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GROUP TERM LIFE AND ACCIDENTAL DEATH DISMEMBERMENT AND LOSS OF SIGHT INSURANCE PLAN OF WOMBLE CARLYLE SANDRIDGE & RICE, LLP 401k Plan overview

Plan NameGROUP TERM LIFE AND ACCIDENTAL DEATH DISMEMBERMENT AND LOSS OF SIGHT INSURANCE PLAN OF WOMBLE CARLYLE SANDRIDGE & RICE, LLP
Plan identification number 502

GROUP TERM LIFE AND ACCIDENTAL DEATH DISMEMBERMENT AND LOSS OF SIGHT INSURANCE PLAN OF WOMBLE CARLYLE SANDRIDGE & RICE, LLP Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover

401k Sponsoring company profile

WOMBLE BOND DICKINSON (US) LLP has sponsored the creation of one or more 401k plans.

Company Name:WOMBLE BOND DICKINSON (US) LLP
Employer identification number (EIN):560308470

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GROUP TERM LIFE AND ACCIDENTAL DEATH DISMEMBERMENT AND LOSS OF SIGHT INSURANCE PLAN OF WOMBLE CARLYLE SANDRIDGE & RICE, LLP

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022022-01-01
5022021-01-01
5022020-01-01
5022019-01-01
5022018-01-01TERRY WILEY
5022017-01-01TERRY WILEY
5022016-01-01TERRY WILEY
5022015-01-01TERRY WILEY
5022014-01-01TERRY WILEY
5022014-01-01TERRY WILEY
5022013-01-01TERRY WILEY
5022012-01-01TERRY WILEY
5022011-01-01TERRY WILEY
5022009-01-01TERRY WILEY
5022009-01-01

Plan Statistics for GROUP TERM LIFE AND ACCIDENTAL DEATH DISMEMBERMENT AND LOSS OF SIGHT INSURANCE PLAN OF WOMBLE CARLYLE SANDRIDGE & RICE, LLP

401k plan membership statisitcs for GROUP TERM LIFE AND ACCIDENTAL DEATH DISMEMBERMENT AND LOSS OF SIGHT INSURANCE PLAN OF WOMBLE CARLYLE SANDRIDGE & RICE, LLP

