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LIFE AND HEALTH INSURANCE PLAN FOR UA GENERAL OFFICERS AND OFFICE EMPLOYEES 401k Plan overview

Plan NameLIFE AND HEALTH INSURANCE PLAN FOR UA GENERAL OFFICERS AND OFFICE EMPLOYEES
Plan identification number 502

LIFE AND HEALTH INSURANCE PLAN FOR UA GENERAL OFFICERS AND OFFICE EMPLOYEES Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)

401k Sponsoring company profile

UA OF JOURNEYMEN & APPRENTICES OF THE PLUMBING & PIPE FITTING INDUSTRY has sponsored the creation of one or more 401k plans.

Company Name:UA OF JOURNEYMEN & APPRENTICES OF THE PLUMBING & PIPE FITTING INDUSTRY
Employer identification number (EIN):530159020
NAIC Classification:813930
NAIC Description:Labor Unions and Similar Labor Organizations

Form 5500 Filing Information

Submission information for form 5500 for 401k plan LIFE AND HEALTH INSURANCE PLAN FOR UA GENERAL OFFICERS AND OFFICE EMPLOYEES

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022022-07-01PATRICK KELLETT2024-01-23 PATRICK KELLETT2024-01-23
5022021-07-01PATRICK KELLETT2022-12-21 PATRICK KELLETT2022-12-21
5022020-07-01PATRICK KELLETT2022-12-21 PATRICK KELLETT2022-12-21
5022019-07-01PATRICK KELLETT2022-12-21 PATRICK KELLETT2022-12-21
5022018-07-01PATRICK KELLET2021-12-21 PATRICK KELLET2022-12-21
5022017-07-01PATRICK KELLETT2022-12-21 PATRICK KELLETT2022-12-21
5022016-07-01PATRICK KELLETT2022-12-21 PATRICK KELLETT2022-12-21
5022015-07-01PATRICK KELLETT2022-12-21 PATRICK KELLETT2022-12-21
5022014-07-01PATRICK KELLETT2022-12-21 PATRICK KELLETT2022-12-21
5022013-07-01PATRICK KELLETT2022-12-21 PATRICK KELLETT2022-12-21
5022012-07-01PATRICK KELLETT2022-12-21 PATRICK KELLETT2022-12-21
5022011-07-01PATRICK KELLETT2022-12-21 PATRICK KELLETT2022-12-21
5022010-07-01PATRICK KELLETT2022-12-21 PATRICK KELLETT2022-12-21
5022009-07-01WILLIAM HITE

Plan Statistics for LIFE AND HEALTH INSURANCE PLAN FOR UA GENERAL OFFICERS AND OFFICE EMPLOYEES

401k plan membership statisitcs for LIFE AND HEALTH INSURANCE PLAN FOR UA GENERAL OFFICERS AND OFFICE EMPLOYEES

