401k Plan data: EMPLOYEE BENEFIT PLAN OF HOME OF THE INNOCENTS

EMPLOYEE BENEFIT PLAN OF HOME OF THE INNOCENTS - LIFE INSURANCE 401k Plan overview

Plan Name	EMPLOYEE BENEFIT PLAN OF HOME OF THE INNOCENTS - LIFE INSURANCE
Plan identification number	501

EMPLOYEE BENEFIT PLAN OF HOME OF THE INNOCENTS - LIFE INSURANCE Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Life insurance Other welfare benefit cover

401k Sponsoring company profile

THE HOME OF THE INNOCENTS, INC. has sponsored the creation of one or more 401k plans.

Company Name: THE HOME OF THE INNOCENTS, INC.

Employer identification number (EIN): 610445834

NAIC Classification: 623000
NAIC Description: Nursing and Residential Care Facilities

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EMPLOYEE BENEFIT PLAN OF HOME OF THE INNOCENTS - LIFE INSURANCE

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2023-01-01 SUSAN VEECH 2024-02-06 SUSAN VEECH 2024-02-06
501 2022-01-01 SUSAN VEECH 2023-03-01 SUSAN VEECH 2023-03-01
501 2021-01-01 SUSAN VEECH 2022-04-29 SUSAN VEECH 2022-04-29
501 2020-01-01 SUSAN VEECH 2021-05-20 SUSAN VEECH 2021-05-20
501 2019-01-01 SUSAN VEECH 2020-04-06 SUSAN VEECH 2020-04-06
501 2018-01-01
501 2017-01-01
501 2016-01-01
501 2015-01-01
501 2014-01-01
501 2013-01-01
501 2012-01-01 EULALIE M. FEE
501 2011-01-01 EULALIE M. FEE
501 2009-01-01 EULALIE FEE

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2023-01-01	SUSAN VEECH	2024-02-06	SUSAN VEECH	2024-02-06
501	2022-01-01	SUSAN VEECH	2023-03-01	SUSAN VEECH	2023-03-01
501	2021-01-01	SUSAN VEECH	2022-04-29	SUSAN VEECH	2022-04-29
501	2020-01-01	SUSAN VEECH	2021-05-20	SUSAN VEECH	2021-05-20
501	2019-01-01	SUSAN VEECH	2020-04-06	SUSAN VEECH	2020-04-06
501	2018-01-01
501	2017-01-01
501	2016-01-01
501	2015-01-01
501	2014-01-01
501	2013-01-01
501	2012-01-01	EULALIE M. FEE
501	2011-01-01	EULALIE M. FEE
501	2009-01-01	EULALIE FEE

Plan Statistics for EMPLOYEE BENEFIT PLAN OF HOME OF THE INNOCENTS - LIFE INSURANCE

401k plan membership statisitcs for EMPLOYEE BENEFIT PLAN OF HOME OF THE INNOCENTS - LIFE INSURANCE

