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GROUP LIFE & HEALTH INSURANCE PLAN FOR EMPLOYEES FOR ATLAS METAL INDUSTRIES, INC. 401k Plan overview

Plan NameGROUP LIFE & HEALTH INSURANCE PLAN FOR EMPLOYEES FOR ATLAS METAL INDUSTRIES, INC.
Plan identification number 501

GROUP LIFE & HEALTH INSURANCE PLAN FOR EMPLOYEES FOR ATLAS METAL INDUSTRIES, INC. Benefits

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

401k Sponsoring company profile

ATLAS METAL INDUSTRIES, INC. has sponsored the creation of one or more 401k plans.

Company Name:ATLAS METAL INDUSTRIES, INC.
Employer identification number (EIN):590746315
NAIC Classification:332900

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GROUP LIFE & HEALTH INSURANCE PLAN FOR EMPLOYEES FOR ATLAS METAL INDUSTRIES, INC.

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012021-09-01
5012020-09-01
5012019-09-01
5012018-09-01
5012017-09-01MARIA ITURRIOZ MARIA ITURRIOZ2019-03-04
5012016-09-01MARIA ITURRIOZ MARIA ITURRIOZ2018-06-19
5012015-09-01MARIA ITURRIOZ MARIA ITURRIOZ2017-03-08
5012014-09-01MARIA ITURRIOZ MARIA ITURRIOZ2016-03-14
5012013-09-01MARIA ITURRIOZ MARIA ITURRIOZ2015-03-15
5012012-09-01MARIA ITURRIOZ MARIA ITURRIOZ2014-03-25
5012011-09-01MARIA ITURRIOZ MARIA ITURRIOZ2013-03-25
5012010-09-01MARIA ITURRIOZ
5012009-09-01MARIA ITURRIOZ

Plan Statistics for GROUP LIFE & HEALTH INSURANCE PLAN FOR EMPLOYEES FOR ATLAS METAL INDUSTRIES, INC.

401k plan membership statisitcs for GROUP LIFE & HEALTH INSURANCE PLAN FOR EMPLOYEES FOR ATLAS METAL INDUSTRIES, INC.