Measure Date Value
2022: LIFE AND HEALTH INSURANCE PLAN FOR UA GENERAL OFFICERS AND OFFICE EMPLOYEES 2022 401k membership
Total participants, beginning-of-year2022-07-01286
Total number of active participants reported on line 7a of the Form 55002022-07-01123
Number of retired or separated participants receiving benefits2022-07-01174
Total of all active and inactive participants2022-07-01297
2021: LIFE AND HEALTH INSURANCE PLAN FOR UA GENERAL OFFICERS AND OFFICE EMPLOYEES 2021 401k membership
Total participants, beginning-of-year2021-07-01290
Total number of active participants reported on line 7a of the Form 55002021-07-01125
Number of retired or separated participants receiving benefits2021-07-01161
Total of all active and inactive participants2021-07-01286
2020: LIFE AND HEALTH INSURANCE PLAN FOR UA GENERAL OFFICERS AND OFFICE EMPLOYEES 2020 401k membership
Total participants, beginning-of-year2020-07-01288
Total number of active participants reported on line 7a of the Form 55002020-07-01128
Number of retired or separated participants receiving benefits2020-07-01162
Total of all active and inactive participants2020-07-01290
2019: LIFE AND HEALTH INSURANCE PLAN FOR UA GENERAL OFFICERS AND OFFICE EMPLOYEES 2019 401k membership
Total participants, beginning-of-year2019-07-01290
Total number of active participants reported on line 7a of the Form 55002019-07-01127
Number of retired or separated participants receiving benefits2019-07-01161
Total of all active and inactive participants2019-07-01288
Total participants2019-07-01288
2018: LIFE AND HEALTH INSURANCE PLAN FOR UA GENERAL OFFICERS AND OFFICE EMPLOYEES 2018 401k membership
Total participants, beginning-of-year2018-07-01299
Total number of active participants reported on line 7a of the Form 55002018-07-01126
Number of retired or separated participants receiving benefits2018-07-01164
Total of all active and inactive participants2018-07-01290
Total participants2018-07-01290
2017: LIFE AND HEALTH INSURANCE PLAN FOR UA GENERAL OFFICERS AND OFFICE EMPLOYEES 2017 401k membership
Total participants, beginning-of-year2017-07-01280
Total number of active participants reported on line 7a of the Form 55002017-07-01134
Number of retired or separated participants receiving benefits2017-07-01165
Total of all active and inactive participants2017-07-01299
2016: LIFE AND HEALTH INSURANCE PLAN FOR UA GENERAL OFFICERS AND OFFICE EMPLOYEES 2016 401k membership
Total participants, beginning-of-year2016-07-01288
Total number of active participants reported on line 7a of the Form 55002016-07-01124
Number of retired or separated participants receiving benefits2016-07-01156
Total of all active and inactive participants2016-07-01280
2015: LIFE AND HEALTH INSURANCE PLAN FOR UA GENERAL OFFICERS AND OFFICE EMPLOYEES 2015 401k membership
Total participants, beginning-of-year2015-07-01287
Total number of active participants reported on line 7a of the Form 55002015-07-01137
Number of retired or separated participants receiving benefits2015-07-01151
Number of other retired or separated participants entitled to future benefits2015-07-010
Total of all active and inactive participants2015-07-01288
2014: LIFE AND HEALTH INSURANCE PLAN FOR UA GENERAL OFFICERS AND OFFICE EMPLOYEES 2014 401k membership
Total participants, beginning-of-year2014-07-01281
Total number of active participants reported on line 7a of the Form 55002014-07-01135
Number of retired or separated participants receiving benefits2014-07-01152
Number of other retired or separated participants entitled to future benefits2014-07-010
Total of all active and inactive participants2014-07-01287
2013: LIFE AND HEALTH INSURANCE PLAN FOR UA GENERAL OFFICERS AND OFFICE EMPLOYEES 2013 401k membership
Total participants, beginning-of-year2013-07-01281
Total number of active participants reported on line 7a of the Form 55002013-07-01125
Number of retired or separated participants receiving benefits2013-07-01156
Total of all active and inactive participants2013-07-01281
2012: LIFE AND HEALTH INSURANCE PLAN FOR UA GENERAL OFFICERS AND OFFICE EMPLOYEES 2012 401k membership
Total participants, beginning-of-year2012-07-01271
Total number of active participants reported on line 7a of the Form 55002012-07-01126
Number of retired or separated participants receiving benefits2012-07-01155
Total of all active and inactive participants2012-07-01281
2011: LIFE AND HEALTH INSURANCE PLAN FOR UA GENERAL OFFICERS AND OFFICE EMPLOYEES 2011 401k membership
Total participants, beginning-of-year2011-07-01270
Total number of active participants reported on line 7a of the Form 55002011-07-01116
Number of retired or separated participants receiving benefits2011-07-01155
Total of all active and inactive participants2011-07-01271
2010: LIFE AND HEALTH INSURANCE PLAN FOR UA GENERAL OFFICERS AND OFFICE EMPLOYEES 2010 401k membership
Total participants, beginning-of-year2010-07-01267
Total number of active participants reported on line 7a of the Form 55002010-07-01126
Number of retired or separated participants receiving benefits2010-07-01144
Total of all active and inactive participants2010-07-01270
2009: LIFE AND HEALTH INSURANCE PLAN FOR UA GENERAL OFFICERS AND OFFICE EMPLOYEES 2009 401k membership
Total participants, beginning-of-year2009-07-01272
Total number of active participants reported on line 7a of the Form 55002009-07-01134
Number of retired or separated participants receiving benefits2009-07-01133
Total of all active and inactive participants2009-07-01267