Measure Date Value
2022: GROUP TERM LIFE AND ACCIDENTAL DEATH DISMEMBERMENT AND LOSS OF SIGHT INSURANCE PLAN OF WOMBLE CARLYLE SANDRIDGE & RICE, LLP 2022 401k membership
Total participants, beginning-of-year2022-01-011,296
Total number of active participants reported on line 7a of the Form 55002022-01-011,129
Number of retired or separated participants receiving benefits2022-01-0114
Number of other retired or separated participants entitled to future benefits2022-01-0110
Total of all active and inactive participants2022-01-011,153
2021: GROUP TERM LIFE AND ACCIDENTAL DEATH DISMEMBERMENT AND LOSS OF SIGHT INSURANCE PLAN OF WOMBLE CARLYLE SANDRIDGE & RICE, LLP 2021 401k membership
Total participants, beginning-of-year2021-01-011,124
Total number of active participants reported on line 7a of the Form 55002021-01-011,080
Number of retired or separated participants receiving benefits2021-01-0121
Number of other retired or separated participants entitled to future benefits2021-01-01195
Total of all active and inactive participants2021-01-011,296
2020: GROUP TERM LIFE AND ACCIDENTAL DEATH DISMEMBERMENT AND LOSS OF SIGHT INSURANCE PLAN OF WOMBLE CARLYLE SANDRIDGE & RICE, LLP 2020 401k membership
Total participants, beginning-of-year2020-01-011,241
Total number of active participants reported on line 7a of the Form 55002020-01-011,124
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-011,124
2019: GROUP TERM LIFE AND ACCIDENTAL DEATH DISMEMBERMENT AND LOSS OF SIGHT INSURANCE PLAN OF WOMBLE CARLYLE SANDRIDGE & RICE, LLP 2019 401k membership
Total participants, beginning-of-year2019-01-011,219
Total number of active participants reported on line 7a of the Form 55002019-01-011,241
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-011,241
2018: GROUP TERM LIFE AND ACCIDENTAL DEATH DISMEMBERMENT AND LOSS OF SIGHT INSURANCE PLAN OF WOMBLE CARLYLE SANDRIDGE & RICE, LLP 2018 401k membership
Total participants, beginning-of-year2018-01-011,120
Total number of active participants reported on line 7a of the Form 55002018-01-011,219
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-011,219
2017: GROUP TERM LIFE AND ACCIDENTAL DEATH DISMEMBERMENT AND LOSS OF SIGHT INSURANCE PLAN OF WOMBLE CARLYLE SANDRIDGE & RICE, LLP 2017 401k membership
Total participants, beginning-of-year2017-01-011,100
Total number of active participants reported on line 7a of the Form 55002017-01-011,120
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-011,120
2016: GROUP TERM LIFE AND ACCIDENTAL DEATH DISMEMBERMENT AND LOSS OF SIGHT INSURANCE PLAN OF WOMBLE CARLYLE SANDRIDGE & RICE, LLP 2016 401k membership
Total participants, beginning-of-year2016-01-011,157
Total number of active participants reported on line 7a of the Form 55002016-01-011,100
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-011,100
2015: GROUP TERM LIFE AND ACCIDENTAL DEATH DISMEMBERMENT AND LOSS OF SIGHT INSURANCE PLAN OF WOMBLE CARLYLE SANDRIDGE & RICE, LLP 2015 401k membership
Total participants, beginning-of-year2015-01-011,226
Total number of active participants reported on line 7a of the Form 55002015-01-011,157
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-011,157
2014: GROUP TERM LIFE AND ACCIDENTAL DEATH DISMEMBERMENT AND LOSS OF SIGHT INSURANCE PLAN OF WOMBLE CARLYLE SANDRIDGE & RICE, LLP 2014 401k membership
Total participants, beginning-of-year2014-01-011,233
Total number of active participants reported on line 7a of the Form 55002014-01-011,226
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-011,226
2013: GROUP TERM LIFE AND ACCIDENTAL DEATH DISMEMBERMENT AND LOSS OF SIGHT INSURANCE PLAN OF WOMBLE CARLYLE SANDRIDGE & RICE, LLP 2013 401k membership
Total participants, beginning-of-year2013-01-011,271
Total number of active participants reported on line 7a of the Form 55002013-01-011,260
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-011,260
2012: GROUP TERM LIFE AND ACCIDENTAL DEATH DISMEMBERMENT AND LOSS OF SIGHT INSURANCE PLAN OF WOMBLE CARLYLE SANDRIDGE & RICE, LLP 2012 401k membership
Total participants, beginning-of-year2012-01-011,297
Total number of active participants reported on line 7a of the Form 55002012-01-011,263
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-011,263
2011: GROUP TERM LIFE AND ACCIDENTAL DEATH DISMEMBERMENT AND LOSS OF SIGHT INSURANCE PLAN OF WOMBLE CARLYLE SANDRIDGE & RICE, LLP 2011 401k membership
Total participants, beginning-of-year2011-01-011,239
Total number of active participants reported on line 7a of the Form 55002011-01-011,239
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-010
Total of all active and inactive participants2011-01-011,239
2009: GROUP TERM LIFE AND ACCIDENTAL DEATH DISMEMBERMENT AND LOSS OF SIGHT INSURANCE PLAN OF WOMBLE CARLYLE SANDRIDGE & RICE, LLP 2009 401k membership
Total participants, beginning-of-year2009-01-011,323
Total number of active participants reported on line 7a of the Form 55002009-01-011,292
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-011,292

Form 5500 Responses for GROUP TERM LIFE AND ACCIDENTAL DEATH DISMEMBERMENT AND LOSS OF SIGHT INSURANCE PLAN OF WOMBLE CARLYLE SANDRIDGE & RICE, LLP

