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WARREN HENRY AUTOMOBILES, INC & SUBS GROUP LIFE INSURANCE PLAN 401k Plan overview

Plan NameWARREN HENRY AUTOMOBILES, INC & SUBS GROUP LIFE INSURANCE PLAN
Plan identification number 511

WARREN HENRY AUTOMOBILES, INC & SUBS GROUP LIFE INSURANCE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Temporary disability (accident and sickness)
  • Prepaid legal
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover

401k Sponsoring company profile

WARREN HENRY AUTOMOBILES, INC. DBA WARREN HENRY AUTO GROUP has sponsored the creation of one or more 401k plans.

Company Name:WARREN HENRY AUTOMOBILES, INC. DBA WARREN HENRY AUTO GROUP
Employer identification number (EIN):592594999
NAIC Classification:441110
NAIC Description:New Car Dealers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan WARREN HENRY AUTOMOBILES, INC & SUBS GROUP LIFE INSURANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5112021-06-01
5112018-01-01ERIK DAY ERIK DAY2019-07-17
5112017-01-01ERIK DAY ERIK DAY2018-08-28
5112016-01-01JANELLE GARCIA JANELLE GARCIA2017-10-10
5112015-01-01JANELLE GARCIA JANELLE GARCIA2016-10-10
5112014-01-01JANELLE GARCIA JANELLE GARCIA2015-07-07
5112013-01-01ROSEMARIE WIENCZKOWSKI ROSEMARIE WIENCZKOWSKI2014-08-20
5112012-01-01ROSEMARIE WIENCZKOWSKI ROSEMARIE WIENCZKOWSKI2013-10-04
5112011-03-01ROSEMARIE WIENCZKOWSKI ROSEMARIE WIENCZKOWSKI2012-09-13
5112009-03-01ROSEMARIE WIENCZKOWSKI ROSEMARIE WIENCZKOWSKI2010-09-22

Plan Statistics for WARREN HENRY AUTOMOBILES, INC & SUBS GROUP LIFE INSURANCE PLAN

401k plan membership statisitcs for WARREN HENRY AUTOMOBILES, INC & SUBS GROUP LIFE INSURANCE PLAN

Measure Date Value
2021: WARREN HENRY AUTOMOBILES, INC & SUBS GROUP LIFE INSURANCE PLAN 2021 401k membership
Total participants, beginning-of-year2021-06-01412
Total number of active participants reported on line 7a of the Form 55002021-06-01418
Number of retired or separated participants receiving benefits2021-06-013
Number of other retired or separated participants entitled to future benefits2021-06-015
Total of all active and inactive participants2021-06-01426
2018: WARREN HENRY AUTOMOBILES, INC & SUBS GROUP LIFE INSURANCE PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01317
Total number of active participants reported on line 7a of the Form 55002018-01-01378
Total of all active and inactive participants2018-01-01378
2017: WARREN HENRY AUTOMOBILES, INC & SUBS GROUP LIFE INSURANCE PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01262
Total number of active participants reported on line 7a of the Form 55002017-01-01317
Total of all active and inactive participants2017-01-01317
2016: WARREN HENRY AUTOMOBILES, INC & SUBS GROUP LIFE INSURANCE PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01224
Total number of active participants reported on line 7a of the Form 55002016-01-01262
Total of all active and inactive participants2016-01-01262
2015: WARREN HENRY AUTOMOBILES, INC & SUBS GROUP LIFE INSURANCE PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01184
Total number of active participants reported on line 7a of the Form 55002015-01-01224
Total of all active and inactive participants2015-01-01224
2014: WARREN HENRY AUTOMOBILES, INC & SUBS GROUP LIFE INSURANCE PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01246
Total number of active participants reported on line 7a of the Form 55002014-01-01184
Total of all active and inactive participants2014-01-01184
2013: WARREN HENRY AUTOMOBILES, INC & SUBS GROUP LIFE INSURANCE PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01242
Total number of active participants reported on line 7a of the Form 55002013-01-01246
Total of all active and inactive participants2013-01-01246
2012: WARREN HENRY AUTOMOBILES, INC & SUBS GROUP LIFE INSURANCE PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01242
Total number of active participants reported on line 7a of the Form 55002012-01-01242
Total of all active and inactive participants2012-01-01242
2011: WARREN HENRY AUTOMOBILES, INC & SUBS GROUP LIFE INSURANCE PLAN 2011 401k membership
Total participants, beginning-of-year2011-03-01235
Total number of active participants reported on line 7a of the Form 55002011-03-01242
Total of all active and inactive participants2011-03-01242
2009: WARREN HENRY AUTOMOBILES, INC & SUBS GROUP LIFE INSURANCE PLAN 2009 401k membership
Total participants, beginning-of-year2009-03-01297
Total number of active participants reported on line 7a of the Form 55002009-03-01220
Total of all active and inactive participants2009-03-01220

