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GROUP LIFE AND ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE FOR EMPLOYEES OF WASHINGTON RADIOLOGY ASSOCIATES PC 401k Plan overview

Plan NameGROUP LIFE AND ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE FOR EMPLOYEES OF WASHINGTON RADIOLOGY ASSOCIATES PC
Plan identification number 504

GROUP LIFE AND ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE FOR EMPLOYEES OF WASHINGTON RADIOLOGY ASSOCIATES PC Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Other welfare benefit cover

401k Sponsoring company profile

WASHINGTON RADIOLOGY ASSOCIATES, PLLC has sponsored the creation of one or more 401k plans.

Company Name:WASHINGTON RADIOLOGY ASSOCIATES, PLLC
Employer identification number (EIN):520940005
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GROUP LIFE AND ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE FOR EMPLOYEES OF WASHINGTON RADIOLOGY ASSOCIATES PC

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5042015-07-01IAN LANDE
5042014-07-01IAN LANDE
5042013-07-01IAN LANDE
5042012-07-01EDWARD LIPSIT
5042011-07-01EDWARD LIPSIT
5042009-08-01EDWARD LIPSIT
5042007-08-01EDWARD LIPSIT
5042006-08-01EDWARD LIPSIT
5042003-11-01EDWARD LIPSIT
5042002-11-01EDWARD LIPSIT
5042001-11-01EDWARD LIPSIT
5042001-07-01EDWARD LIPSIT
5042001-07-01EDWARD LIPSIT
5042000-07-01EDWARD LIPSIT
5042000-07-01EDWARD LIPSIT
5041999-07-01EDWARD LIPSIT
5041998-07-01EDWARD LIPSIT
5041998-07-01EDWARD LIPSIT
5041997-07-01EDWARD LIPSIT

Plan Statistics for GROUP LIFE AND ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE FOR EMPLOYEES OF WASHINGTON RADIOLOGY ASSOCIATES PC

401k plan membership statisitcs for GROUP LIFE AND ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE FOR EMPLOYEES OF WASHINGTON RADIOLOGY ASSOCIATES PC