Measure Date Value
2021: GROUP LIFE & HEALTH INSURANCE PLAN FOR EMPLOYEES FOR ATLAS METAL INDUSTRIES, INC. 2021 401k membership
Total participants, beginning-of-year2021-09-0155
Total number of active participants reported on line 7a of the Form 55002021-09-0155
Total of all active and inactive participants2021-09-0155
Total participants2021-09-0155
2020: GROUP LIFE & HEALTH INSURANCE PLAN FOR EMPLOYEES FOR ATLAS METAL INDUSTRIES, INC. 2020 401k membership
Total participants, beginning-of-year2020-09-0164
Total number of active participants reported on line 7a of the Form 55002020-09-0155
Total of all active and inactive participants2020-09-0155
Total participants2020-09-0155
2019: GROUP LIFE & HEALTH INSURANCE PLAN FOR EMPLOYEES FOR ATLAS METAL INDUSTRIES, INC. 2019 401k membership
Total participants, beginning-of-year2019-09-0167
Total number of active participants reported on line 7a of the Form 55002019-09-0164
Total of all active and inactive participants2019-09-0164
Total participants2019-09-0164
2018: GROUP LIFE & HEALTH INSURANCE PLAN FOR EMPLOYEES FOR ATLAS METAL INDUSTRIES, INC. 2018 401k membership
Total participants, beginning-of-year2018-09-0169
Total number of active participants reported on line 7a of the Form 55002018-09-0167
Total of all active and inactive participants2018-09-0167
Total participants2018-09-0167
2017: GROUP LIFE & HEALTH INSURANCE PLAN FOR EMPLOYEES FOR ATLAS METAL INDUSTRIES, INC. 2017 401k membership
Total participants, beginning-of-year2017-09-0172
Total number of active participants reported on line 7a of the Form 55002017-09-0169
Total of all active and inactive participants2017-09-0169
Total participants2017-09-0169
2016: GROUP LIFE & HEALTH INSURANCE PLAN FOR EMPLOYEES FOR ATLAS METAL INDUSTRIES, INC. 2016 401k membership
Total participants, beginning-of-year2016-09-0172
Total number of active participants reported on line 7a of the Form 55002016-09-0172
Total of all active and inactive participants2016-09-0172
Total participants2016-09-0172
2015: GROUP LIFE & HEALTH INSURANCE PLAN FOR EMPLOYEES FOR ATLAS METAL INDUSTRIES, INC. 2015 401k membership
Total participants, beginning-of-year2015-09-0172
Total number of active participants reported on line 7a of the Form 55002015-09-0172
Total of all active and inactive participants2015-09-0172
Total participants2015-09-0172
2014: GROUP LIFE & HEALTH INSURANCE PLAN FOR EMPLOYEES FOR ATLAS METAL INDUSTRIES, INC. 2014 401k membership
Total participants, beginning-of-year2014-09-0176
Total number of active participants reported on line 7a of the Form 55002014-09-0172
Total of all active and inactive participants2014-09-0172
Total participants2014-09-0172
2013: GROUP LIFE & HEALTH INSURANCE PLAN FOR EMPLOYEES FOR ATLAS METAL INDUSTRIES, INC. 2013 401k membership
Total participants, beginning-of-year2013-09-0175
Total number of active participants reported on line 7a of the Form 55002013-09-0176
Total of all active and inactive participants2013-09-0176
Total participants2013-09-0176
2012: GROUP LIFE & HEALTH INSURANCE PLAN FOR EMPLOYEES FOR ATLAS METAL INDUSTRIES, INC. 2012 401k membership
Total participants, beginning-of-year2012-09-0176
Total number of active participants reported on line 7a of the Form 55002012-09-0175
Number of retired or separated participants receiving benefits2012-09-010
Number of other retired or separated participants entitled to future benefits2012-09-010
Total of all active and inactive participants2012-09-0175
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-09-010
Total participants2012-09-0175
Number of participants with account balances2012-09-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-09-010
Number of employers contributing to the scheme2012-09-010
2011: GROUP LIFE & HEALTH INSURANCE PLAN FOR EMPLOYEES FOR ATLAS METAL INDUSTRIES, INC. 2011 401k membership
Total participants, beginning-of-year2011-09-0183
Total number of active participants reported on line 7a of the Form 55002011-09-0176
Number of retired or separated participants receiving benefits2011-09-010
Number of other retired or separated participants entitled to future benefits2011-09-010
Total of all active and inactive participants2011-09-0176
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-09-010
Total participants2011-09-0176
Number of participants with account balances2011-09-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-09-010
2010: GROUP LIFE & HEALTH INSURANCE PLAN FOR EMPLOYEES FOR ATLAS METAL INDUSTRIES, INC. 2010 401k membership
Total participants, beginning-of-year2010-09-0183
Total number of active participants reported on line 7a of the Form 55002010-09-0183
Number of retired or separated participants receiving benefits2010-09-010
Number of other retired or separated participants entitled to future benefits2010-09-010
Total of all active and inactive participants2010-09-0183
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-09-010
Total participants2010-09-0183
Number of participants with account balances2010-09-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-09-010
2009: GROUP LIFE & HEALTH INSURANCE PLAN FOR EMPLOYEES FOR ATLAS METAL INDUSTRIES, INC. 2009 401k membership
Total participants, beginning-of-year2009-09-0183
Total number of active participants reported on line 7a of the Form 55002009-09-0183
Number of retired or separated participants receiving benefits2009-09-010
Number of other retired or separated participants entitled to future benefits2009-09-010
Total of all active and inactive participants2009-09-0183
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-09-010
Total participants2009-09-0183
Number of participants with account balances2009-09-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-09-010

Financial Data on GROUP LIFE & HEALTH INSURANCE PLAN FOR EMPLOYEES FOR ATLAS METAL INDUSTRIES, INC.

