CUMBERLAND ELECTRIC MEMBERSHIP CORPORATION has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan LIFE, ACCIDENTAL DEALTH & DISMEMBERMENT, DEPENDENT LIFE FOR EMPLOYEES OF CEMC
401k plan membership statisitcs for LIFE, ACCIDENTAL DEALTH & DISMEMBERMENT, DEPENDENT LIFE FOR EMPLOYEES OF CEMC
| Measure | Date | Value |
|---|
| 2021: LIFE, ACCIDENTAL DEALTH & DISMEMBERMENT, DEPENDENT LIFE FOR EMPLOYEES OF CEMC 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-03-01 | 92 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-03-01 | 39 |
| Number of retired or separated participants receiving benefits | 2021-03-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2021-03-01 | 49 |
| Total of all active and inactive participants | 2021-03-01 | 88 |
| 2020: LIFE, ACCIDENTAL DEALTH & DISMEMBERMENT, DEPENDENT LIFE FOR EMPLOYEES OF CEMC 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-03-01 | 100 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-03-01 | 40 |
| Number of other retired or separated participants entitled to future benefits | 2020-03-01 | 52 |
| Total of all active and inactive participants | 2020-03-01 | 92 |
| Total participants | 2020-03-01 | 92 |
| 2019: LIFE, ACCIDENTAL DEALTH & DISMEMBERMENT, DEPENDENT LIFE FOR EMPLOYEES OF CEMC 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-03-01 | 109 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-03-01 | 46 |
| Number of other retired or separated participants entitled to future benefits | 2019-03-01 | 54 |
| Total of all active and inactive participants | 2019-03-01 | 100 |
| Total participants | 2019-03-01 | 100 |
| 2018: LIFE, ACCIDENTAL DEALTH & DISMEMBERMENT, DEPENDENT LIFE FOR EMPLOYEES OF CEMC 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-03-01 | 116 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-03-01 | 51 |
| Number of other retired or separated participants entitled to future benefits | 2018-03-01 | 58 |
| Total of all active and inactive participants | 2018-03-01 | 109 |
| Total participants | 2018-03-01 | 109 |
| 2017: LIFE, ACCIDENTAL DEALTH & DISMEMBERMENT, DEPENDENT LIFE FOR EMPLOYEES OF CEMC 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-03-01 | 124 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-03-01 | 61 |
| Number of other retired or separated participants entitled to future benefits | 2017-03-01 | 55 |
| Total of all active and inactive participants | 2017-03-01 | 116 |
| Total participants | 2017-03-01 | 116 |
| 2016: LIFE, ACCIDENTAL DEALTH & DISMEMBERMENT, DEPENDENT LIFE FOR EMPLOYEES OF CEMC 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-03-01 | 126 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-03-01 | 62 |
| Number of other retired or separated participants entitled to future benefits | 2016-03-01 | 62 |
| Total of all active and inactive participants | 2016-03-01 | 124 |
| Total participants | 2016-03-01 | 124 |
| 2015: LIFE, ACCIDENTAL DEALTH & DISMEMBERMENT, DEPENDENT LIFE FOR EMPLOYEES OF CEMC 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-03-01 | 137 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-03-01 | 65 |
| Number of retired or separated participants receiving benefits | 2015-03-01 | 61 |
| Total of all active and inactive participants | 2015-03-01 | 126 |
| Total participants | 2015-03-01 | 126 |
| 2014: LIFE, ACCIDENTAL DEALTH & DISMEMBERMENT, DEPENDENT LIFE FOR EMPLOYEES OF CEMC 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-03-01 | 143 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-03-01 | 74 |
| Number of other retired or separated participants entitled to future benefits | 2014-03-01 | 63 |
| Total of all active and inactive participants | 2014-03-01 | 137 |
| Total participants | 2014-03-01 | 137 |
| 2013: LIFE, ACCIDENTAL DEALTH & DISMEMBERMENT, DEPENDENT LIFE FOR EMPLOYEES OF CEMC 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-01-01 | 154 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 80 |
| Number of retired or separated participants receiving benefits | 2013-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2013-01-01 | 62 |
| Total of all active and inactive participants | 2013-01-01 | 142 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2013-01-01 | 0 |
| Total participants | 2013-01-01 | 142 |
| 2012: LIFE, ACCIDENTAL DEALTH & DISMEMBERMENT, DEPENDENT LIFE FOR EMPLOYEES OF CEMC 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-03-01 | 159 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-03-01 | 92 |
