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LIFE INSURANCE COMPANY OF NORTH AMERICA 401k Plan overview

Plan NameLIFE INSURANCE COMPANY OF NORTH AMERICA
Plan identification number 503

LIFE INSURANCE COMPANY OF NORTH AMERICA Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Temporary disability (accident and sickness)
  • Long-term disability cover

401k Sponsoring company profile

INTERIM HEALTHCARE OF GREENVILLE, INC has sponsored the creation of one or more 401k plans.

Company Name:INTERIM HEALTHCARE OF GREENVILLE, INC
Employer identification number (EIN):570678887
NAIC Classification:621610
NAIC Description:Home Health Care Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan LIFE INSURANCE COMPANY OF NORTH AMERICA

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5032014-01-01CRYSTAL ADAMS
5032014-01-01CRYSTAL ADAMS
5032013-01-01CRYSTAL ADAMS
5032012-01-01CRYSTAL ADAMS
5032011-01-01CRYSTAL ADAMS
5032009-01-01ELIZABETH GOULD

Plan Statistics for LIFE INSURANCE COMPANY OF NORTH AMERICA

401k plan membership statisitcs for LIFE INSURANCE COMPANY OF NORTH AMERICA

Measure Date Value
2014: LIFE INSURANCE COMPANY OF NORTH AMERICA 2014 401k membership
Total participants, beginning-of-year2014-01-01181
Total number of active participants reported on line 7a of the Form 55002014-01-01172
Total of all active and inactive participants2014-01-01172
Total participants2014-01-01172
2013: LIFE INSURANCE COMPANY OF NORTH AMERICA 2013 401k membership
Total participants, beginning-of-year2013-01-01109
Total number of active participants reported on line 7a of the Form 55002013-01-01115
Total of all active and inactive participants2013-01-01115
Total participants2013-01-01115
2012: LIFE INSURANCE COMPANY OF NORTH AMERICA 2012 401k membership
Total participants, beginning-of-year2012-01-01182
Total number of active participants reported on line 7a of the Form 55002012-01-01285
Total of all active and inactive participants2012-01-01285
Total participants2012-01-01285
2011: LIFE INSURANCE COMPANY OF NORTH AMERICA 2011 401k membership
Total participants, beginning-of-year2011-01-01218
Total number of active participants reported on line 7a of the Form 55002011-01-01182
Total of all active and inactive participants2011-01-01182
Total participants2011-01-01182
2009: LIFE INSURANCE COMPANY OF NORTH AMERICA 2009 401k membership
Total participants, beginning-of-year2009-01-01186
Total number of active participants reported on line 7a of the Form 55002009-01-01215
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 participants2009-01-01215
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-01215
Number of participants with account balances2009-01-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-010

Form 5500 Responses for LIFE INSURANCE COMPANY OF NORTH AMERICA

2014: LIFE INSURANCE COMPANY OF NORTH AMERICA 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)Yes
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: LIFE INSURANCE COMPANY OF NORTH AMERICA 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01First time form 5500 has been submittedYes
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: LIFE INSURANCE COMPANY OF NORTH AMERICA 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01First time form 5500 has been submittedYes
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: LIFE INSURANCE COMPANY OF NORTH AMERICA 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01First time form 5500 has been submittedYes
2011-01-01Submission has been amendedNo
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: LIFE INSURANCE COMPANY OF NORTH AMERICA 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
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

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberVDT961097
Policy instance 1
Insurance contract or identification numberVDT961097
Number of Individuals Covered109
Insurance policy start date2014-01-01
Insurance policy end date2014-01-31
Total amount of commissions paid to insurance brokerUSD $170
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 BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
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 $8,476
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $170
Insurance broker nameARTHUR H HAYES
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberVDT961096
Policy instance 1
Insurance contract or identification numberVDT961096
Number of Individuals Covered172
Insurance policy start date2014-01-01
Insurance policy end date2014-01-31
Total amount of commissions paid to insurance brokerUSD $259
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 BenefitNo
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $12,962
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberVDT961097
Policy instance 1
Insurance contract or identification numberVDT961097
Number of Individuals Covered115
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $1,053
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 BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,052
Insurance broker nameCORPORATE BENEFITS, INC
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberVDT961096
Policy instance 1
Insurance contract or identification numberVDT961096
Number of Individuals Covered181
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $1,599
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 BenefitNo
Temporary Disability Insurance Welfare BenefitYes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberVDT961096
Policy instance 1
Insurance contract or identification numberVDT961096
Number of Individuals Covered175
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $1,401
Total amount of fees paid to insurance companyUSD $1,259
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $70,697
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14
Amount paid for insurance broker fees1259
Additional information about fees paid to insurance brokerOVERRIDE
Insurance broker nameARTHUR HAYS
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberOK 966158
Policy instance 4
Insurance contract or identification numberOK 966158
Number of Individuals Covered84
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $61
Total amount of fees paid to insurance companyUSD $73
Other welfare benefits providedACCIDENTAL DEATH
Welfare Benefit Premiums Paid to CarrierUSD $3,082
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1
Amount paid for insurance broker fees73
Additional information about fees paid to insurance brokerOVERRIDE
Insurance broker nameARTHUR HAYS
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX964571
Policy instance 2
Insurance contract or identification numberFLX964571
Number of Individuals Covered285
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $1,646
Total amount of fees paid to insurance companyUSD $1,261
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $81,622
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerOVERRIDE
Insurance broker nameARTHUR HAYS
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberVDT961097
Policy instance 3
Insurance contract or identification numberVDT961097
Number of Individuals Covered118
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $990
Total amount of fees paid to insurance companyUSD $1,164
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $49,504
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10
Amount paid for insurance broker fees1164
Additional information about fees paid to insurance brokerOVERRIDE
Insurance broker nameARTHUR HAYS
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number5410544
Policy instance 1
Insurance contract or identification number5410544
Number of Individuals Covered182
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $16,709
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $111,391
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number5410544
Policy instance 1
Insurance contract or identification number5410544
Number of Individuals Covered218
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $16,597
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $110,646
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,597
Insurance broker organization code?3
Insurance broker nameARTHUR H. HAYS

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