Measure Date Value
2022 : GROUP LIFE & HEALTH INSURANCE PLAN FOR EMPLOYEES FOR ATLAS METAL INDUSTRIES, INC. 2022 401k financial data
Total plan liabilities at end of year2022-08-31$0
Total plan liabilities at beginning of year2022-08-31$0
Total income from all sources2022-08-31$873,626
Expenses. Total of all expenses incurred2022-08-31$873,626
Benefits paid (including direct rollovers)2022-08-31$873,626
Total plan assets at end of year2022-08-31$0
Total plan assets at beginning of year2022-08-31$0
Total contributions received or receivable from participants2022-08-31$125,265
Net income (gross income less expenses)2022-08-31$0
Net plan assets at end of year (total assets less liabilities)2022-08-31$0
Net plan assets at beginning of year (total assets less liabilities)2022-08-31$0
Total contributions received or receivable from employer(s)2022-08-31$748,361
2021 : GROUP LIFE & HEALTH INSURANCE PLAN FOR EMPLOYEES FOR ATLAS METAL INDUSTRIES, INC. 2021 401k financial data
Total plan liabilities at end of year2021-08-31$0
Total plan liabilities at beginning of year2021-08-31$0
Total income from all sources2021-08-31$944,853
Expenses. Total of all expenses incurred2021-08-31$944,853
Benefits paid (including direct rollovers)2021-08-31$944,853
Total plan assets at end of year2021-08-31$0
Total plan assets at beginning of year2021-08-31$0
Total contributions received or receivable from participants2021-08-31$137,037
Net income (gross income less expenses)2021-08-31$0
Net plan assets at end of year (total assets less liabilities)2021-08-31$0
Net plan assets at beginning of year (total assets less liabilities)2021-08-31$0
Total contributions received or receivable from employer(s)2021-08-31$807,816
2020 : GROUP LIFE & HEALTH INSURANCE PLAN FOR EMPLOYEES FOR ATLAS METAL INDUSTRIES, INC. 2020 401k financial data
Total plan liabilities at end of year2020-08-31$0
Total plan liabilities at beginning of year2020-08-31$0
Total income from all sources2020-08-31$1,070,797
Expenses. Total of all expenses incurred2020-08-31$1,070,797
Benefits paid (including direct rollovers)2020-08-31$1,070,797
Total plan assets at end of year2020-08-31$0
Total plan assets at beginning of year2020-08-31$0
Total contributions received or receivable from participants2020-08-31$157,721
Net income (gross income less expenses)2020-08-31$0
Net plan assets at end of year (total assets less liabilities)2020-08-31$0
Net plan assets at beginning of year (total assets less liabilities)2020-08-31$0
Total contributions received or receivable from employer(s)2020-08-31$913,076
2019 : GROUP LIFE & HEALTH INSURANCE PLAN FOR EMPLOYEES FOR ATLAS METAL INDUSTRIES, INC. 2019 401k financial data
Total income from all sources2019-08-31$1,063,320
Expenses. Total of all expenses incurred2019-08-31$1,063,320
Benefits paid (including direct rollovers)2019-08-31$1,063,320
Total contributions received or receivable from participants2019-08-31$146,222
Net income (gross income less expenses)2019-08-31$0
Net plan assets at end of year (total assets less liabilities)2019-08-31$0
Net plan assets at beginning of year (total assets less liabilities)2019-08-31$0
Total contributions received or receivable from employer(s)2019-08-31$917,098
2018 : GROUP LIFE & HEALTH INSURANCE PLAN FOR EMPLOYEES FOR ATLAS METAL INDUSTRIES, INC. 2018 401k financial data
Total income from all sources2018-08-31$1,102,603
Expenses. Total of all expenses incurred2018-08-31$1,102,603
Benefits paid (including direct rollovers)2018-08-31$1,102,603