Measure Date Value
2023: EMPLOYEE BENEFIT PLAN OF HOME OF THE INNOCENTS - LIFE INSURANCE 2023 401k membership
Total participants, beginning-of-year 2023-01-01 392
Total number of active participants reported on line 7a of the Form 5500 2023-01-01 370
Total of all active and inactive participants 2023-01-01 370
2022: EMPLOYEE BENEFIT PLAN OF HOME OF THE INNOCENTS - LIFE INSURANCE 2022 401k membership
Total participants, beginning-of-year 2022-01-01 425
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 392
Total of all active and inactive participants 2022-01-01 392
2021: EMPLOYEE BENEFIT PLAN OF HOME OF THE INNOCENTS - LIFE INSURANCE 2021 401k membership
Total participants, beginning-of-year 2021-01-01 532
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 425
Total of all active and inactive participants 2021-01-01 425
2020: EMPLOYEE BENEFIT PLAN OF HOME OF THE INNOCENTS - LIFE INSURANCE 2020 401k membership
Total participants, beginning-of-year 2020-01-01 462
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 532
Total of all active and inactive participants 2020-01-01 532
2019: EMPLOYEE BENEFIT PLAN OF HOME OF THE INNOCENTS - LIFE INSURANCE 2019 401k membership
Total participants, beginning-of-year 2019-01-01 405
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 462
Total of all active and inactive participants 2019-01-01 462
2018: EMPLOYEE BENEFIT PLAN OF HOME OF THE INNOCENTS - LIFE INSURANCE 2018 401k membership
Total participants, beginning-of-year 2018-01-01 385
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 405
Total of all active and inactive participants 2018-01-01 405
2017: EMPLOYEE BENEFIT PLAN OF HOME OF THE INNOCENTS - LIFE INSURANCE 2017 401k membership
Total participants, beginning-of-year 2017-01-01 333
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 385
Total of all active and inactive participants 2017-01-01 385
2016: EMPLOYEE BENEFIT PLAN OF HOME OF THE INNOCENTS - LIFE INSURANCE 2016 401k membership
Total participants, beginning-of-year 2016-01-01 326
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 333
Total of all active and inactive participants 2016-01-01 333
2015: EMPLOYEE BENEFIT PLAN OF HOME OF THE INNOCENTS - LIFE INSURANCE 2015 401k membership
Total participants, beginning-of-year 2015-01-01 350
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 326
Total of all active and inactive participants 2015-01-01 326
2014: EMPLOYEE BENEFIT PLAN OF HOME OF THE INNOCENTS - LIFE INSURANCE 2014 401k membership
Total participants, beginning-of-year 2014-01-01 337
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 350
Total of all active and inactive participants 2014-01-01 350
2013: EMPLOYEE BENEFIT PLAN OF HOME OF THE INNOCENTS - LIFE INSURANCE 2013 401k membership
Total participants, beginning-of-year 2013-01-01 365
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 337
Total of all active and inactive participants 2013-01-01 337
2012: EMPLOYEE BENEFIT PLAN OF HOME OF THE INNOCENTS - LIFE INSURANCE 2012 401k membership
Total participants, beginning-of-year 2012-01-01 350
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 365
Total of all active and inactive participants 2012-01-01 365
2011: EMPLOYEE BENEFIT PLAN OF HOME OF THE INNOCENTS - LIFE INSURANCE 2011 401k membership
Total participants, beginning-of-year 2011-01-01 305
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 350
Total of all active and inactive participants 2011-01-01 350
2009: EMPLOYEE BENEFIT PLAN OF HOME OF THE INNOCENTS - LIFE INSURANCE 2009 401k membership
Total participants, beginning-of-year 2009-01-01 282
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 283
Total of all active and inactive participants 2009-01-01 283