Measure Date Value
2015: GROUP LIFE AND ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE FOR EMPLOYEES OF WASHINGTON RADIOLOGY ASSOCIATES PC 2015 401k membership
Total participants, beginning-of-year2015-07-01220
Total number of active participants reported on line 7a of the Form 55002015-07-010
Number of retired or separated participants receiving benefits2015-07-010
Number of other retired or separated participants entitled to future benefits2015-07-010
Total of all active and inactive participants2015-07-010
2014: GROUP LIFE AND ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE FOR EMPLOYEES OF WASHINGTON RADIOLOGY ASSOCIATES PC 2014 401k membership
Total participants, beginning-of-year2014-07-01218
Total number of active participants reported on line 7a of the Form 55002014-07-01221
Number of retired or separated participants receiving benefits2014-07-010
Number of other retired or separated participants entitled to future benefits2014-07-010
Total of all active and inactive participants2014-07-01221
2013: GROUP LIFE AND ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE FOR EMPLOYEES OF WASHINGTON RADIOLOGY ASSOCIATES PC 2013 401k membership
Total participants, beginning-of-year2013-07-01219
Total number of active participants reported on line 7a of the Form 55002013-07-01220
Number of retired or separated participants receiving benefits2013-07-010
Number of other retired or separated participants entitled to future benefits2013-07-010
Total of all active and inactive participants2013-07-01220
2012: GROUP LIFE AND ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE FOR EMPLOYEES OF WASHINGTON RADIOLOGY ASSOCIATES PC 2012 401k membership
Total participants, beginning-of-year2012-07-01214
Total number of active participants reported on line 7a of the Form 55002012-07-01217
Number of retired or separated participants receiving benefits2012-07-010
Number of other retired or separated participants entitled to future benefits2012-07-010
Total of all active and inactive participants2012-07-01217
2011: GROUP LIFE AND ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE FOR EMPLOYEES OF WASHINGTON RADIOLOGY ASSOCIATES PC 2011 401k membership
Total participants, beginning-of-year2011-07-01212
Total number of active participants reported on line 7a of the Form 55002011-07-01218
Number of retired or separated participants receiving benefits2011-07-010
Number of other retired or separated participants entitled to future benefits2011-07-010
Total of all active and inactive participants2011-07-01218
2009: GROUP LIFE AND ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE FOR EMPLOYEES OF WASHINGTON RADIOLOGY ASSOCIATES PC 2009 401k membership
Total participants, beginning-of-year2009-08-01219
Total number of active participants reported on line 7a of the Form 55002009-08-01209
Number of retired or separated participants receiving benefits2009-08-010
Number of other retired or separated participants entitled to future benefits2009-08-010
Total of all active and inactive participants2009-08-01209
2007: GROUP LIFE AND ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE FOR EMPLOYEES OF WASHINGTON RADIOLOGY ASSOCIATES PC 2007 401k membership
Total participants, beginning-of-year2007-08-01217
Total number of active participants reported on line 7a of the Form 55002007-08-01237
Number of retired or separated participants receiving benefits2007-08-010
Number of other retired or separated participants entitled to future benefits2007-08-010
Total of all active and inactive participants2007-08-01237
2006: GROUP LIFE AND ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE FOR EMPLOYEES OF WASHINGTON RADIOLOGY ASSOCIATES PC 2006 401k membership
Total participants, beginning-of-year2006-08-01220
Total number of active participants reported on line 7a of the Form 55002006-08-01212
Number of retired or separated participants receiving benefits2006-08-010
Number of other retired or separated participants entitled to future benefits2006-08-010
Total of all active and inactive participants2006-08-01212
2003: GROUP LIFE AND ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE FOR EMPLOYEES OF WASHINGTON RADIOLOGY ASSOCIATES PC 2003 401k membership
Total participants, beginning-of-year2003-11-01208
Total number of active participants reported on line 7a of the Form 55002003-11-01200
Number of retired or separated participants receiving benefits2003-11-010
Number of other retired or separated participants entitled to future benefits2003-11-010
Total of all active and inactive participants2003-11-01200
2002: GROUP LIFE AND ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE FOR EMPLOYEES OF WASHINGTON RADIOLOGY ASSOCIATES PC 2002 401k membership
Total participants, beginning-of-year2002-11-01200
Total number of active participants reported on line 7a of the Form 55002002-11-01213
Number of retired or separated participants receiving benefits2002-11-010
Number of other retired or separated participants entitled to future benefits2002-11-010
Total of all active and inactive participants2002-11-01213
2001: GROUP LIFE AND ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE FOR EMPLOYEES OF WASHINGTON RADIOLOGY ASSOCIATES PC 2001 401k membership
Total participants, beginning-of-year2001-11-01199
Total number of active participants reported on line 7a of the Form 55002001-11-01197
Number of retired or separated participants receiving benefits2001-11-010
Number of other retired or separated participants entitled to future benefits2001-11-010
Total of all active and inactive participants2001-11-01197
Total participants, beginning-of-year2001-07-01183
Total number of active participants reported on line 7a of the Form 55002001-07-01196
Number of retired or separated participants receiving benefits2001-07-010
Number of other retired or separated participants entitled to future benefits2001-07-010
Total of all active and inactive participants2001-07-01196
2000: GROUP LIFE AND ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE FOR EMPLOYEES OF WASHINGTON RADIOLOGY ASSOCIATES PC 2000 401k membership
Total participants, beginning-of-year2000-07-01167
Total number of active participants reported on line 7a of the Form 55002000-07-01187
Number of retired or separated participants receiving benefits2000-07-010
Number of other retired or separated participants entitled to future benefits2000-07-010
Total of all active and inactive participants2000-07-01187
1999: GROUP LIFE AND ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE FOR EMPLOYEES OF WASHINGTON RADIOLOGY ASSOCIATES PC 1999 401k membership
Total participants, beginning-of-year1999-07-01128
Total number of active participants reported on line 7a of the Form 55001999-07-01148
Number of retired or separated participants receiving benefits1999-07-010
Number of other retired or separated participants entitled to future benefits1999-07-010
Total of all active and inactive participants1999-07-01148
1998: GROUP LIFE AND ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE FOR EMPLOYEES OF WASHINGTON RADIOLOGY ASSOCIATES PC 1998 401k membership
Total participants, beginning-of-year1998-07-01125
Total number of active participants reported on line 7a of the Form 55001998-07-01131
Number of retired or separated participants receiving benefits1998-07-010
Number of other retired or separated participants entitled to future benefits1998-07-010
Total of all active and inactive participants1998-07-01131
1997: GROUP LIFE AND ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE FOR EMPLOYEES OF WASHINGTON RADIOLOGY ASSOCIATES PC 1997 401k membership
Total participants, beginning-of-year1997-07-01102
Total number of active participants reported on line 7a of the Form 55001997-07-01117
Number of retired or separated participants receiving benefits1997-07-010
Number of other retired or separated participants entitled to future benefits1997-07-010
Total of all active and inactive participants1997-07-01117