Total contributions received or receivable from participants2018-08-31$155,880
Net income (gross income less expenses)2018-08-31$0
Net plan assets at end of year (total assets less liabilities)2018-08-31$0
Net plan assets at beginning of year (total assets less liabilities)2018-08-31$0
Total contributions received or receivable from employer(s)2018-08-31$946,723
2017 : GROUP LIFE & HEALTH INSURANCE PLAN FOR EMPLOYEES FOR ATLAS METAL INDUSTRIES, INC. 2017 401k financial data
Total income from all sources2017-08-31$974,806
Expenses. Total of all expenses incurred2017-08-31$974,806
Benefits paid (including direct rollovers)2017-08-31$974,806
Total contributions received or receivable from participants2017-08-31$139,934
Net income (gross income less expenses)2017-08-31$0
Total contributions received or receivable from employer(s)2017-08-31$834,872
2016 : GROUP LIFE & HEALTH INSURANCE PLAN FOR EMPLOYEES FOR ATLAS METAL INDUSTRIES, INC. 2016 401k financial data
Total income from all sources2016-08-31$989,931
Expenses. Total of all expenses incurred2016-08-31$989,931
Benefits paid (including direct rollovers)2016-08-31$989,931
Total contributions received or receivable from participants2016-08-31$166,823
Net income (gross income less expenses)2016-08-31$0
Total contributions received or receivable from employer(s)2016-08-31$823,108
2015 : GROUP LIFE & HEALTH INSURANCE PLAN FOR EMPLOYEES FOR ATLAS METAL INDUSTRIES, INC. 2015 401k financial data
Total income from all sources2015-08-31$932,520
Expenses. Total of all expenses incurred2015-08-31$932,520
Benefits paid (including direct rollovers)2015-08-31$932,520
Total contributions received or receivable from participants2015-08-31$144,141
Net income (gross income less expenses)2015-08-31$0
Total contributions received or receivable from employer(s)2015-08-31$788,379
2014 : GROUP LIFE & HEALTH INSURANCE PLAN FOR EMPLOYEES FOR ATLAS METAL INDUSTRIES, INC. 2014 401k financial data
Total income from all sources2014-08-31$815,521
Expenses. Total of all expenses incurred2014-08-31$815,521
Benefits paid (including direct rollovers)2014-08-31$815,521
Total contributions received or receivable from participants2014-08-31$127,462
Net income (gross income less expenses)2014-08-31$0
Total contributions received or receivable from employer(s)2014-08-31$688,059
2013 : GROUP LIFE & HEALTH INSURANCE PLAN FOR EMPLOYEES FOR ATLAS METAL INDUSTRIES, INC. 2013 401k financial data
Total income from all sources2013-08-31$761,096
Expenses. Total of all expenses incurred2013-08-31$761,096
Benefits paid (including direct rollovers)2013-08-31$761,096
Total contributions received or receivable from participants2013-08-31$122,211
Net income (gross income less expenses)2013-08-31$0
Total contributions received or receivable from employer(s)2013-08-31$638,885
2012 : GROUP LIFE & HEALTH INSURANCE PLAN FOR EMPLOYEES FOR ATLAS METAL INDUSTRIES, INC. 2012 401k financial data
Total income from all sources2012-08-31$729,153
Total contributions received or receivable from participants2012-08-31$118,258
Net income (gross income less expenses)2012-08-31$729,153
Total contributions received or receivable from employer(s)2012-08-31$610,895
2011 : GROUP LIFE & HEALTH INSURANCE PLAN FOR EMPLOYEES FOR ATLAS METAL INDUSTRIES, INC. 2011 401k financial data
Total income from all sources2011-08-31$756,032
Total contributions received or receivable from participants2011-08-31$124,804
Net income (gross income less expenses)2011-08-31$756,032
Total contributions received or receivable from employer(s)2011-08-31$631,228