Form 5500 Responses for LIFE AND HEALTH INSURANCE PLAN FOR UA GENERAL OFFICERS AND OFFICE EMPLOYEES

2022: LIFE AND HEALTH INSURANCE PLAN FOR UA GENERAL OFFICERS AND OFFICE EMPLOYEES 2022 form 5500 responses
2022-07-01Type of plan entityMulitple employer plan
2022-07-01Plan is a collectively bargained planYes
2022-07-01Plan funding arrangement – InsuranceYes
2022-07-01Plan funding arrangement – General assets of the sponsorYes
2022-07-01Plan benefit arrangement – InsuranceYes
2021: LIFE AND HEALTH INSURANCE PLAN FOR UA GENERAL OFFICERS AND OFFICE EMPLOYEES 2021 form 5500 responses
2021-07-01Type of plan entityMulitple employer plan
2021-07-01Plan is a collectively bargained planYes
2021-07-01Plan funding arrangement – InsuranceYes
2021-07-01Plan funding arrangement – General assets of the sponsorYes
2021-07-01Plan benefit arrangement – InsuranceYes
2020: LIFE AND HEALTH INSURANCE PLAN FOR UA GENERAL OFFICERS AND OFFICE EMPLOYEES 2020 form 5500 responses
2020-07-01Type of plan entityMulitple employer plan
2020-07-01Plan is a collectively bargained planYes
2020-07-01Plan funding arrangement – InsuranceYes
2020-07-01Plan funding arrangement – General assets of the sponsorYes
2020-07-01Plan benefit arrangement – InsuranceYes
2019: LIFE AND HEALTH INSURANCE PLAN FOR UA GENERAL OFFICERS AND OFFICE EMPLOYEES 2019 form 5500 responses
2019-07-01Type of plan entityMulitple employer plan
2019-07-01Submission has been amendedNo
2019-07-01This submission is the final filingNo
2019-07-01This return/report is a short plan year return/report (less than 12 months)No
2019-07-01Plan is a collectively bargained planYes
2019-07-01Plan funding arrangement – InsuranceYes
2019-07-01Plan funding arrangement – General assets of the sponsorYes
2019-07-01Plan benefit arrangement – InsuranceYes
2018: LIFE AND HEALTH INSURANCE PLAN FOR UA GENERAL OFFICERS AND OFFICE EMPLOYEES 2018 form 5500 responses
2018-07-01Type of plan entityMulitple employer plan
2018-07-01Submission has been amendedNo
2018-07-01This submission is the final filingNo
2018-07-01This return/report is a short plan year return/report (less than 12 months)No
2018-07-01Plan is a collectively bargained planYes
2018-07-01Plan funding arrangement – InsuranceYes
2018-07-01Plan funding arrangement – General assets of the sponsorYes
2018-07-01Plan benefit arrangement – InsuranceYes
2017: LIFE AND HEALTH INSURANCE PLAN FOR UA GENERAL OFFICERS AND OFFICE EMPLOYEES 2017 form 5500 responses
2017-07-01Type of plan entityMulitple employer plan
2017-07-01Plan is a collectively bargained planYes
2017-07-01Plan funding arrangement – InsuranceYes
2017-07-01Plan funding arrangement – General assets of the sponsorYes
2017-07-01Plan benefit arrangement – InsuranceYes
2016: LIFE AND HEALTH INSURANCE PLAN FOR UA GENERAL OFFICERS AND OFFICE EMPLOYEES 2016 form 5500 responses
2016-07-01Type of plan entityMulitple employer plan
2016-07-01Plan is a collectively bargained planYes
2016-07-01Plan funding arrangement – InsuranceYes
2016-07-01Plan funding arrangement – General assets of the sponsorYes
2016-07-01Plan benefit arrangement – InsuranceYes
2015: LIFE AND HEALTH INSURANCE PLAN FOR UA GENERAL OFFICERS AND OFFICE EMPLOYEES 2015 form 5500 responses
2015-07-01Type of plan entityMulitple employer plan
2015-07-01Plan is a collectively bargained planYes
2015-07-01Plan funding arrangement – InsuranceYes
2015-07-01Plan funding arrangement – General assets of the sponsorYes
2015-07-01Plan benefit arrangement – InsuranceYes
2014: LIFE AND HEALTH INSURANCE PLAN FOR UA GENERAL OFFICERS AND OFFICE EMPLOYEES 2014 form 5500 responses
2014-07-01Type of plan entityMulitple employer plan
2014-07-01Plan is a collectively bargained planYes
2014-07-01Plan funding arrangement – InsuranceYes
2014-07-01Plan funding arrangement – General assets of the sponsorYes
2014-07-01Plan benefit arrangement – InsuranceYes
2013: LIFE AND HEALTH INSURANCE PLAN FOR UA GENERAL OFFICERS AND OFFICE EMPLOYEES 2013 form 5500 responses
2013-07-01Type of plan entityMulitple employer plan
2013-07-01Plan is a collectively bargained planYes
2013-07-01Plan funding arrangement – InsuranceYes
2013-07-01Plan funding arrangement – General assets of the sponsorYes
2013-07-01Plan benefit arrangement – InsuranceYes
2012: LIFE AND HEALTH INSURANCE PLAN FOR UA GENERAL OFFICERS AND OFFICE EMPLOYEES 2012 form 5500 responses
2012-07-01Type of plan entityMulitple employer plan
2012-07-01Plan is a collectively bargained planYes
2012-07-01Plan funding arrangement – InsuranceYes
2012-07-01Plan funding arrangement – General assets of the sponsorYes
2012-07-01Plan benefit arrangement – InsuranceYes
2011: LIFE AND HEALTH INSURANCE PLAN FOR UA GENERAL OFFICERS AND OFFICE EMPLOYEES 2011 form 5500 responses
2011-07-01Type of plan entityMulitple employer plan
2011-07-01Plan is a collectively bargained planYes
2011-07-01Plan funding arrangement – InsuranceYes
2011-07-01Plan funding arrangement – General assets of the sponsorYes
2011-07-01Plan benefit arrangement – InsuranceYes
2010: LIFE AND HEALTH INSURANCE PLAN FOR UA GENERAL OFFICERS AND OFFICE EMPLOYEES 2010 form 5500 responses
2010-07-01Type of plan entityMulitple employer plan
2010-07-01Plan is a collectively bargained planYes
2010-07-01Plan funding arrangement – InsuranceYes
2010-07-01Plan funding arrangement – General assets of the sponsorYes
2010-07-01Plan benefit arrangement – InsuranceYes
2009: LIFE AND HEALTH INSURANCE PLAN FOR UA GENERAL OFFICERS AND OFFICE EMPLOYEES 2009 form 5500 responses