Form 5500 Responses for GROUP LIFE AND ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE FOR EMPLOYEES OF WASHINGTON RADIOLOGY ASSOCIATES PC

2015: GROUP LIFE AND ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE FOR EMPLOYEES OF WASHINGTON RADIOLOGY ASSOCIATES PC 2015 form 5500 responses
2015-07-01Type of plan entitySingle employer plan
2015-07-01Submission has been amendedNo
2015-07-01This submission is the final filingYes
2015-07-01This return/report is a short plan year return/report (less than 12 months)No
2015-07-01Plan is a collectively bargained planNo
2015-07-01Plan funding arrangement – InsuranceYes
2015-07-01Plan benefit arrangement – InsuranceYes
2014: GROUP LIFE AND ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE FOR EMPLOYEES OF WASHINGTON RADIOLOGY ASSOCIATES PC 2014 form 5500 responses
2014-07-01Type of plan entitySingle employer plan
2014-07-01Submission has been amendedNo
2014-07-01This submission is the final filingNo
2014-07-01This return/report is a short plan year return/report (less than 12 months)No
2014-07-01Plan is a collectively bargained planNo
2014-07-01Plan funding arrangement – InsuranceYes
2014-07-01Plan benefit arrangement – InsuranceYes
2013: GROUP LIFE AND ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE FOR EMPLOYEES OF WASHINGTON RADIOLOGY ASSOCIATES PC 2013 form 5500 responses
2013-07-01Type of plan entitySingle employer plan
2013-07-01Submission has been amendedNo
2013-07-01This submission is the final filingNo
2013-07-01This return/report is a short plan year return/report (less than 12 months)No
2013-07-01Plan is a collectively bargained planNo
2013-07-01Plan funding arrangement – InsuranceYes
2013-07-01Plan benefit arrangement – InsuranceYes
2012: GROUP LIFE AND ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE FOR EMPLOYEES OF WASHINGTON RADIOLOGY ASSOCIATES PC 2012 form 5500 responses
2012-07-01Type of plan entitySingle employer plan
2012-07-01Submission has been amendedNo
2012-07-01This submission is the final filingNo
2012-07-01This return/report is a short plan year return/report (less than 12 months)No
2012-07-01Plan is a collectively bargained planNo
2012-07-01Plan funding arrangement – InsuranceYes
2012-07-01Plan benefit arrangement – InsuranceYes
2011: GROUP LIFE AND ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE FOR EMPLOYEES OF WASHINGTON RADIOLOGY ASSOCIATES PC 2011 form 5500 responses
2011-07-01Type of plan entitySingle employer plan
2011-07-01Submission has been amendedNo
2011-07-01This submission is the final filingNo
2011-07-01This return/report is a short plan year return/report (less than 12 months)No
2011-07-01Plan is a collectively bargained planNo
2011-07-01Plan funding arrangement – InsuranceYes
2011-07-01Plan benefit arrangement – InsuranceYes
2009: GROUP LIFE AND ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE FOR EMPLOYEES OF WASHINGTON RADIOLOGY ASSOCIATES PC 2009 form 5500 responses
2009-08-01Type of plan entitySingle employer plan
2009-08-01Submission has been amendedNo
2009-08-01This submission is the final filingNo
2009-08-01This return/report is a short plan year return/report (less than 12 months)No
2009-08-01Plan is a collectively bargained planNo
2009-08-01Plan funding arrangement – InsuranceYes
2009-08-01Plan benefit arrangement – InsuranceYes
2007: GROUP LIFE AND ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE FOR EMPLOYEES OF WASHINGTON RADIOLOGY ASSOCIATES PC 2007 form 5500 responses
2007-08-01Type of plan entitySingle employer plan
2007-08-01Submission has been amendedNo
2007-08-01This submission is the final filingNo
2007-08-01This return/report is a short plan year return/report (less than 12 months)No
2007-08-01Plan is a collectively bargained planNo
2007-08-01Plan funding arrangement – InsuranceYes
2007-08-01Plan benefit arrangement – InsuranceYes
2006: GROUP LIFE AND ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE FOR EMPLOYEES OF WASHINGTON RADIOLOGY ASSOCIATES PC 2006 form 5500 responses
2006-08-01Type of plan entitySingle employer plan
2006-08-01Submission has been amendedNo
2006-08-01This submission is the final filingNo
2006-08-01This return/report is a short plan year return/report (less than 12 months)No
2006-08-01Plan is a collectively bargained planNo
2006-08-01Plan funding arrangement – InsuranceYes
2006-08-01Plan benefit arrangement – InsuranceYes
2003: GROUP LIFE AND ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE FOR EMPLOYEES OF WASHINGTON RADIOLOGY ASSOCIATES PC 2003 form 5500 responses
2003-11-01Type of plan entitySingle employer plan
2003-11-01Submission has been amendedNo
2003-11-01This submission is the final filingNo
2003-11-01This return/report is a short plan year return/report (less than 12 months)No
2003-11-01Plan is a collectively bargained planNo
2003-11-01Plan funding arrangement – InsuranceYes
2003-11-01Plan benefit arrangement – InsuranceYes
2002: GROUP LIFE AND ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE FOR EMPLOYEES OF WASHINGTON RADIOLOGY ASSOCIATES PC 2002 form 5500 responses
2002-11-01Type of plan entitySingle employer plan
2002-11-01Submission has been amendedNo
2002-11-01This submission is the final filingNo
2002-11-01This return/report is a short plan year return/report (less than 12 months)No
