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LONG TERM DISABILITY - PHYSICIANS 401k Plan overview

Plan NameLONG TERM DISABILITY - PHYSICIANS
Plan identification number 507

LONG TERM DISABILITY - PHYSICIANS Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Long-term disability cover

401k Sponsoring company profile

WATSON CLINIC LLP has sponsored the creation of one or more 401k plans.

Company Name:WATSON CLINIC LLP
Employer identification number (EIN):590704934
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan LONG TERM DISABILITY - PHYSICIANS

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5072021-01-01
5072020-01-01
5072019-01-01
5072018-01-01AMY FEJES AMY FEJES2019-05-14
5072017-01-01AMY FEJES
5072016-01-01AMY FEJES AMY FEJES2017-07-24
5072015-01-01AMY FEJES
5072014-01-01LOUIS SACO LOUIS SACO2015-09-14
5072013-01-01LEE ANN BROOKS LEE ANN BROOKS2014-07-08
5072012-01-01LEE ANN BROOKS LEE ANN BROOKS2013-10-15
5072011-01-01LEE ANN BROOKS
5072010-01-01LEE ANN BROOKS
5072009-01-01LEE ANN BROOKS

Plan Statistics for LONG TERM DISABILITY - PHYSICIANS

401k plan membership statisitcs for LONG TERM DISABILITY - PHYSICIANS

Measure Date Value
2021: LONG TERM DISABILITY - PHYSICIANS 2021 401k membership
Total participants, beginning-of-year2021-01-01231
Total number of active participants reported on line 7a of the Form 55002021-01-01222
Number of retired or separated participants receiving benefits2021-01-012
Total of all active and inactive participants2021-01-01224
Total participants2021-01-01224
2020: LONG TERM DISABILITY - PHYSICIANS 2020 401k membership
Total participants, beginning-of-year2020-01-01244
Total number of active participants reported on line 7a of the Form 55002020-01-01230
Number of retired or separated participants receiving benefits2020-01-011
Total of all active and inactive participants2020-01-01231
Total participants2020-01-01231
2019: LONG TERM DISABILITY - PHYSICIANS 2019 401k membership
Total participants, beginning-of-year2019-01-01237
Total number of active participants reported on line 7a of the Form 55002019-01-01243
Number of retired or separated participants receiving benefits2019-01-011
Total of all active and inactive participants2019-01-01244
Total participants2019-01-01244
2018: LONG TERM DISABILITY - PHYSICIANS 2018 401k membership
Total participants, beginning-of-year2018-01-01241
Total number of active participants reported on line 7a of the Form 55002018-01-01236
Number of retired or separated participants receiving benefits2018-01-011
Total of all active and inactive participants2018-01-01237
Total participants2018-01-01237
2017: LONG TERM DISABILITY - PHYSICIANS 2017 401k membership
Total participants, beginning-of-year2017-01-01241
Total number of active participants reported on line 7a of the Form 55002017-01-01237
Number of retired or separated participants receiving benefits2017-01-014
Total of all active and inactive participants2017-01-01241
Total participants2017-01-01241
2016: LONG TERM DISABILITY - PHYSICIANS 2016 401k membership
Total participants, beginning-of-year2016-01-01246
Total number of active participants reported on line 7a of the Form 55002016-01-01237
Number of retired or separated participants receiving benefits2016-01-014
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-01241
Total participants2016-01-01241
2015: LONG TERM DISABILITY - PHYSICIANS 2015 401k membership
Total participants, beginning-of-year2015-01-01253
Total number of active participants reported on line 7a of the Form 55002015-01-01241
Number of retired or separated participants receiving benefits2015-01-015
Total of all active and inactive participants2015-01-01246
Total participants2015-01-01246
2014: LONG TERM DISABILITY - PHYSICIANS 2014 401k membership
Total participants, beginning-of-year2014-01-01253
Total number of active participants reported on line 7a of the Form 55002014-01-01252
Number of retired or separated participants receiving benefits2014-01-011
Total of all active and inactive participants2014-01-01253
Total participants2014-01-01253
2013: LONG TERM DISABILITY - PHYSICIANS 2013 401k membership
Total participants, beginning-of-year2013-01-01244
Total number of active participants reported on line 7a of the Form 55002013-01-01250
Number of retired or separated participants receiving benefits2013-01-013
Total of all active and inactive participants2013-01-01253
Total participants2013-01-01253
2012: LONG TERM DISABILITY - PHYSICIANS 2012 401k membership
Total participants, beginning-of-year2012-01-01240
Total number of active participants reported on line 7a of the Form 55002012-01-01242
Number of other retired or separated participants entitled to future benefits2012-01-012
Total of all active and inactive participants2012-01-01244
Total participants2012-01-01244
2011: LONG TERM DISABILITY - PHYSICIANS 2011 401k membership
Total participants, beginning-of-year2011-01-01237
Total number of active participants reported on line 7a of the Form 55002011-01-01238
Number of other retired or separated participants entitled to future benefits2011-01-012
Total of all active and inactive participants2011-01-01240
Total participants2011-01-01240
2010: LONG TERM DISABILITY - PHYSICIANS 2010 401k membership
Total participants, beginning-of-year2010-01-01236
Total number of active participants reported on line 7a of the Form 55002010-01-01235
Number of other retired or separated participants entitled to future benefits2010-01-012
Total of all active and inactive participants2010-01-01237
Total participants2010-01-01237
2009: LONG TERM DISABILITY - PHYSICIANS 2009 401k membership
Total participants, beginning-of-year2009-01-01231
Total number of active participants reported on line 7a of the Form 55002009-01-01235
Number of other retired or separated participants entitled to future benefits2009-01-011
Total of all active and inactive participants2009-01-01236
Total participants2009-01-01236