Form 5500 Responses for GROUP LIFE & HEALTH INSURANCE PLAN FOR EMPLOYEES FOR ATLAS METAL INDUSTRIES, INC.

2021: GROUP LIFE & HEALTH INSURANCE PLAN FOR EMPLOYEES FOR ATLAS METAL INDUSTRIES, INC. 2021 form 5500 responses
2021-09-01Type of plan entitySingle employer plan
2021-09-01Submission has been amendedNo
2021-09-01This submission is the final filingNo
2021-09-01This return/report is a short plan year return/report (less than 12 months)No
2021-09-01Plan is a collectively bargained planNo
2021-09-01Plan funding arrangement – InsuranceYes
2021-09-01Plan benefit arrangement – InsuranceYes
2020: GROUP LIFE & HEALTH INSURANCE PLAN FOR EMPLOYEES FOR ATLAS METAL INDUSTRIES, INC. 2020 form 5500 responses
2020-09-01Type of plan entitySingle employer plan
2020-09-01Submission has been amendedNo
2020-09-01This submission is the final filingNo
2020-09-01This return/report is a short plan year return/report (less than 12 months)No
2020-09-01Plan is a collectively bargained planNo
2020-09-01Plan funding arrangement – InsuranceYes
2020-09-01Plan benefit arrangement – InsuranceYes
2019: GROUP LIFE & HEALTH INSURANCE PLAN FOR EMPLOYEES FOR ATLAS METAL INDUSTRIES, INC. 2019 form 5500 responses
2019-09-01Type of plan entitySingle employer plan
2019-09-01Submission has been amendedNo
2019-09-01This submission is the final filingNo
2019-09-01This return/report is a short plan year return/report (less than 12 months)No
2019-09-01Plan is a collectively bargained planNo
2019-09-01Plan funding arrangement – InsuranceYes
2019-09-01Plan benefit arrangement – InsuranceYes
2018: GROUP LIFE & HEALTH INSURANCE PLAN FOR EMPLOYEES FOR ATLAS METAL INDUSTRIES, INC. 2018 form 5500 responses
2018-09-01Type of plan entitySingle employer plan
2018-09-01Submission has been amendedNo
2018-09-01This submission is the final filingNo
2018-09-01This return/report is a short plan year return/report (less than 12 months)No
2018-09-01Plan is a collectively bargained planNo
2018-09-01Plan funding arrangement – InsuranceYes
2018-09-01Plan benefit arrangement – InsuranceYes
2017: GROUP LIFE & HEALTH INSURANCE PLAN FOR EMPLOYEES FOR ATLAS METAL INDUSTRIES, INC. 2017 form 5500 responses
2017-09-01Type of plan entitySingle employer plan
2017-09-01Submission has been amendedNo
2017-09-01This submission is the final filingNo
2017-09-01This return/report is a short plan year return/report (less than 12 months)No
2017-09-01Plan is a collectively bargained planNo
2017-09-01Plan funding arrangement – InsuranceYes
2017-09-01Plan benefit arrangement – InsuranceYes
2016: GROUP LIFE & HEALTH INSURANCE PLAN FOR EMPLOYEES FOR ATLAS METAL INDUSTRIES, INC. 2016 form 5500 responses
2016-09-01Type of plan entitySingle employer plan
2016-09-01Submission has been amendedNo
2016-09-01This submission is the final filingNo
2016-09-01This return/report is a short plan year return/report (less than 12 months)No
2016-09-01Plan is a collectively bargained planNo
2016-09-01Plan funding arrangement – InsuranceYes
2016-09-01Plan benefit arrangement – InsuranceYes
2015: GROUP LIFE & HEALTH INSURANCE PLAN FOR EMPLOYEES FOR ATLAS METAL INDUSTRIES, INC. 2015 form 5500 responses
2015-09-01Type of plan entitySingle employer plan
2015-09-01Submission has been amendedNo
2015-09-01This submission is the final filingNo
2015-09-01This return/report is a short plan year return/report (less than 12 months)No
2015-09-01Plan is a collectively bargained planNo
2015-09-01Plan funding arrangement – InsuranceYes
2015-09-01Plan benefit arrangement – InsuranceYes
2014: GROUP LIFE & HEALTH INSURANCE PLAN FOR EMPLOYEES FOR ATLAS METAL INDUSTRIES, INC. 2014 form 5500 responses
2014-09-01Type of plan entitySingle employer plan
2014-09-01Submission has been amendedNo
2014-09-01This submission is the final filingNo
2014-09-01This return/report is a short plan year return/report (less than 12 months)No
2014-09-01Plan is a collectively bargained planNo
2014-09-01Plan funding arrangement – InsuranceYes
2014-09-01Plan benefit arrangement – InsuranceYes
2013: GROUP LIFE & HEALTH INSURANCE PLAN FOR EMPLOYEES FOR ATLAS METAL INDUSTRIES, INC. 2013 form 5500 responses
2013-09-01Type of plan entitySingle employer plan
2013-09-01Submission has been amendedNo
2013-09-01This submission is the final filingNo
2013-09-01This return/report is a short plan year return/report (less than 12 months)No
2013-09-01Plan is a collectively bargained planNo
2013-09-01Plan funding arrangement – InsuranceYes
2013-09-01Plan benefit arrangement – InsuranceYes
2012: GROUP LIFE & HEALTH INSURANCE PLAN FOR EMPLOYEES FOR ATLAS METAL INDUSTRIES, INC. 2012 form 5500 responses
2012-09-01Type of plan entitySingle employer plan
2012-09-01Submission has been amendedNo
2012-09-01This submission is the final filingNo
2012-09-01This return/report is a short plan year return/report (less than 12 months)No
2012-09-01Plan is a collectively bargained planNo
2012-09-01Plan funding arrangement – InsuranceYes
2012-09-01Plan benefit arrangement – InsuranceYes
2011: GROUP LIFE & HEALTH INSURANCE PLAN FOR EMPLOYEES FOR ATLAS METAL INDUSTRIES, INC. 2011 form 5500 responses
2011-09-01Type of plan entitySingle employer plan
2011-09-01Submission has been amendedNo
2011-09-01This submission is the final filingNo
2011-09-01This return/report is a short plan year return/report (less than 12 months)No
2011-09-01Plan is a collectively bargained planNo