2009-07-01Type of plan entitySingle employer plan
2009-07-01This submission is the final filingNo
2009-07-01Plan funding arrangement – InsuranceYes
2009-07-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 )
Policy contract numberG2766, C3549
Policy instance 3
Insurance contract or identification numberG2766, C3549
Number of Individuals Covered70
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $19,600
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 )
Policy contract numberG0432, C0450
Policy instance 2
Insurance contract or identification numberG0432, C0450
Number of Individuals Covered104
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $167,517
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3220904
Policy instance 1
Insurance contract or identification number3220904
Number of Individuals Covered297
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $968,328
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 )
Policy contract numberG2766, C3549
Policy instance 3
Insurance contract or identification numberG2766, C3549
Number of Individuals Covered70
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $20,442
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 )
Policy contract numberG0432, C0450
Policy instance 2
Insurance contract or identification numberG0432, C0450
Number of Individuals Covered110
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $172,625
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3220904
Policy instance 1
Insurance contract or identification number3220904
Number of Individuals Covered286
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,002,313
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3220904
Policy instance 1
Insurance contract or identification number3220904
Number of Individuals Covered290
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $936,109
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 )
Policy contract numberG0432, C0450
Policy instance 2
Insurance contract or identification numberG0432, C0450
Number of Individuals Covered107
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $174,832
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 )
Policy contract numberG2766, C3549
Policy instance 3
Insurance contract or identification numberG2766, C3549
Number of Individuals Covered75
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $20,739
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 )
Policy contract numberG0432, C0450
Policy instance 2
Insurance contract or identification numberG0432, C0450
Number of Individuals Covered108
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $187,596
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3220904
Policy instance 3
Insurance contract or identification number3220904
Number of Individuals Covered288
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $933,486
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 )
Policy contract numberG2766/C3549
Policy instance 1
Insurance contract or identification numberG2766/C3549
Number of Individuals Covered73
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $21,825
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3220904
Policy instance 1
Insurance contract or identification number3220904
Number of Individuals Covered290
Insurance policy start date2018-03-01
Insurance policy end date2018-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $458,865
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 )
Policy contract numberG2766/C3549
Policy instance 2
Insurance contract or identification numberG2766/C3549
Number of Individuals Covered73
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $22,850
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 )
Policy contract numberG0432, C0450
Policy instance 3
Insurance contract or identification numberG0432, C0450
Number of Individuals Covered105
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $185,270
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 )
Policy contract numberG2766, C3549
Policy instance 3
Insurance contract or identification numberG2766, C3549
Number of Individuals Covered82
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $23,950
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 )
Policy contract numberG0432, C0450
Policy instance 2
Insurance contract or identification numberG0432, C0450
Number of Individuals Covered104
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $179,898
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3220904
Policy instance 1
Insurance contract or identification number3220904
Number of Individuals Covered299
Insurance policy start date2017-03-01
Insurance policy end date2018-02-28
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $572,450
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 )
Policy contract numberG2766, C3549
Policy instance 3
Insurance contract or identification numberG2766, C3549
Number of Individuals Covered77
Insurance policy start date2016-01-01
Insurance policy end date2016-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $22,925
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 )
Policy contract numberG0432, C0450
Policy instance 2
Insurance contract or identification numberG0432, C0450
Number of Individuals Covered94
Insurance policy start date2016-01-01
Insurance policy end date2016-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $164,048
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3220904