Measure	Date	Value
2023: EMPLOYEE BENEFIT PLAN OF HOME OF THE INNOCENTS - LIFE INSURANCE 2023 401k membership
Total participants, beginning-of-year	2023-01-01	392
Total number of active participants reported on line 7a of the Form 5500	2023-01-01	370
Total of all active and inactive participants	2023-01-01	370
2022: EMPLOYEE BENEFIT PLAN OF HOME OF THE INNOCENTS - LIFE INSURANCE 2022 401k membership
Total participants, beginning-of-year	2022-01-01	425
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	392
Total of all active and inactive participants	2022-01-01	392
2021: EMPLOYEE BENEFIT PLAN OF HOME OF THE INNOCENTS - LIFE INSURANCE 2021 401k membership
Total participants, beginning-of-year	2021-01-01	532
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	425
Total of all active and inactive participants	2021-01-01	425
2020: EMPLOYEE BENEFIT PLAN OF HOME OF THE INNOCENTS - LIFE INSURANCE 2020 401k membership
Total participants, beginning-of-year	2020-01-01	462
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	532
Total of all active and inactive participants	2020-01-01	532
2019: EMPLOYEE BENEFIT PLAN OF HOME OF THE INNOCENTS - LIFE INSURANCE 2019 401k membership
Total participants, beginning-of-year	2019-01-01	405
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	462
Total of all active and inactive participants	2019-01-01	462
2018: EMPLOYEE BENEFIT PLAN OF HOME OF THE INNOCENTS - LIFE INSURANCE 2018 401k membership
Total participants, beginning-of-year	2018-01-01	385
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	405
Total of all active and inactive participants	2018-01-01	405
2017: EMPLOYEE BENEFIT PLAN OF HOME OF THE INNOCENTS - LIFE INSURANCE 2017 401k membership
Total participants, beginning-of-year	2017-01-01	333
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	385
Total of all active and inactive participants	2017-01-01	385
2016: EMPLOYEE BENEFIT PLAN OF HOME OF THE INNOCENTS - LIFE INSURANCE 2016 401k membership
Total participants, beginning-of-year	2016-01-01	326
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	333
Total of all active and inactive participants	2016-01-01	333
2015: EMPLOYEE BENEFIT PLAN OF HOME OF THE INNOCENTS - LIFE INSURANCE 2015 401k membership
Total participants, beginning-of-year	2015-01-01	350
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	326
Total of all active and inactive participants	2015-01-01	326
2014: EMPLOYEE BENEFIT PLAN OF HOME OF THE INNOCENTS - LIFE INSURANCE 2014 401k membership
Total participants, beginning-of-year	2014-01-01	337
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	350
Total of all active and inactive participants	2014-01-01	350
2013: EMPLOYEE BENEFIT PLAN OF HOME OF THE INNOCENTS - LIFE INSURANCE 2013 401k membership
Total participants, beginning-of-year	2013-01-01	365
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	337
Total of all active and inactive participants	2013-01-01	337
2012: EMPLOYEE BENEFIT PLAN OF HOME OF THE INNOCENTS - LIFE INSURANCE 2012 401k membership
Total participants, beginning-of-year	2012-01-01	350
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	365
Total of all active and inactive participants	2012-01-01	365
2011: EMPLOYEE BENEFIT PLAN OF HOME OF THE INNOCENTS - LIFE INSURANCE 2011 401k membership
Total participants, beginning-of-year	2011-01-01	305
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	350
Total of all active and inactive participants	2011-01-01	350
2009: EMPLOYEE BENEFIT PLAN OF HOME OF THE INNOCENTS - LIFE INSURANCE 2009 401k membership
Total participants, beginning-of-year	2009-01-01	282
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	283
Total of all active and inactive participants	2009-01-01	283

Form 5500 Responses for EMPLOYEE BENEFIT PLAN OF HOME OF THE INNOCENTS - LIFE INSURANCE

2023: EMPLOYEE BENEFIT PLAN OF HOME OF THE INNOCENTS - LIFE INSURANCE 2023 form 5500 responses
2023-01-01	Type of plan entity	Single employer plan
2023-01-01	Plan funding arrangement – Insurance	Yes
2023-01-01	Plan benefit arrangement – Insurance	Yes
2022: EMPLOYEE BENEFIT PLAN OF HOME OF THE INNOCENTS - LIFE INSURANCE 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2021: EMPLOYEE BENEFIT PLAN OF HOME OF THE INNOCENTS - LIFE INSURANCE 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2020: EMPLOYEE BENEFIT PLAN OF HOME OF THE INNOCENTS - LIFE INSURANCE 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2019: EMPLOYEE BENEFIT PLAN OF HOME OF THE INNOCENTS - LIFE INSURANCE 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2018: EMPLOYEE BENEFIT PLAN OF HOME OF THE INNOCENTS - LIFE INSURANCE 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2017: EMPLOYEE BENEFIT PLAN OF HOME OF THE INNOCENTS - LIFE INSURANCE 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2016: EMPLOYEE BENEFIT PLAN OF HOME OF THE INNOCENTS - LIFE INSURANCE 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2015: EMPLOYEE BENEFIT PLAN OF HOME OF THE INNOCENTS - LIFE INSURANCE 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2014: EMPLOYEE BENEFIT PLAN OF HOME OF THE INNOCENTS - LIFE INSURANCE 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2013: EMPLOYEE BENEFIT PLAN OF HOME OF THE INNOCENTS - LIFE INSURANCE 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2012: EMPLOYEE BENEFIT PLAN OF HOME OF THE INNOCENTS - LIFE INSURANCE 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2011: EMPLOYEE BENEFIT PLAN OF HOME OF THE INNOCENTS - LIFE INSURANCE 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2009: EMPLOYEE BENEFIT PLAN OF HOME OF THE INNOCENTS - LIFE INSURANCE 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	This submission is the final filing	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )

