CHANDLER CONCRETE CO., INC. has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan GROUP LIFE, ACCIDENTAL DEATH & DISMEMBERMENT, & LIFE INSURANCE ON DEPENDENTS FOR EMPLOYEES OF CHANDLER CONCRETE CO., INC.
401k plan membership statisitcs for GROUP LIFE, ACCIDENTAL DEATH & DISMEMBERMENT, & LIFE INSURANCE ON DEPENDENTS FOR EMPLOYEES OF CHANDLER CONCRETE CO., INC.
| Measure | Date | Value |
|---|
| 2022: GROUP LIFE, ACCIDENTAL DEATH & DISMEMBERMENT, & LIFE INSURANCE ON DEPENDENTS FOR EMPLOYEES OF CHANDLER CONCRETE CO., INC. 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-01-01 | 455 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 469 |
| Number of retired or separated participants receiving benefits | 2022-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2022-01-01 | 0 |
| Total of all active and inactive participants | 2022-01-01 | 469 |
| 2021: GROUP LIFE, ACCIDENTAL DEATH & DISMEMBERMENT, & LIFE INSURANCE ON DEPENDENTS FOR EMPLOYEES OF CHANDLER CONCRETE CO., INC. 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-01-01 | 404 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 410 |
| Number of retired or separated participants receiving benefits | 2021-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2021-01-01 | 0 |
| Total of all active and inactive participants | 2021-01-01 | 410 |
| 2020: GROUP LIFE, ACCIDENTAL DEATH & DISMEMBERMENT, & LIFE INSURANCE ON DEPENDENTS FOR EMPLOYEES OF CHANDLER CONCRETE CO., INC. 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-01-01 | 412 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 404 |
| Number of retired or separated participants receiving benefits | 2020-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2020-01-01 | 0 |
| Total of all active and inactive participants | 2020-01-01 | 404 |
| 2019: GROUP LIFE, ACCIDENTAL DEATH & DISMEMBERMENT, & LIFE INSURANCE ON DEPENDENTS FOR EMPLOYEES OF CHANDLER CONCRETE CO., INC. 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-01-01 | 408 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 412 |
| Number of retired or separated participants receiving benefits | 2019-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2019-01-01 | 0 |
| Total of all active and inactive participants | 2019-01-01 | 412 |
| 2018: GROUP LIFE, ACCIDENTAL DEATH & DISMEMBERMENT, & LIFE INSURANCE ON DEPENDENTS FOR EMPLOYEES OF CHANDLER CONCRETE CO., INC. 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-01-01 | 396 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 408 |
| Number of retired or separated participants receiving benefits | 2018-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2018-01-01 | 0 |
| Total of all active and inactive participants | 2018-01-01 | 408 |
| 2017: GROUP LIFE, ACCIDENTAL DEATH & DISMEMBERMENT, & LIFE INSURANCE ON DEPENDENTS FOR EMPLOYEES OF CHANDLER CONCRETE CO., INC. 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-01-01 | 398 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 396 |
| Number of retired or separated participants receiving benefits | 2017-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2017-01-01 | 0 |
| Total of all active and inactive participants | 2017-01-01 | 396 |
| 2016: GROUP LIFE, ACCIDENTAL DEATH & DISMEMBERMENT, & LIFE INSURANCE ON DEPENDENTS FOR EMPLOYEES OF CHANDLER CONCRETE CO., INC. 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-01-01 | 394 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 398 |
| Number of retired or separated participants receiving benefits | 2016-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2016-01-01 | 0 |
| Total of all active and inactive participants | 2016-01-01 | 398 |
| 2015: GROUP LIFE, ACCIDENTAL DEATH & DISMEMBERMENT, & LIFE INSURANCE ON DEPENDENTS FOR EMPLOYEES OF CHANDLER CONCRETE CO., INC. 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-01-01 | 378 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 394 |
| Number of retired or separated participants receiving benefits | 2015-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2015-01-01 | 0 |
| Total of all active and inactive participants | 2015-01-01 | 394 |
| 2014: GROUP LIFE, ACCIDENTAL DEATH & DISMEMBERMENT, & LIFE INSURANCE ON DEPENDENTS FOR EMPLOYEES OF CHANDLER CONCRETE CO., INC. 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-01-01 | 356 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 378 |
| Number of retired or separated participants receiving benefits | 2014-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2014-01-01 | 0 |