Policy instance 1
Insurance contract or identification number3220904
Number of Individuals Covered280
Insurance policy start date2016-03-01
Insurance policy end date2017-02-28
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $618,928
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 )
Policy contract numberG0432, C0450
Policy instance 2
Insurance contract or identification numberG0432, C0450
Number of Individuals Covered97
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $168,857
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 )
Policy contract numberG2766, C3549
Policy instance 3
Insurance contract or identification numberG2766, C3549
Number of Individuals Covered77
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $22,950
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 )
Policy contract number3220904
Policy instance 1
Insurance contract or identification number3220904
Number of Individuals Covered288
Insurance policy start date2015-03-01
Insurance policy end date2016-02-29
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $608,873
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 )
Policy contract numberG2766, C3549
Policy instance 3
Insurance contract or identification numberG2766, C3549
Number of Individuals Covered75
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $21,200
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 )
Policy contract numberG0432, C0450
Policy instance 2
Insurance contract or identification numberG0432, C0450
Number of Individuals Covered99
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $172,388
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 )
Policy contract number3220904
Policy instance 1
Insurance contract or identification number3220904
Number of Individuals Covered287
Insurance policy start date2014-03-01
Insurance policy end date2015-02-28
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $761,090
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 )
Policy contract numberG0432, C0450
Policy instance 2
Insurance contract or identification numberG0432, C0450
Number of Individuals Covered102
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $175,658
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 )
Policy contract number3220904
Policy instance 1
Insurance contract or identification number3220904
Number of Individuals Covered281
Insurance policy start date2013-03-01
Insurance policy end date2014-02-28
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $832,054
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 )
Policy contract numberG2766, C3549
Policy instance 3
Insurance contract or identification numberG2766, C3549
Number of Individuals Covered67
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $20,750
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 )
Policy contract numberG2766, C3549
Policy instance 3
Insurance contract or identification numberG2766, C3549
Number of Individuals Covered71
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $20,675
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 )
Policy contract numberG0432, C0450
Policy instance 2
Insurance contract or identification numberG0432, C0450
Number of Individuals Covered104
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $172,360
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 )
Policy contract number3220904
Policy instance 1
Insurance contract or identification number3220904
Number of Individuals Covered281
Insurance policy start date2012-03-01
Insurance policy end date2013-02-28
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $766,659
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 )
Policy contract number3220904
Policy instance 1
Insurance contract or identification number3220904
Number of Individuals Covered271
Insurance policy start date2011-03-01
Insurance policy end date2012-02-29
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $634,987
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 )
Policy contract numberG0432, C0450
Policy instance 2
Insurance contract or identification numberG0432, C0450
Number of Individuals Covered103
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $162,720
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 )
Policy contract numberG2766, C3549
Policy instance 3
Insurance contract or identification numberG2766, C3549
Number of Individuals Covered68
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $20,275
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 )
Policy contract numberG2766, C3549
Policy instance 3
Insurance contract or identification numberG2766, C3549
Number of Individuals Covered68
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $19,998
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 )
Policy contract number3220904
Policy instance 1
Insurance contract or identification number3220904
Number of Individuals Covered270
Insurance policy start date2010-03-01
Insurance policy end date2011-02-28
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $562,824
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE UNION LABOR LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 52414 )
Policy contract numberG0432, C0450
Policy instance 2
Insurance contract or identification numberG0432, C0450
Number of Individuals Covered100
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $155,851
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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