Policy contract number

VAR 208595

Policy instance

Insurance contract or identification number	VAR 208595
Number of Individuals Covered	24
Insurance policy start date	2022-07-01
Insurance policy end date	2023-06-30
Total amount of commissions paid to insurance broker	USD $58
Total amount of fees paid to insurance company	USD $53
Other welfare benefits provided	ACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $389
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )

Policy contract number

GL 160659

Policy instance

Insurance contract or identification number	GL 160659
Number of Individuals Covered	41
Insurance policy start date	2022-07-01
Insurance policy end date	2023-06-30
Total amount of commissions paid to insurance broker	USD $1,298
Total amount of fees paid to insurance company	USD $886
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $8,654
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )

Policy contract number

GL 151432

Policy instance

Insurance contract or identification number	GL 151432
Number of Individuals Covered	329
Insurance policy start date	2023-02-01
Insurance policy end date	2024-01-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $1,169
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $43,840
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )

Policy contract number

GL 151432

Policy instance

Insurance contract or identification number	GL 151432
Number of Individuals Covered	349
Insurance policy start date	2022-02-01
Insurance policy end date	2023-01-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $1,066
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $37,645
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	1066
Additional information about fees paid to insurance broker	ADMINISTRATIVE FEES
Insurance broker organization code?	3

RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )

Policy contract number

GL 160659

Policy instance

Insurance contract or identification number	GL 160659
Number of Individuals Covered	43
Insurance policy start date	2021-07-01
Insurance policy end date	2022-06-30
Total amount of commissions paid to insurance broker	USD $2,129
Total amount of fees paid to insurance company	USD $436
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $14,193
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,129
Amount paid for insurance broker fees	436
Additional information about fees paid to insurance broker	ADMINISTRATIVE FEES
Insurance broker organization code?	3

RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )

Policy contract number

VAR 208595

Policy instance

Insurance contract or identification number	VAR 208595
Number of Individuals Covered	38
Insurance policy start date	2021-07-01
Insurance policy end date	2022-06-30
Total amount of commissions paid to insurance broker	USD $130
Total amount of fees paid to insurance company	USD $39
Other welfare benefits provided	ACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $866
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $130
Amount paid for insurance broker fees	39
Additional information about fees paid to insurance broker	ADMINISTRATIVE FEES
Insurance broker organization code?	3

RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )

Policy contract number

VAR 208595

Policy instance

Insurance contract or identification number	VAR 208595
Number of Individuals Covered	44
Insurance policy start date	2020-07-01
Insurance policy end date	2021-06-30
Total amount of commissions paid to insurance broker	USD $151
Total amount of fees paid to insurance company	USD $0
Other welfare benefits provided	ACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $1,009
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $151
Insurance broker organization code?	3

RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )

Policy contract number

GL 160659

Policy instance

Insurance contract or identification number	GL 160659
Number of Individuals Covered	45
Insurance policy start date	2020-07-01
Insurance policy end date	2021-06-30
Total amount of commissions paid to insurance broker	USD $2,123
Total amount of fees paid to insurance company	USD $0
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $14,155
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,123
Insurance broker organization code?	3

RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )

Policy contract number

GL 151432

Policy instance

Insurance contract or identification number	GL 151432
Number of Individuals Covered	380
Insurance policy start date	2021-02-01
Insurance policy end date	2022-01-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $1,004
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $39,885
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	1004
Additional information about fees paid to insurance broker	ADMINISTRATIVE FEES
Insurance broker organization code?	3

RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )

Policy contract number

VAR 208595

Policy instance

Insurance contract or identification number	VAR 208595
Number of Individuals Covered	61
Insurance policy start date	2019-07-01
Insurance policy end date	2020-06-30
Total amount of commissions paid to insurance broker	USD $209
Total amount of fees paid to insurance company	USD $32
Other welfare benefits provided	ACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $1,391
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $209
Amount paid for insurance broker fees	32
Additional information about fees paid to insurance broker	ADMINISTRATIVE FEES
Insurance broker organization code?	3

RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )

Policy contract number

GL 160659

Policy instance

Insurance contract or identification number	GL 160659
Number of Individuals Covered	47
Insurance policy start date	2019-07-01
Insurance policy end date	2020-06-30
Total amount of commissions paid to insurance broker	USD $1,787
Total amount of fees paid to insurance company	USD $253
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $11,912
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,787
Amount paid for insurance broker fees	253
Additional information about fees paid to insurance broker	ADMINISTRATIVE FEES
Insurance broker organization code?	3

RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )

Policy contract number

GL 151432

Policy instance

Insurance contract or identification number	GL 151432
Number of Individuals Covered	424
Insurance policy start date	2020-02-01
Insurance policy end date	2021-01-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $1,559
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $30,345
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	1559
Additional information about fees paid to insurance broker	ADMINISTRATIVE FEES
Insurance broker organization code?	3

RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )

Policy contract number

GL 151432

Policy instance

Insurance contract or identification number	GL 151432
Number of Individuals Covered	462
Insurance policy start date	2019-02-01
Insurance policy end date	2020-01-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $674
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $38,804
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	674
Additional information about fees paid to insurance broker	ADMINISTRATIVE FEES
Insurance broker organization code?	3

RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )

Policy contract number

GL 151432

Policy instance

Insurance contract or identification number	GL 151432
Number of Individuals Covered	405
Insurance policy start date	2018-02-01
Insurance policy end date	2019-01-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $1,309
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $43,632
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	1309
Additional information about fees paid to insurance broker	ADMINISTRATIVE FEES
Insurance broker organization code?	3

RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )

Policy contract number

GL 151432

Policy instance

Insurance contract or identification number	GL 151432
Number of Individuals Covered	385
Insurance policy start date	2017-02-01
Insurance policy end date	2018-01-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $1,223
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $40,755
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	1223
Additional information about fees paid to insurance broker	ADMINISTRATIVE FEES
Insurance broker organization code?	3
Insurance broker name	THE BENEFIT COMPANY, INC.

RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )

Policy contract number

GL 151432

Policy instance

Insurance contract or identification number	GL 151432
Number of Individuals Covered	326
Insurance policy start date	2015-02-01
Insurance policy end date	2016-01-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $2,208
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $35,273
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	1150
Additional information about fees paid to insurance broker	ADMINISTRATIVE FEES
Insurance broker organization code?	3
Insurance broker name	THE BENEFIT COMPANY, INC.

RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )

Policy contract number

GL 151432

Policy instance

Insurance contract or identification number	GL 151432
Number of Individuals Covered	350
Insurance policy start date	2014-02-01
Insurance policy end date	2015-01-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $1,598
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $34,148
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	1024
Additional information about fees paid to insurance broker	ADMINISTRATIVE FEES
Insurance broker organization code?	3
Insurance broker name	BB&T INSURANCE SERVICES, INC.

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

TM05710533

Policy instance

Insurance contract or identification number	TM05710533
Number of Individuals Covered	337
Insurance policy start date	2013-02-01
Insurance policy end date	2014-01-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $14,144
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

TM05710533

Policy instance

Insurance contract or identification number	TM05710533
Number of Individuals Covered	365
Insurance policy start date	2012-02-01
Insurance policy end date	2013-01-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $-646
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $34,500
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	-646
Additional information about fees paid to insurance broker	SUPPLEMENTAL COMPENSATION
Insurance broker organization code?	3
Insurance broker name	BB&T INSURANCE SERVICES, INC.

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

TM05710533

Policy instance

Insurance contract or identification number	TM05710533
Number of Individuals Covered	350
Insurance policy start date	2011-02-01
Insurance policy end date	2012-01-31
Total amount of commissions paid to insurance broker	USD $1,637
Total amount of fees paid to insurance company	USD $1,001
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $34,977
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

TM05710533

Policy instance

Insurance contract or identification number	TM05710533
Number of Individuals Covered	305
Insurance policy start date	2010-02-01
Insurance policy end date	2011-01-31
Total amount of commissions paid to insurance broker	USD $2,048
Total amount of fees paid to insurance company	USD $519
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $26,211
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,048
Amount paid for insurance broker fees	519
Additional information about fees paid to insurance broker	BASE COMMISSIONS, SUPPLEMENTAL COMPENSATION
Insurance broker organization code?	3
Insurance broker name	BB & T INSURANCE SERVICES

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Company Name:	THE HOME OF THE INNOCENTS, INC.
Employer identification number (EIN):	610445834
NAIC Classification:	623000
NAIC Description:	Nursing and Residential Care Facilities