2002-11-01Plan is a collectively bargained planNo
2002-11-01Plan funding arrangement – InsuranceYes
2002-11-01Plan benefit arrangement – InsuranceYes
2001: GROUP LIFE AND ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE FOR EMPLOYEES OF WASHINGTON RADIOLOGY ASSOCIATES PC 2001 form 5500 responses
2001-11-01Type of plan entitySingle employer plan
2001-11-01Submission has been amendedNo
2001-11-01This submission is the final filingNo
2001-11-01This return/report is a short plan year return/report (less than 12 months)No
2001-11-01Plan is a collectively bargained planNo
2001-11-01Plan funding arrangement – InsuranceYes
2001-11-01Plan benefit arrangement – InsuranceYes
2001-07-01Type of plan entitySingle employer plan
2001-07-01Submission has been amendedNo
2001-07-01This submission is the final filingNo
2001-07-01This return/report is a short plan year return/report (less than 12 months)Yes
2001-07-01Plan is a collectively bargained planNo
2001-07-01Plan funding arrangement – InsuranceYes
2001-07-01Plan benefit arrangement – InsuranceYes
2000: GROUP LIFE AND ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE FOR EMPLOYEES OF WASHINGTON RADIOLOGY ASSOCIATES PC 2000 form 5500 responses
2000-07-01Type of plan entitySingle employer plan
2000-07-01Submission has been amendedYes
2000-07-01This submission is the final filingNo
2000-07-01This return/report is a short plan year return/report (less than 12 months)No
2000-07-01Plan is a collectively bargained planNo
2000-07-01Plan funding arrangement – InsuranceYes
2000-07-01Plan benefit arrangement – InsuranceYes
1999: GROUP LIFE AND ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE FOR EMPLOYEES OF WASHINGTON RADIOLOGY ASSOCIATES PC 1999 form 5500 responses
1999-07-01Type of plan entitySingle employer plan
1999-07-01Submission has been amendedNo
1999-07-01This submission is the final filingNo
1999-07-01This return/report is a short plan year return/report (less than 12 months)No
1999-07-01Plan is a collectively bargained planNo
1999-07-01Plan funding arrangement – InsuranceYes
1999-07-01Plan benefit arrangement – InsuranceYes
1998: GROUP LIFE AND ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE FOR EMPLOYEES OF WASHINGTON RADIOLOGY ASSOCIATES PC 1998 form 5500 responses
1998-07-01Type of plan entitySingle employer plan
1998-07-01Submission has been amendedYes
1998-07-01This submission is the final filingNo
1998-07-01This return/report is a short plan year return/report (less than 12 months)No
1998-07-01Plan is a collectively bargained planNo
1998-07-01Plan funding arrangement – InsuranceYes
1998-07-01Plan benefit arrangement – InsuranceYes
1997: GROUP LIFE AND ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE FOR EMPLOYEES OF WASHINGTON RADIOLOGY ASSOCIATES PC 1997 form 5500 responses
1997-07-01Type of plan entitySingle employer plan
1997-07-01First time form 5500 has been submittedYes
1997-07-01Submission has been amendedNo
1997-07-01This submission is the final filingNo
1997-07-01This return/report is a short plan year return/report (less than 12 months)No
1997-07-01Plan is a collectively bargained planNo
1997-07-01Plan funding arrangement – InsuranceYes
1997-07-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010143108
Policy instance 1
Insurance contract or identification number000010143108
Number of Individuals Covered212
Insurance policy start date2015-07-01
Insurance policy end date2016-06-30
Total amount of commissions paid to insurance brokerUSD $1,802
Total amount of fees paid to insurance companyUSD $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 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 BenefitNo
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 $17,747
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,802
Insurance broker organization code?3
Insurance broker nameWILLIS OF MARYLAND
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010143108
Policy instance 1
Insurance contract or identification number000010143108
Number of Individuals Covered221
Insurance policy start date2014-07-01
Insurance policy end date2015-06-30
Total amount of commissions paid to insurance brokerUSD $1,614
Total amount of fees paid to insurance companyUSD $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 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 BenefitNo
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 $16,791
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,614
Insurance broker organization code?3
Insurance broker nameWILLIS OF MARYLAND
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010143108
Policy instance 1
Insurance contract or identification number000010143108
Number of Individuals Covered219
Insurance policy start date2013-07-01
Insurance policy end date2014-06-30
Total amount of commissions paid to insurance brokerUSD $2,071
Total amount of fees paid to insurance companyUSD $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 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 BenefitNo
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 $19,852
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,071
Insurance broker organization code?3
Insurance broker nameWILLIS OF MARYLAND
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010143108
Policy instance 1
Insurance contract or identification number000010143108