| Total of all active and inactive participants | 2014-01-01 | 378 |
| 2013: GROUP LIFE, ACCIDENTAL DEATH & DISMEMBERMENT, & LIFE INSURANCE ON DEPENDENTS FOR EMPLOYEES OF CHANDLER CONCRETE CO., INC. 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-01-01 | 362 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 356 |
| Total of all active and inactive participants | 2013-01-01 | 356 |
| 2012: GROUP LIFE, ACCIDENTAL DEATH & DISMEMBERMENT, & LIFE INSURANCE ON DEPENDENTS FOR EMPLOYEES OF CHANDLER CONCRETE CO., INC. 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-01-01 | 400 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 362 |
| Total of all active and inactive participants | 2012-01-01 | 362 |
| 2011: GROUP LIFE, ACCIDENTAL DEATH & DISMEMBERMENT, & LIFE INSURANCE ON DEPENDENTS FOR EMPLOYEES OF CHANDLER CONCRETE CO., INC. 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-01-01 | 430 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 400 |
| Total of all active and inactive participants | 2011-01-01 | 400 |
| 2010: GROUP LIFE, ACCIDENTAL DEATH & DISMEMBERMENT, & LIFE INSURANCE ON DEPENDENTS FOR EMPLOYEES OF CHANDLER CONCRETE CO., INC. 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-01-01 | 467 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-01-01 | 430 |
| Total of all active and inactive participants | 2010-01-01 | 430 |
| 2009: GROUP LIFE, ACCIDENTAL DEATH & DISMEMBERMENT, & LIFE INSURANCE ON DEPENDENTS FOR EMPLOYEES OF CHANDLER CONCRETE CO., INC. 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-01-01 | 497 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 467 |
| Total of all active and inactive participants | 2009-01-01 | 467 |
| 2022: GROUP LIFE, ACCIDENTAL DEATH & DISMEMBERMENT, & LIFE INSURANCE ON DEPENDENTS FOR EMPLOYEES OF CHANDLER CONCRETE CO., INC. 2022 form 5500 responses |
|---|
| 2022-01-01 | Type of plan entity | Single employer plan |
| 2022-01-01 | Plan funding arrangement – Insurance | Yes |
| 2022-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2021: GROUP LIFE, ACCIDENTAL DEATH & DISMEMBERMENT, & LIFE INSURANCE ON DEPENDENTS FOR EMPLOYEES OF CHANDLER CONCRETE CO., INC. 2021 form 5500 responses |
|---|
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | Plan funding arrangement – Insurance | Yes |
| 2021-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2020: GROUP LIFE, ACCIDENTAL DEATH & DISMEMBERMENT, & LIFE INSURANCE ON DEPENDENTS FOR EMPLOYEES OF CHANDLER CONCRETE CO., INC. 2020 form 5500 responses |
|---|
| 2020-01-01 | Type of plan entity | Single employer plan |
| 2020-01-01 | Plan funding arrangement – Insurance | Yes |
| 2020-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2019: GROUP LIFE, ACCIDENTAL DEATH & DISMEMBERMENT, & LIFE INSURANCE ON DEPENDENTS FOR EMPLOYEES OF CHANDLER CONCRETE CO., INC. 2019 form 5500 responses |
|---|
| 2019-01-01 | Type of plan entity | Single employer plan |
| 2019-01-01 | Plan funding arrangement – Insurance | Yes |
| 2019-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: GROUP LIFE, ACCIDENTAL DEATH & DISMEMBERMENT, & LIFE INSURANCE ON DEPENDENTS FOR EMPLOYEES OF CHANDLER CONCRETE CO., INC. 2018 form 5500 responses |
|---|
| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | Plan funding arrangement – Insurance | Yes |
| 2018-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: GROUP LIFE, ACCIDENTAL DEATH & DISMEMBERMENT, & LIFE INSURANCE ON DEPENDENTS FOR EMPLOYEES OF CHANDLER CONCRETE CO., INC. 2017 form 5500 responses |
|---|
| 2017-01-01 | Type of plan entity | Single employer plan |
| 2017-01-01 | Plan funding arrangement – Insurance | Yes |
| 2017-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: GROUP LIFE, ACCIDENTAL DEATH & DISMEMBERMENT, & LIFE INSURANCE ON DEPENDENTS FOR EMPLOYEES OF CHANDLER CONCRETE CO., INC. 2016 form 5500 responses |
|---|
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | Plan funding arrangement – Insurance | Yes |
| 2016-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: GROUP LIFE, ACCIDENTAL DEATH & DISMEMBERMENT, & LIFE INSURANCE ON DEPENDENTS FOR EMPLOYEES OF CHANDLER CONCRETE CO., INC. 2015 form 5500 responses |
|---|
| 2015-01-01 | Type of plan entity | Single employer plan |
| 2015-01-01 | Plan funding arrangement – Insurance | Yes |
| 2015-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: GROUP LIFE, ACCIDENTAL DEATH & DISMEMBERMENT, & LIFE INSURANCE ON DEPENDENTS FOR EMPLOYEES OF CHANDLER CONCRETE CO., INC. 2014 form 5500 responses |