Form 5500 Responses for WARREN HENRY AUTOMOBILES, INC & SUBS GROUP LIFE INSURANCE PLAN

2021: WARREN HENRY AUTOMOBILES, INC & SUBS GROUP LIFE INSURANCE PLAN 2021 form 5500 responses
2021-06-01Type of plan entitySingle employer plan
2021-06-01Submission has been amendedNo
2021-06-01This submission is the final filingNo
2021-06-01This return/report is a short plan year return/report (less than 12 months)No
2021-06-01Plan is a collectively bargained planNo
2021-06-01Plan funding arrangement – InsuranceYes
2021-06-01Plan benefit arrangement – InsuranceYes
2018: WARREN HENRY AUTOMOBILES, INC & SUBS GROUP LIFE INSURANCE PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: WARREN HENRY AUTOMOBILES, INC & SUBS GROUP LIFE INSURANCE PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: WARREN HENRY AUTOMOBILES, INC & SUBS GROUP LIFE INSURANCE PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: WARREN HENRY AUTOMOBILES, INC & SUBS GROUP LIFE INSURANCE PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: WARREN HENRY AUTOMOBILES, INC & SUBS GROUP LIFE INSURANCE PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: WARREN HENRY AUTOMOBILES, INC & SUBS GROUP LIFE INSURANCE PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: WARREN HENRY AUTOMOBILES, INC & SUBS GROUP LIFE INSURANCE PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: WARREN HENRY AUTOMOBILES, INC & SUBS GROUP LIFE INSURANCE PLAN 2011 form 5500 responses
2011-03-01Type of plan entitySingle employer plan
2011-03-01This return/report is a short plan year return/report (less than 12 months)Yes
2011-03-01Plan funding arrangement – InsuranceYes
2011-03-01Plan benefit arrangement – InsuranceYes
2009: WARREN HENRY AUTOMOBILES, INC & SUBS GROUP LIFE INSURANCE PLAN 2009 form 5500 responses
2009-03-01Type of plan entitySingle employer plan
2009-03-01This submission is the final filingNo
2009-03-01Plan funding arrangement – InsuranceYes
2009-03-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