2011-09-01Plan funding arrangement – InsuranceYes
2011-09-01Plan benefit arrangement – InsuranceYes
2010: GROUP LIFE & HEALTH INSURANCE PLAN FOR EMPLOYEES FOR ATLAS METAL INDUSTRIES, INC. 2010 form 5500 responses
2010-09-01Type of plan entitySingle employer plan
2010-09-01Submission has been amendedNo
2010-09-01This submission is the final filingNo
2010-09-01This return/report is a short plan year return/report (less than 12 months)No
2010-09-01Plan is a collectively bargained planNo
2010-09-01Plan funding arrangement – InsuranceYes
2010-09-01Plan benefit arrangement – InsuranceYes
2009: GROUP LIFE & HEALTH INSURANCE PLAN FOR EMPLOYEES FOR ATLAS METAL INDUSTRIES, INC. 2009 form 5500 responses
2009-09-01Type of plan entitySingle employer plan
2009-09-01Submission has been amendedNo
2009-09-01This submission is the final filingNo
2009-09-01This return/report is a short plan year return/report (less than 12 months)No
2009-09-01Plan is a collectively bargained planNo
2009-09-01Plan funding arrangement – InsuranceYes
2009-09-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number0742715
Policy instance 2
Insurance contract or identification number0742715
Number of Individuals Covered55
Insurance policy start date2021-09-01
Insurance policy end date2022-08-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $849,001
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00942587
Policy instance 1
Insurance contract or identification number00942587
Number of Individuals Covered240
Insurance policy start date2021-09-01
Insurance policy end date2022-08-31
Total amount of commissions paid to insurance brokerUSD $0
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 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 $49,005
Commission paid to Insurance BrokerUSD $2,351
Amount paid for insurance broker fees548
LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 )
Policy contract numberGD3-88001048001
Policy instance 1
Insurance contract or identification numberGD3-88001048001
Number of Individuals Covered75
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $445
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 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 $8,822
Commission paid to Insurance BrokerUSD $445
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 )
Policy contract numberGD3-88001048001
Policy instance 1
Insurance contract or identification numberGD3-88001048001
Number of Individuals Covered80
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $915
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 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 $9,227
Commission paid to Insurance BrokerUSD $915
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 )
Policy contract numberGD3-88001048001
Policy instance 1
Insurance contract or identification numberGD3-88001048001
Number of Individuals Covered80
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $848
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 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 $9,239
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $848
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 )
Policy contract numberGS3880010480PL
Policy instance 2
Insurance contract or identification numberGS3880010480PL
Number of Individuals Covered145
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $0
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 BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedNEW YORK PAID FAMILY LEAVE
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 $3,628
LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 )
Policy contract numberGD3-88001048001
Policy instance 1
Insurance contract or identification numberGD3-88001048001
Number of Individuals Covered82
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $615
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 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 $6,145
LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 )
Policy contract numberGS388001048001
Policy instance 3
Insurance contract or identification numberGS388001048001
Number of Individuals Covered145
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $1,993
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 BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedNEW YORK STATUTORY
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 $19,945
LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 )
Policy contract numberGS388001048001
Policy instance 1
Insurance contract or identification numberGS388001048001
Number of Individuals Covered154
Insurance policy start date2015-07-01
Insurance policy end date2016-06-30
Total amount of commissions paid to insurance brokerUSD $2,421
Total amount of fees paid to insurance companyUSD $0
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 BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedNEW YORK STATUTORY
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 $23,077
Commission paid to Insurance BrokerUSD $2,421
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
Insurance broker nameGALLAGHER BENEFIT SERVICES
LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 )
Policy contract numberGD388001048001
Policy instance 2
Insurance contract or identification numberGD388001048001
Number of Individuals Covered84
Insurance policy start date2015-07-01
Insurance policy end date2016-06-30