Form 5500 Responses for LONG TERM DISABILITY - PHYSICIANS

2021: LONG TERM DISABILITY - PHYSICIANS 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: LONG TERM DISABILITY - PHYSICIANS 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: LONG TERM DISABILITY - PHYSICIANS 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: LONG TERM DISABILITY - PHYSICIANS 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: LONG TERM DISABILITY - PHYSICIANS 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: LONG TERM DISABILITY - PHYSICIANS 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: LONG TERM DISABILITY - PHYSICIANS 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: LONG TERM DISABILITY - PHYSICIANS 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)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: LONG TERM DISABILITY - PHYSICIANS 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: LONG TERM DISABILITY - PHYSICIANS 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: LONG TERM DISABILITY - PHYSICIANS 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
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
2010: LONG TERM DISABILITY - PHYSICIANS 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – InsuranceYes
2009: LONG TERM DISABILITY - PHYSICIANS 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

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10257157
Policy instance 1
Insurance contract or identification number10257157
Number of Individuals Covered224
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $16,846
Total amount of fees paid to insurance companyUSD $6,317
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 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 $210,581
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,369
Amount paid for insurance broker fees1263
Additional information about fees paid to insurance brokerSUPPLEMENTAL SALES AND SERVICE COMPENSATION
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010257157
Policy instance 1
Insurance contract or identification number000010257157
Number of Individuals Covered231
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $18,970
Total amount of fees paid to insurance companyUSD $11,099
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 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 $237,129
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,794
Amount paid for insurance broker fees2220
Additional information about fees paid to insurance brokerSUPPLEMENTAL SALES AND SERVICE COMPENSATION
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract numberLTD902098
Policy instance 1
Insurance contract or identification numberLTD902098
Number of Individuals Covered244
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $18,741
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 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 $234,268
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $18,741
Additional information about fees paid to insurance brokerSUPPLEMENTAL SALES AND SERVICE COMPENSATION
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number768030G
Policy instance 2
Insurance contract or identification number768030G
Number of Individuals Covered0
Insurance policy start date2018-01-01
Insurance policy end date2018-01-31
Total amount of commissions paid to insurance brokerUSD $1,090
Total amount of fees paid to insurance companyUSD $2,107
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 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 $13,625
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees2107
Additional information about fees paid to insurance brokerSUPPLEMENTAL SALES AND SERVICE COMPENSATION
Insurance broker organization code?3
Commission paid to Insurance BrokerUSD $1,090
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract numberLTD902098
Policy instance 1
Insurance contract or identification numberLTD902098
Number of Individuals Covered237
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $17,286
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 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 $216,069
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,917
Additional information about fees paid to insurance brokerSUPPLEMENTAL SALES AND SERVICE COMPENSATION
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number768030G
Policy instance 1
Insurance contract or identification number768030G
Number of Individuals Covered241
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $12,950
Total amount of fees paid to insurance companyUSD $2,003
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 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 $162,062
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,950
Additional information about fees paid to insurance brokerSUPPLEMENTAL SALES AND SERVICE COMPENSATION
Insurance broker organization code?3
Amount paid for insurance broker fees2003
Insurance broker nameUSI INS SERVICES LLC
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number768030G
Policy instance 1
Insurance contract or identification number768030G
Number of Individuals Covered246
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $11,470
Total amount of fees paid to insurance companyUSD $7,823
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 $143,377
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees7823
Additional information about fees paid to insurance brokerSUPPLEMENTAL SALES AND SERVICE COMPENSATION
Insurance broker organization code?3
Insurance broker nameUSI INS SERVICES LLC
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number598434
Policy instance 1
Insurance contract or identification number598434
Number of Individuals Covered253
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $55,755
Total amount of fees paid to insurance companyUSD $5,227
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 $696,943
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $55,755
Amount paid for insurance broker fees5227
Additional information about fees paid to insurance brokerSUPPLEMENTAL SALES AND SERVICE COMPENSATION
Insurance broker organization code?3
Insurance broker nameLANIER UPSHAW INC
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number598434
Policy instance 1
Insurance contract or identification number598434
Number of Individuals Covered253
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $52,387
Total amount of fees paid to insurance companyUSD $4,911
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 $654,836
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $52,387
Amount paid for insurance broker fees4911
Additional information about fees paid to insurance brokerSUPPLEMENTAL SALES AND SERVICE COMPENSATION
Insurance broker organization code?3
Insurance broker nameLANIER UPSHAW INC
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number598434
Policy instance 1
Insurance contract or identification number598434
Number of Individuals Covered244
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $50,701
Total amount of fees paid to insurance companyUSD $4,753
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $633,758
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $50,701
Amount paid for insurance broker fees4753
Additional information about fees paid to insurance brokerSUPPLEMENTAL SALES AND SERVICE COMPENSATION
Insurance broker organization code?3
Insurance broker nameLANIER UPSHAW INC
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number598434
Policy instance 1
Insurance contract or identification number598434
Number of Individuals Covered240
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $50,609
Total amount of fees paid to insurance companyUSD $7,908
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $632,608
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number598434
Policy instance 1
Insurance contract or identification number598434
Number of Individuals Covered237
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $57,255
Total amount of fees paid to insurance companyUSD $8,946
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $715,687
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $57,255
Amount paid for insurance broker fees8946
Additional information about fees paid to insurance brokerSUPPLEMENTAL SALES AND SERVICE COMPENSATION
Insurance broker organization code?3
Insurance broker nameLANIER UPSHAW INC.

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