PRE-PAID LEGAL SERVICES DBA LEGAL SHIELD (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number160494
Policy instance 5
Insurance contract or identification number160494
Number of Individuals Covered24
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Total amount of commissions paid to insurance brokerUSD $1,778
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 providedLEGAL SERVICES
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 $3,750
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,059
Insurance broker organization code?4
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000400266387
Policy instance 4
Insurance contract or identification number000400266387
Number of Individuals Covered141
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Total amount of commissions paid to insurance brokerUSD $7,943
Total amount of fees paid to insurance companyUSD $1,731
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedVOL CHILD LIFE, VOL SPOUSE AD&D, VOL SPOUSE LIFE, VOLUNTARY AD&D, VOLUNTARY LIFE
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 $52,954
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,943
Insurance broker organization code?3
Amount paid for insurance broker fees1201
Additional information about fees paid to insurance brokerENROLLMENT
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010266386
Policy instance 3
Insurance contract or identification number000010266386
Number of Individuals Covered77
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Total amount of commissions paid to insurance brokerUSD $7,305
Total amount of fees paid to insurance companyUSD $1,381
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 $48,701
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,305
Insurance broker organization code?3
Amount paid for insurance broker fees894
Additional information about fees paid to insurance brokerENROLLMENT
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010266385
Policy instance 2
Insurance contract or identification number000010266385
Number of Individuals Covered425
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Total amount of commissions paid to insurance brokerUSD $12,781
Total amount of fees paid to insurance companyUSD $2,859
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 $85,208
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,781
Insurance broker organization code?3
Amount paid for insurance broker fees2007
Additional information about fees paid to insurance brokerENROLLMENT
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010266384
Policy instance 1
Insurance contract or identification number000010266384
Number of Individuals Covered425
Insurance policy start date2021-06-01
Insurance policy end date2022-05-31
Total amount of commissions paid to insurance brokerUSD $2,730
Total amount of fees paid to insurance companyUSD $600
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
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 $18,203
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,730
Insurance broker organization code?3
Amount paid for insurance broker fees418
Additional information about fees paid to insurance brokerENROLLMENT
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000400140452
Policy instance 4
Insurance contract or identification number000400140452
Number of Individuals Covered114
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $4,715
Total amount of fees paid to insurance companyUSD $1,478
Life Insurance Welfare BenefitYes
Other welfare benefits providedVOL LIFE, VOL CHILD/SPOUSE LIFE
Welfare Benefit Premiums Paid to CarrierUSD $31,436
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,715
Insurance broker organization code?3
Amount paid for insurance broker fees1478
Additional information about fees paid to insurance brokerBROKER BONUS
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000400003002
Policy instance 3
Insurance contract or identification number000400003002
Number of Individuals Covered51
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $7,184
Total amount of fees paid to insurance companyUSD $1,854
Other welfare benefits providedVOL LTD
Welfare Benefit Premiums Paid to CarrierUSD $47,892
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,184
Insurance broker organization code?3
Amount paid for insurance broker fees1854
Additional information about fees paid to insurance brokerBROKER BONUS
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010096857
Policy instance 2
Insurance contract or identification number000010096857
Number of Individuals Covered379
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $11,000
Total amount of fees paid to insurance companyUSD $3,364
Other welfare benefits providedWEEKLY INCOME
Welfare Benefit Premiums Paid to CarrierUSD $73,333
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,000
Insurance broker organization code?3
Amount paid for insurance broker fees3364
Additional information about fees paid to insurance brokerBROKER BONUS
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010012716
Policy instance 1
Insurance contract or identification number000010012716
Number of Individuals Covered379
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $6,400
Total amount of fees paid to insurance companyUSD $1,902
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $42,670
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,400
Insurance broker organization code?3
Amount paid for insurance broker fees1902
Additional information about fees paid to insurance brokerBROKER BONUS
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000400140452
Policy instance 4
Insurance contract or identification number000400140452
Number of Individuals Covered132
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $4,669
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedVOL LIFE, VOL CHILD/SPOUSE LIFE
Welfare Benefit Premiums Paid to CarrierUSD $31,124
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,669
Insurance broker organization code?3
Insurance broker nameUSI INS SVCS NATIONAL INC
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000400003002
Policy instance 3
Insurance contract or identification number000400003002
Number of Individuals Covered54
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $5,856
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedVOL LTD
Welfare Benefit Premiums Paid to CarrierUSD $39,040
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,856
Insurance broker organization code?3
Insurance broker nameUSI INS SVCS NATIONAL INC
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010096857
Policy instance 2
Insurance contract or identification number000010096857
Number of Individuals Covered321
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $10,624
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedWEEKLY INCOME
Welfare Benefit Premiums Paid to CarrierUSD $70,828
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,624
Insurance broker organization code?3
Insurance broker nameUSI INS SVCS NATIONAL INC
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010012716
Policy instance 1
Insurance contract or identification number000010012716
Number of Individuals Covered321
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $6,006
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $40,042
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,006
Insurance broker organization code?3
Insurance broker nameUSI INS SVCS NATIONAL INC
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010012716
Policy instance 1
Insurance contract or identification number000010012716
Number of Individuals Covered224
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $4,461
Total amount of fees paid to insurance companyUSD $1,038
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $29,741