Total amount of commissions paid to insurance brokerUSD $700
Total amount of fees paid to insurance companyUSD $0
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 $6,359
Commission paid to Insurance BrokerUSD $700
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
Insurance broker nameGALLAGHER BENEFIT SERVICES
LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 )
Policy contract numberGS388001048001
Policy instance 2
Insurance contract or identification numberGS388001048001
Number of Individuals Covered177
Insurance policy start date2014-07-01
Insurance policy end date2015-06-30
Total amount of commissions paid to insurance brokerUSD $2,149
Total amount of fees paid to insurance companyUSD $0
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 BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedNY DISABILITY STAT
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 $2,149
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
Insurance broker nameGALLAGHER BENEFIT SERVICES, INC.
LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 )
Policy contract numberGD388001048001
Policy instance 1
Insurance contract or identification numberGD388001048001
Number of Individuals Covered84
Insurance policy start date2014-07-01
Insurance policy end date2015-06-30
Total amount of commissions paid to insurance brokerUSD $668
Total amount of fees paid to insurance companyUSD $0
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
Commission paid to Insurance BrokerUSD $668
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
Insurance broker nameGALLAGHER BENEFIT SERVICES
LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 )
Policy contract numberGS3-880-010480
Policy instance 2
Insurance contract or identification numberGS3-880-010480
Number of Individuals Covered148
Insurance policy start date2013-09-01
Insurance policy end date2014-08-31
Total amount of commissions paid to insurance brokerUSD $1,249
Total amount of fees paid to insurance companyUSD $0
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 BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedNY DISABILITY STAT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Commission paid to Insurance BrokerUSD $1,249
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
Insurance broker nameGALLAGHER BENEFIT SERVICES, INC.
LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 )
Policy contract numberGD3-880-010480
Policy instance 1
Insurance contract or identification numberGD3-880-010480
Number of Individuals Covered87
Insurance policy start date2013-09-01
Insurance policy end date2014-08-31
Total amount of commissions paid to insurance brokerUSD $2,212
Total amount of fees paid to insurance companyUSD $0
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
Commission paid to Insurance BrokerUSD $2,212
Insurance broker organization code?3
Insurance broker nameGALLAGHER BENEFIT SERVICES
LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 )
Policy contract numberGS3-880-010480
Policy instance 1
Insurance contract or identification numberGS3-880-010480
Number of Individuals Covered148
Insurance policy start date2012-09-01
Insurance policy end date2013-08-31
Total amount of commissions paid to insurance brokerUSD $2,405
Total amount of fees paid to insurance companyUSD $0
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 BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedNY DISABILITY STAT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Commission paid to Insurance BrokerUSD $2,405
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
Insurance broker nameGALLAGER BENEFIT SERVICES, INC.
LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 )
Policy contract numberGD3-880-010480
Policy instance 2
Insurance contract or identification numberGD3-880-010480
Number of Individuals Covered90
Insurance policy start date2012-09-01
Insurance policy end date2013-08-31
Total amount of commissions paid to insurance brokerUSD $765
Total amount of fees paid to insurance companyUSD $0
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
Commission paid to Insurance BrokerUSD $765
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
Insurance broker nameGALLAGER BENEFIT SERVICES, INC.
LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 )
Policy contract numberGD388001048001
Policy instance 1
Insurance contract or identification numberGD388001048001
Number of Individuals Covered92
Insurance policy start date2011-09-01
Insurance policy end date2012-08-31
Total amount of commissions paid to insurance brokerUSD $885
Temporary Disability Insurance Welfare BenefitYes
LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 )
Policy contract numberGD388001048001
Policy instance 1
Insurance contract or identification numberGD388001048001
Number of Individuals Covered101
Insurance policy start date2010-09-01
Insurance policy end date2011-08-31
Total amount of commissions paid to insurance brokerUSD $857
Temporary Disability Insurance Welfare BenefitYes
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number540141
Policy instance 2
Insurance contract or identification number540141
Number of Individuals Covered112
Insurance policy start date2010-09-01
Insurance policy end date2011-08-31
Total amount of commissions paid to insurance brokerUSD $42,012
Health Insurance Welfare BenefitYes

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