Insurance policy start date | 2022-08-01 | | Insurance policy end date | 2023-08-01 | | Total amount of commissions paid to insurance broker | USD $5,702 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH | | Welfare Benefit Premiums Paid to Carrier | USD $33,564 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,702 | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 098859 |
| Policy instance | 2 |
| Insurance contract or identification number | 098859 | | Number of Individuals Covered | 69 | | Insurance policy start date | 2021-08-01 | | Insurance policy end date | 2022-08-01 | | Total amount of commissions paid to insurance broker | USD $3,951 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH | | Welfare Benefit Premiums Paid to Carrier | USD $23,243 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,951 | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 295860 |
| Policy instance | 1 |
| Insurance contract or identification number | 295860 | | Number of Individuals Covered | 176 | | Insurance policy start date | 2021-08-01 | | Insurance policy end date | 2022-08-01 | | Total amount of commissions paid to insurance broker | USD $4,935 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH | | Welfare Benefit Premiums Paid to Carrier | USD $29,027 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,935 | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 295860 |
| Policy instance | 1 |
| Insurance contract or identification number | 295860 | | Number of Individuals Covered | 155 | | Insurance policy start date | 2020-08-01 | | Insurance policy end date | 2021-08-01 | | Total amount of commissions paid to insurance broker | USD $4,687 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH | | Welfare Benefit Premiums Paid to Carrier | USD $25,508 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,687 | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 098859 |
| Policy instance | 2 |
| Insurance contract or identification number | 098859 | | Number of Individuals Covered | 60 | | Insurance policy start date | 2020-08-01 | | Insurance policy end date | 2021-08-01 | | Total amount of commissions paid to insurance broker | USD $3,534 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH | | Welfare Benefit Premiums Paid to Carrier | USD $19,234 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,534 | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 098859 |
| Policy instance | 2 |
| Insurance contract or identification number | 098859 | | Number of Individuals Covered | 39 | | Insurance policy start date | 2019-08-01 | | Insurance policy end date | 2020-08-01 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $2,995 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH | | Welfare Benefit Premiums Paid to Carrier | USD $17,312 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 2995 | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 295860 |
| Policy instance | 1 |
| Insurance contract or identification number | 295860 | | Number of Individuals Covered | 146 | | Insurance policy start date | 2019-08-01 | | Insurance policy end date | 2020-08-01 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $4,087 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH | | Welfare Benefit Premiums Paid to Carrier | USD $23,567 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 4087 | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 098859 |
| Policy instance | 2 |
| Insurance contract or identification number | 098859 | | Number of Individuals Covered | 24 | | Insurance policy start date | 2018-08-01 | | Insurance policy end date | 2019-08-01 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $2,070 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $10,894 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 2070 | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 295860 |
| Policy instance | 1 |
| Insurance contract or identification number | 295860 | | Number of Individuals Covered | 94 | | Insurance policy start date | 2018-08-01 | | Insurance policy end date | 2019-08-01 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $4,245 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $22,337 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 4245 | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 098859 |
| Policy instance | 2 |
| Insurance contract or identification number | 098859 | | Number of Individuals Covered | 19 | | Insurance policy start date | 2017-08-01 | | Insurance policy end date | 2018-08-01 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $1,935 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $10,017 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 295860 |
| Policy instance | 1 |
| Insurance contract or identification number | 295860 | | Number of Individuals Covered | 98 | | Insurance policy start date | 2017-08-01 | | Insurance policy end date | 2018-08-01 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $4,221 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $22,212 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 295860 |
| Policy instance | 1 |
| Insurance contract or identification number | 295860 | | Number of Individuals Covered | 155 | | Insurance policy start date | 2015-08-01 | | Insurance policy end date | 2016-08-01 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $4,399 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $23,149 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 4399 | | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION PAID. | | Insurance broker name | NORIDIAN INSURANCE SERVICES |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 098859 |
| Policy instance | 2 |
| Insurance contract or identification number | 098859 | | Number of Individuals Covered | 21 | | Insurance policy start date | 2015-08-01 | | Insurance policy end date | 2016-08-01 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $1,675 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $8,814 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 1675 | | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION PAID | | Insurance broker name | NORIDIAN INSURANCE SERVICES |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 295860 |
| Policy instance | 1 |
| Insurance contract or identification number | 295860 | | Number of Individuals Covered | 178 | | Insurance policy start date | 2014-08-01 | | Insurance policy end date | 2015-08-01 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $4,002 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $21,058 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 4002 | | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION PAID. | | Insurance broker name | NORIDIAN INSURANCE SERVICES |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 295860-002 |
| Policy instance | 1 |
| Insurance contract or identification number | 295860-002 | | Number of Individuals Covered | 122 | | Insurance policy start date | 2013-08-01 | | Insurance policy end date | 2014-08-01 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $603 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $3,258 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 603 | | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION PAID. | | Insurance broker name | NORIDIAN INSURANCE SERVICES |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 098859-0001 |
| Policy instance | 2 |
| Insurance contract or identification number | 098859-0001 | | Number of Individuals Covered | 44 | | Insurance policy start date | 2013-08-01 | | Insurance policy end date | 2014-08-01 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $2,977 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $16,098 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 2977 | | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION PAID. | | Insurance broker name | NORIDIAN INSURANCE SERVICES |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 098859 |
| Policy instance | 2 |
| Insurance contract or identification number | 098859 | | Number of Individuals Covered | 34 | | Insurance policy start date | 2012-08-01 | | Insurance policy end date | 2013-08-01 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $3,096 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $14,363 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 3096 | | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION PAID. | | Insurance broker name | NORIDIAN INSURANCE SERVICES |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 295860 |
| Policy instance | 1 |
| Insurance contract or identification number | 295860 | | Number of Individuals Covered | 167 | | Insurance policy start date | 2012-08-01 | | Insurance policy end date | 2013-08-01 | | Total amount of commissions paid to insurance broker | USD $1,538 | | Total amount of fees paid to insurance company | USD $2,204 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $19,663 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,538 | | Amount paid for insurance broker fees | 2204 | | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION PAID. | | Insurance broker name | NORIDIAN INSURANCE SERVICES |
|
| LINCOLN MUTUAL LIFE & CASUALTY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65641 ) |
| Policy contract number | 2205600 |
| Policy instance | 1 |
| Insurance contract or identification number | 2205600 | | Number of Individuals Covered | 155 | | Insurance policy start date | 2011-08-01 | | Insurance policy end date | 2012-05-31 | | Total amount of commissions paid to insurance broker | USD $1,525 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $11,632 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 295860 |
| Policy instance | 2 |
| Insurance contract or identification number | 295860 | | Number of Individuals Covered | 188 | | Insurance policy start date | 2011-08-01 | | Insurance policy end date | 2012-08-01 | | Total amount of commissions paid to insurance broker | USD $2,422 | | Total amount of fees paid to insurance company | USD $168 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $17,004 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 098859 |
| Policy instance | 3 |
| Insurance contract or identification number | 098859 | | Number of Individuals Covered | 45 | | Insurance policy start date | 2011-08-01 | | Insurance policy end date | 2012-08-01 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $800 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LINCOLN MUTUAL LIFE & CASUALTY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65641 ) |
| Policy contract number | 2205600 |
| Policy instance | 1 |
| Insurance contract or identification number | 2205600 | | Number of Individuals Covered | 155 | | Insurance policy start date | 2010-08-01 | | Insurance policy end date | 2011-07-31 | | Total amount of commissions paid to insurance broker | USD $891 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $14,728 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