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,461
Insurance broker organization code?3
Amount paid for insurance broker fees1038
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker nameWELLS FARGO INS SVCS USA INC
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010096857
Policy instance 2
Insurance contract or identification number000010096857
Number of Individuals Covered48
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $3,588
Total amount of fees paid to insurance companyUSD $843
Other welfare benefits providedWEEKLY INCOME
Welfare Benefit Premiums Paid to CarrierUSD $23,917
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,588
Insurance broker organization code?3
Amount paid for insurance broker fees843
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker nameWELLS FARGO INS SVCS USA INC
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010084904
Policy instance 3
Insurance contract or identification number000010084904
Number of Individuals Covered87
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $12,290
Total amount of fees paid to insurance companyUSD $2,033
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $61,452
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,290
Insurance broker organization code?3
Amount paid for insurance broker fees2033
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker nameWELLS FARGO INS SVCS USA INC
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000400003002
Policy instance 4
Insurance contract or identification number000400003002
Number of Individuals Covered16
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $1,448
Total amount of fees paid to insurance companyUSD $372
Other welfare benefits providedVOL LTD
Welfare Benefit Premiums Paid to CarrierUSD $9,650
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,448
Insurance broker organization code?3
Amount paid for insurance broker fees372
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker nameWELLS FARGO INS SVCS USA INC
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000400140452
Policy instance 5
Insurance contract or identification number000400140452
Number of Individuals Covered112
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $4,164
Total amount of fees paid to insurance companyUSD $1,218
Life Insurance Welfare BenefitYes
Other welfare benefits providedVOL LIFE, VOL CHILD/SPOUSE LIFE
Welfare Benefit Premiums Paid to CarrierUSD $27,757
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,164
Insurance broker organization code?3
Amount paid for insurance broker fees1218
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker nameWELLS FARGO INS SVCS USA INC
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000400003002
Policy instance 4
Insurance contract or identification number000400003002
Number of Individuals Covered20
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $1,735
Total amount of fees paid to insurance companyUSD $279
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Other welfare benefits providedVOL LTD
Welfare Benefit Premiums Paid to CarrierUSD $9,914
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,735
Insurance broker organization code?3
Amount paid for insurance broker fees279
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker nameWELLS FARGO INS SVCS USA INC
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010012716
Policy instance 1
Insurance contract or identification number000010012716
Number of Individuals Covered184
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $4,789
Total amount of fees paid to insurance companyUSD $610
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $27,687
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,789
Insurance broker organization code?3
Amount paid for insurance broker fees610
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker nameWELLS FARGO INS SVCS USA INC
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010096857
Policy instance 2
Insurance contract or identification number000010096857
Number of Individuals Covered52
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $3,882
Total amount of fees paid to insurance companyUSD $616
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Other welfare benefits providedWEEKLY INCOME
Welfare Benefit Premiums Paid to CarrierUSD $22,476
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,882
Insurance broker organization code?3
Amount paid for insurance broker fees616
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker nameWELLS FARGO INS SVCS USA INC
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010084904
Policy instance 3
Insurance contract or identification number000010084904
Number of Individuals Covered87
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $12,158
Total amount of fees paid to insurance companyUSD $1,563
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $54,220
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,158
Insurance broker organization code?3
Amount paid for insurance broker fees1563
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker nameWELLS FARGO INS SVCS USA INC
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000400140452
Policy instance 5
Insurance contract or identification number000400140452
Number of Individuals Covered131
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $5,633
Total amount of fees paid to insurance companyUSD $878
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Other welfare benefits providedVOL LIFE, VOL CHILD/SPOUSE LIFE
Welfare Benefit Premiums Paid to CarrierUSD $32,493
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,633
Insurance broker organization code?3
Amount paid for insurance broker fees878
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker nameWELLS FARGO INS SVCS USA INC
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010084904
Policy instance 3
Insurance contract or identification number000010084904
Number of Individuals Covered108
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $13,897
Total amount of fees paid to insurance companyUSD $1,700
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $69,487
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,897
Insurance broker organization code?3
Amount paid for insurance broker fees1700
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker nameWELLS FARGO INS SVCS USA INC
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000400003002
Policy instance 4
Insurance contract or identification number000400003002
Number of Individuals Covered26
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $1,561
Total amount of fees paid to insurance companyUSD $604
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Other welfare benefits providedVOL LTD
Welfare Benefit Premiums Paid to CarrierUSD $10,409
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,561
Insurance broker organization code?3
Amount paid for insurance broker fees604
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker nameWELLS FARGO INS SVCS USA INC
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010012716
Policy instance 1
Insurance contract or identification number000010012716
Number of Individuals Covered223
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $4,066
Total amount of fees paid to insurance companyUSD $1,053
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $27,106
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,066
Insurance broker organization code?3
Amount paid for insurance broker fees1053
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker nameWELLS FARGO INS SVCS USA INC
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010096857
Policy instance 2
Insurance contract or identification number000010096857
Number of Individuals Covered61
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $4,104
Total amount of fees paid to insurance companyUSD $947