2022: GROUP TERM LIFE AND ACCIDENTAL DEATH DISMEMBERMENT AND LOSS OF SIGHT INSURANCE PLAN OF WOMBLE CARLYLE SANDRIDGE & RICE, LLP 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – InsuranceYes
2021: GROUP TERM LIFE AND ACCIDENTAL DEATH DISMEMBERMENT AND LOSS OF SIGHT INSURANCE PLAN OF WOMBLE CARLYLE SANDRIDGE & RICE, LLP 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – InsuranceYes
2020: GROUP TERM LIFE AND ACCIDENTAL DEATH DISMEMBERMENT AND LOSS OF SIGHT INSURANCE PLAN OF WOMBLE CARLYLE SANDRIDGE & RICE, LLP 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – InsuranceYes
2019: GROUP TERM LIFE AND ACCIDENTAL DEATH DISMEMBERMENT AND LOSS OF SIGHT INSURANCE PLAN OF WOMBLE CARLYLE SANDRIDGE & RICE, LLP 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: GROUP TERM LIFE AND ACCIDENTAL DEATH DISMEMBERMENT AND LOSS OF SIGHT INSURANCE PLAN OF WOMBLE CARLYLE SANDRIDGE & RICE, LLP 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: GROUP TERM LIFE AND ACCIDENTAL DEATH DISMEMBERMENT AND LOSS OF SIGHT INSURANCE PLAN OF WOMBLE CARLYLE SANDRIDGE & RICE, LLP 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: GROUP TERM LIFE AND ACCIDENTAL DEATH DISMEMBERMENT AND LOSS OF SIGHT INSURANCE PLAN OF WOMBLE CARLYLE SANDRIDGE & RICE, LLP 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: GROUP TERM LIFE AND ACCIDENTAL DEATH DISMEMBERMENT AND LOSS OF SIGHT INSURANCE PLAN OF WOMBLE CARLYLE SANDRIDGE & RICE, LLP 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: GROUP TERM LIFE AND ACCIDENTAL DEATH DISMEMBERMENT AND LOSS OF SIGHT INSURANCE PLAN OF WOMBLE CARLYLE SANDRIDGE & RICE, LLP 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedYes
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: GROUP TERM LIFE AND ACCIDENTAL DEATH DISMEMBERMENT AND LOSS OF SIGHT INSURANCE PLAN OF WOMBLE CARLYLE SANDRIDGE & RICE, LLP 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: GROUP TERM LIFE AND ACCIDENTAL DEATH DISMEMBERMENT AND LOSS OF SIGHT INSURANCE PLAN OF WOMBLE CARLYLE SANDRIDGE & RICE, LLP 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: GROUP TERM LIFE AND ACCIDENTAL DEATH DISMEMBERMENT AND LOSS OF SIGHT INSURANCE PLAN OF WOMBLE CARLYLE SANDRIDGE & RICE, LLP 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedYes
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2009: GROUP TERM LIFE AND ACCIDENTAL DEATH DISMEMBERMENT AND LOSS OF SIGHT INSURANCE PLAN OF WOMBLE CARLYLE SANDRIDGE & RICE, LLP 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedYes
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number447900
Policy instance 1
Insurance contract or identification number447900
Number of Individuals Covered1129
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $72,185
Total amount of fees paid to insurance companyUSD $45,625
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 AND DISMEMBERMENT, LOSS OF SIGHT
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 $424,619
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $72,185
Amount paid for insurance broker fees45625
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION PAID
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number034765G
Policy instance 1
Insurance contract or identification number034765G
Number of Individuals Covered1090
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $31,679
Total amount of fees paid to insurance companyUSD $19,423
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 AND DISMEMBERMENT, LOSS OF SIGHT
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 $202,384
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $31,679
Amount paid for insurance broker fees19423
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION PAID
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number034765G
Policy instance 1
Insurance contract or identification number034765G
Number of Individuals Covered1582
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $29,922
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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, LOSS OF SIGHT
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 $498,706
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $29,922
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number034765G
Policy instance 1
Insurance contract or identification number034765G
Number of Individuals Covered1494
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $35,869
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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, LOSS OF SIGHT
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 $597,948
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $35,869
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number034765G
Policy instance 1
Insurance contract or identification number034765G
Number of Individuals Covered1477
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $34,500
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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, LOSS OF SIGHT
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 $619,783
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $34,500
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number034765G
Policy instance 1
Insurance contract or identification number034765G
Number of Individuals Covered1625
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $32,370
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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, LOSS OF SIGHT
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 $539,122
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $32,370
Insurance broker organization code?3
Insurance broker nameSUE S. WARDEN
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number034765G
Policy instance 1
Insurance contract or identification number034765G
Number of Individuals Covered1719
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $25,419
Total amount of fees paid to insurance companyUSD $15,080
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, LOSS OF SIGHT
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 $462,454
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $25,419
Amount paid for insurance broker fees15080
Additional information about fees paid to insurance brokerBONUS COMMISIONS
Insurance broker organization code?3
Insurance broker nameD.L. DAVIS & COMPANY, INC.
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number034765G
Policy instance 1
Insurance contract or identification number034765G
Number of Individuals Covered1533
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $27,933
Total amount of fees paid to insurance companyUSD $16,971
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, LOSS OF SIGHT
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 $463,977
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $27,933
Amount paid for insurance broker fees16971
Additional information about fees paid to insurance brokerBONUS COMMISIONS
Insurance broker organization code?3
Insurance broker nameD.L. DAVIS & COMPANY, INC.
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number034765G
Policy instance 1
Insurance contract or identification number034765G
Number of Individuals Covered1853
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $27,459
Total amount of fees paid to insurance companyUSD $13,999
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, LOSS OF SIGHT
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 $454,027
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $27,459
Amount paid for insurance broker fees13999
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameD L DAVIS & COMPANY INC
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number034765G
Policy instance 1
Insurance contract or identification number034765G
Number of Individuals Covered1916
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $24,396
Total amount of fees paid to insurance companyUSD $11,987
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, LOSS OF SIGHT
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 $405,797
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $24,396
Amount paid for insurance broker fees11987
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameD L DAVIS & COMPANY INC
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number034765G
Policy instance 1
Insurance contract or identification number034765G
Number of Individuals Covered1942
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $23,434
Total amount of fees paid to insurance companyUSD $11,356
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, LOSS OF SIGHT
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 $388,092
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number034765G
Policy instance 1
Insurance contract or identification number034765G
Number of Individuals Covered1239
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $23,999
Total amount of fees paid to insurance companyUSD $11,356
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, LOSS OF SIGHT
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 $369,137
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $23,999
Amount paid for insurance broker fees11356
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameD L DAVIS & COMPANY INC

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