|---|
| 2014-01-01 | Type of plan entity | Single employer plan |
| 2014-01-01 | Plan funding arrangement – Insurance | Yes |
| 2014-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: GROUP LIFE, ACCIDENTAL DEATH & DISMEMBERMENT, & LIFE INSURANCE ON DEPENDENTS FOR EMPLOYEES OF CHANDLER CONCRETE CO., INC. 2013 form 5500 responses |
|---|
| 2013-01-01 | Type of plan entity | Single employer plan |
| 2013-01-01 | Plan funding arrangement – Insurance | Yes |
| 2013-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: GROUP LIFE, ACCIDENTAL DEATH & DISMEMBERMENT, & LIFE INSURANCE ON DEPENDENTS FOR EMPLOYEES OF CHANDLER CONCRETE CO., INC. 2012 form 5500 responses |
|---|
| 2012-01-01 | Type of plan entity | Single employer plan |
| 2012-01-01 | Plan funding arrangement – Insurance | Yes |
| 2012-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: GROUP LIFE, ACCIDENTAL DEATH & DISMEMBERMENT, & LIFE INSURANCE ON DEPENDENTS FOR EMPLOYEES OF CHANDLER CONCRETE CO., INC. 2011 form 5500 responses |
|---|
| 2011-01-01 | Type of plan entity | Single employer plan |
| 2011-01-01 | Plan funding arrangement – Insurance | Yes |
| 2011-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2010: GROUP LIFE, ACCIDENTAL DEATH & DISMEMBERMENT, & LIFE INSURANCE ON DEPENDENTS FOR EMPLOYEES OF CHANDLER CONCRETE CO., INC. 2010 form 5500 responses |
|---|
| 2010-01-01 | Type of plan entity | Single employer plan |
| 2010-01-01 | Plan funding arrangement – Insurance | Yes |
| 2010-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: GROUP LIFE, ACCIDENTAL DEATH & DISMEMBERMENT, & LIFE INSURANCE ON DEPENDENTS FOR EMPLOYEES OF CHANDLER CONCRETE CO., INC. 2009 form 5500 responses |
|---|
| 2009-01-01 | Type of plan entity | Single employer plan |
| 2009-01-01 | This submission is the final filing | No |
| 2009-01-01 | Plan funding arrangement – Insurance | Yes |
| 2009-01-01 | Plan benefit arrangement – Insurance | Yes |
| AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) |
| Policy contract number | 50435 |
| Policy instance | 2 |
| Insurance contract or identification number | 50435 | | Number of Individuals Covered | 123 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $15,193 | | Other welfare benefits provided | CRITICAL ILLNESS | | Welfare Benefit Premiums Paid to Carrier | USD $58,208 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $7,616 | | Insurance broker organization code? | 3 |
|
| MONY (National Association of Insurance Commissioners NAIC id number: 78077 ) |
| Policy contract number | 008216 |
| Policy instance | 1 |
| Insurance contract or identification number | 008216 | | Number of Individuals Covered | 469 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $42,275 | | Total amount of fees paid to insurance company | USD $9,991 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $338,804 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $42,275 | | Amount paid for insurance broker fees | 9991 | | Additional information about fees paid to insurance broker | BONUS | | Insurance broker organization code? | 3 |
|
| AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) |
| Policy contract number | 50435 |
| Policy instance | 2 |
| Insurance contract or identification number | 50435 | | Number of Individuals Covered | 92 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $21,690 | | Other welfare benefits provided | CRITICAL ILLNESS | | Welfare Benefit Premiums Paid to Carrier | USD $47,719 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $10,858 | | Insurance broker organization code? | 3 |
|
| MONY (National Association of Insurance Commissioners NAIC id number: 78077 ) |
| Policy contract number | 008216 |
| Policy instance | 1 |
| Insurance contract or identification number | 008216 | | Number of Individuals Covered | 410 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $19,400 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $167,064 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $19,400 | | Insurance broker organization code? | 3 |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00474355 |
| Policy instance | 1 |
| Insurance contract or identification number | 00474355 | | Number of Individuals Covered | 404 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $25,048 | | Total amount of fees paid to insurance company | USD $6,194 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISABILITY | | Welfare Benefit Premiums Paid to Carrier | USD $168,926 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $14,836 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 6194 |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00474355 |