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Other welfare benefits providedWEEKLY INCOME
Welfare Benefit Premiums Paid to CarrierUSD $27,357
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,104
Insurance broker organization code?3
Amount paid for insurance broker fees947
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker nameWELLS FARGO INS SVCS USA INC
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010012716
Policy instance 1
Insurance contract or identification number000010012716
Number of Individuals Covered242
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $4,862
Total amount of fees paid to insurance companyUSD $667
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $32,412
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,803
Insurance broker organization code?3
Amount paid for insurance broker fees667
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker nameWELLS FARGO INS SVCS USA INC
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010096857
Policy instance 2
Insurance contract or identification number000010096857
Number of Individuals Covered75
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $4,370
Total amount of fees paid to insurance companyUSD $620
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Other welfare benefits providedWEEKLY INCOME
Welfare Benefit Premiums Paid to CarrierUSD $29,132
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,476
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
Amount paid for insurance broker fees620
Insurance broker nameWELLS FARGO INS SVCS USA INC
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010084904
Policy instance 3
Insurance contract or identification number000010084904
Number of Individuals Covered79
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $10,464
Total amount of fees paid to insurance companyUSD $1,320
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Other welfare benefits providedLTD
Welfare Benefit Premiums Paid to CarrierUSD $52,316
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,786
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
Amount paid for insurance broker fees1320
Insurance broker nameWELLS FARGO INS SVCS USA INC
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000400003002
Policy instance 4
Insurance contract or identification number000400003002
Number of Individuals Covered40
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $2,788
Total amount of fees paid to insurance companyUSD $340
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Other welfare benefits providedVOL LTD
Welfare Benefit Premiums Paid to CarrierUSD $18,587
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,606
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
Amount paid for insurance broker fees340
Insurance broker nameWELLS FARGO INS SVCS USA INC
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000400140452
Policy instance 5
Insurance contract or identification number000400140452
Number of Individuals Covered84
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $7,004
Total amount of fees paid to insurance companyUSD $621
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Other welfare benefits providedVOL CHILD, VOL SPOUSE, VOL LIFE
Welfare Benefit Premiums Paid to CarrierUSD $46,695
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,227
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
Amount paid for insurance broker fees621
Insurance broker nameWELLS FARGO INS SVCS USA INC
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000400003002
Policy instance 4
Insurance contract or identification number000400003002
Number of Individuals Covered37
Insurance policy start date2010-11-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $1,918
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Other welfare benefits providedVOL LTD
Welfare Benefit Premiums Paid to CarrierUSD $12,787
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010012716
Policy instance 1
Insurance contract or identification number000010012716
Number of Individuals Covered244
Insurance policy start date2010-10-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $4,323
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $28,819
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010096857
Policy instance 2
Insurance contract or identification number000010096857
Number of Individuals Covered71
Insurance policy start date2010-11-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $3,738
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Other welfare benefits providedWEEKLY INCOME
Welfare Benefit Premiums Paid to CarrierUSD $24,920
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010084904
Policy instance 3
Insurance contract or identification number000010084904
Number of Individuals Covered81
Insurance policy start date2010-11-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $10,662
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Other welfare benefits providedLTD
Welfare Benefit Premiums Paid to CarrierUSD $53,310
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010084904
Policy instance 3
Insurance contract or identification number000010084904
Number of Individuals Covered84
Insurance policy start date2009-11-01
Insurance policy end date2010-10-31
Total amount of commissions paid to insurance brokerUSD $9,984
Total amount of fees paid to insurance companyUSD $1,178
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Other welfare benefits providedLTD
Welfare Benefit Premiums Paid to CarrierUSD $49,922
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,984
Insurance broker organization code?3
Amount paid for insurance broker fees1178
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker nameEDIFY LLC.
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010012716
Policy instance 1
Insurance contract or identification number000010012716
Number of Individuals Covered241
Insurance policy start date2009-10-01
Insurance policy end date2010-09-30
Total amount of commissions paid to insurance brokerUSD $3,449
Total amount of fees paid to insurance companyUSD $471
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $22,994
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,449
Insurance broker organization code?3
Amount paid for insurance broker fees471
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker nameEDIFY LLC.
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000400003002
Policy instance 4
Insurance contract or identification number000400003002
Number of Individuals Covered29
Insurance policy start date2009-11-01
Insurance policy end date2010-10-31
Total amount of commissions paid to insurance brokerUSD $1,049
Total amount of fees paid to insurance companyUSD $153
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Other welfare benefits providedVOL LTD
Welfare Benefit Premiums Paid to CarrierUSD $6,995
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,049
Insurance broker organization code?3
Amount paid for insurance broker fees153
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker nameEDIFY LLC.
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010096857
Policy instance 2
Insurance contract or identification number000010096857
Number of Individuals Covered63
Insurance policy start date2009-11-01
Insurance policy end date2010-10-31
Total amount of commissions paid to insurance brokerUSD $2,797
Total amount of fees paid to insurance companyUSD $381
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Other welfare benefits providedWEEKLY INCOME
Welfare Benefit Premiums Paid to CarrierUSD $18,648
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,797
Insurance broker organization code?3
Amount paid for insurance broker fees381
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker nameEDIFY LLC.

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