Number of Individuals Covered217
Insurance policy start date2012-07-01
Insurance policy end date2013-06-30
Total amount of commissions paid to insurance brokerUSD $1,835
Total amount of fees paid to insurance companyUSD $172
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 BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
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 $18,220
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,729
Amount paid for insurance broker fees172
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
Insurance broker nameWILLIS OF MARYLAND
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010143108
Policy instance 1
Insurance contract or identification number000010143108
Number of Individuals Covered214
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
Total amount of commissions paid to insurance brokerUSD $1,793
Total amount of fees paid to insurance companyUSD $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 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 BenefitNo
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 $17,611
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 numberFLX961419
Policy instance 1
Insurance contract or identification numberFLX961419
Number of Individuals Covered212
Insurance policy start date2010-08-01
Insurance policy end date2011-06-30
Total amount of commissions paid to insurance brokerUSD $1,051
Total amount of fees paid to insurance companyUSD $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 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 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 $10,509
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 numberFLX961419
Policy instance 1
Insurance contract or identification numberFLX961419
Number of Individuals Covered219
Insurance policy start date2008-08-01
Insurance policy end date2009-07-31
Total amount of commissions paid to insurance brokerUSD $1,212
Total amount of fees paid to insurance companyUSD $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 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 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 $12,119
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,212
Insurance broker organization code?3
Insurance broker nameTERENCE E BURKE
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX961419
Policy instance 1
Insurance contract or identification numberFLX961419
Number of Individuals Covered212
Insurance policy start date2006-08-01
Insurance policy end date2007-07-31
Total amount of commissions paid to insurance brokerUSD $982
Total amount of fees paid to insurance companyUSD $117
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 BenefitYes
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 $9,820
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $982
Amount paid for insurance broker fees117
Additional information about fees paid to insurance brokerOVERRIDE
Insurance broker organization code?3
Insurance broker nameTERENCE E BURKE
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number563299
Policy instance 1
Insurance contract or identification number563299
Number of Individuals Covered208
Insurance policy start date2005-11-01
Insurance policy end date2006-07-31
Total amount of commissions paid to insurance brokerUSD $1,122
Total amount of fees paid to insurance companyUSD $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 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 BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
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 $8,310
Commission paid to Insurance BrokerUSD $1,122
Insurance broker organization code?3
Insurance broker nameTERENCE E BURKE
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number563299
Policy instance 1
Insurance contract or identification number563299
Number of Individuals Covered197
Insurance policy start date2004-11-01
Insurance policy end date2005-10-31
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 BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&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?Yes
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number563299
Policy instance 1
Insurance contract or identification number563299
Number of Individuals Covered208
Insurance policy start date2003-11-01
Insurance policy end date2004-10-31
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 BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&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?Yes
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number563299
Policy instance 1
Insurance contract or identification number563299
Number of Individuals Covered198
Insurance policy start date2002-11-01
Insurance policy end date2003-10-31
Total amount of commissions paid to insurance brokerUSD $1,282
Total amount of fees paid to insurance companyUSD $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 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 BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
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 $10,686
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,282
Insurance broker organization code?3
Insurance broker nameTERENCE BURKE

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