| Policy instance | 1 |
| Insurance contract or identification number | 00474355 | | Number of Individuals Covered | 412 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $19,690 | | Total amount of fees paid to insurance company | USD $6,579 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISABILITY | | Welfare Benefit Premiums Paid to Carrier | USD $136,648 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $19,690 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 6579 |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00474355 |
| Policy instance | 1 |
| Insurance contract or identification number | 00474355 | | Number of Individuals Covered | 396 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $19,619 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISABILITY | | Welfare Benefit Premiums Paid to Carrier | USD $129,493 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $14,311 | | Insurance broker name | HUB INTERNATIONAL SOUTHEAST |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00474355 |
| Policy instance | 1 |
| Insurance contract or identification number | 00474355 | | Number of Individuals Covered | 394 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $18,104 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISABILITY | | Welfare Benefit Premiums Paid to Carrier | USD $122,426 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $18,104 | | Insurance broker name | HUB INTERNATIONAL SOUTHEAST |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00474355 |
| Policy instance | 1 |
| Insurance contract or identification number | 00474355 | | Number of Individuals Covered | 378 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $16,658 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISABILITY | | Welfare Benefit Premiums Paid to Carrier | USD $114,140 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $13,885 | | Insurance broker name | HUB INTERNATIONAL MIDWEST LIMITED |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 000MU616 |
| Policy instance | 1 |
| Insurance contract or identification number | 000MU616 | | Number of Individuals Covered | 356 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $16,150 | | Total amount of fees paid to insurance company | USD $4,560 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISABILITY | | Welfare Benefit Premiums Paid to Carrier | USD $111,112 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $16,150 | | Amount paid for insurance broker fees | 4560 | | Insurance broker name | HUB INTERNATIONAL MIDWEST LIMITED |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00474355 |
| Policy instance | 1 |
| Insurance contract or identification number | 00474355 | | Number of Individuals Covered | 362 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $14,863 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISABILITY | | Welfare Benefit Premiums Paid to Carrier | USD $106,654 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $14,863 | | Insurance broker name | HUB INTERNATIONAL MIDWEST LIMITED |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 095630 |
| Policy instance | 2 |
| Insurance contract or identification number | 095630 | | Number of Individuals Covered | 88 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $10,047 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $44,923 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 095631 |
| Policy instance | 1 |
| Insurance contract or identification number | 095631 | | Number of Individuals Covered | 400 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $9,626 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISABILITY | | Welfare Benefit Premiums Paid to Carrier | USD $82,855 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 095631 |
| Policy instance | 1 |
| Insurance contract or identification number | 095631 | | Number of Individuals Covered | 430 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $7,316 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISABILITY | | Welfare Benefit Premiums Paid to Carrier | USD $69,401 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $7,316 | | Insurance broker name | KNAUFF INSURANCE AGENCY |
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