| Number of retired or separated participants receiving benefits | 2012-03-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2012-03-01 | 62 |
| Total of all active and inactive participants | 2012-03-01 | 154 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2012-03-01 | 0 |
| Total participants | 2012-03-01 | 154 |
| 2011: LIFE, ACCIDENTAL DEALTH & DISMEMBERMENT, DEPENDENT LIFE FOR EMPLOYEES OF CEMC 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-03-01 | 164 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-03-01 | 97 |
| Number of retired or separated participants receiving benefits | 2011-03-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2011-03-01 | 62 |
| Total of all active and inactive participants | 2011-03-01 | 159 |
| Total participants | 2011-03-01 | 159 |
| 2010: LIFE, ACCIDENTAL DEALTH & DISMEMBERMENT, DEPENDENT LIFE FOR EMPLOYEES OF CEMC 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-03-01 | 171 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-03-01 | 100 |
| Number of retired or separated participants receiving benefits | 2010-03-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2010-03-01 | 64 |
| Total of all active and inactive participants | 2010-03-01 | 164 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2010-03-01 | 0 |
| Total participants | 2010-03-01 | 164 |
| 2009: LIFE, ACCIDENTAL DEALTH & DISMEMBERMENT, DEPENDENT LIFE FOR EMPLOYEES OF CEMC 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-03-01 | 175 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-03-01 | 103 |
| Number of retired or separated participants receiving benefits | 2009-03-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2009-03-01 | 68 |
| Total of all active and inactive participants | 2009-03-01 | 171 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2009-03-01 | 1 |
| Total participants | 2009-03-01 | 172 |
| 2021: LIFE, ACCIDENTAL DEALTH & DISMEMBERMENT, DEPENDENT LIFE FOR EMPLOYEES OF CEMC 2021 form 5500 responses |
|---|
| 2021-03-01 | Type of plan entity | Single employer plan |
| 2021-03-01 | Submission has been amended | No |
| 2021-03-01 | This submission is the final filing | Yes |
| 2021-03-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2021-03-01 | Plan is a collectively bargained plan | No |
| 2021-03-01 | Plan funding arrangement – Insurance | Yes |
| 2021-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2020: LIFE, ACCIDENTAL DEALTH & DISMEMBERMENT, DEPENDENT LIFE FOR EMPLOYEES OF CEMC 2020 form 5500 responses |
|---|
| 2020-03-01 | Type of plan entity | Single employer plan |
| 2020-03-01 | Submission has been amended | No |
| 2020-03-01 | This submission is the final filing | No |
| 2020-03-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2020-03-01 | Plan is a collectively bargained plan | No |
| 2020-03-01 | Plan funding arrangement – Insurance | Yes |
| 2020-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2019: LIFE, ACCIDENTAL DEALTH & DISMEMBERMENT, DEPENDENT LIFE FOR EMPLOYEES OF CEMC 2019 form 5500 responses |
|---|
| 2019-03-01 | Type of plan entity | Single employer plan |
| 2019-03-01 | Submission has been amended | No |
| 2019-03-01 | This submission is the final filing | No |
| 2019-03-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2019-03-01 | Plan is a collectively bargained plan | No |
| 2019-03-01 | Plan funding arrangement – Insurance | Yes |
| 2019-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: LIFE, ACCIDENTAL DEALTH & DISMEMBERMENT, DEPENDENT LIFE FOR EMPLOYEES OF CEMC 2018 form 5500 responses |
|---|
| 2018-03-01 | Type of plan entity | Single employer plan |
| 2018-03-01 | Submission has been amended | No |
| 2018-03-01 | This submission is the final filing | No |
| 2018-03-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2018-03-01 | Plan is a collectively bargained plan | No |
| 2018-03-01 | Plan funding arrangement – Insurance | Yes |
| 2018-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: LIFE, ACCIDENTAL DEALTH & DISMEMBERMENT, DEPENDENT LIFE FOR EMPLOYEES OF CEMC 2017 form 5500 responses |
|---|
| 2017-03-01 | Type of plan entity | Single employer plan |
| 2017-03-01 | Submission has been amended | No |
| 2017-03-01 | This submission is the final filing | No |
| 2017-03-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2017-03-01 | Plan is a collectively bargained plan | No |
| 2017-03-01 | Plan funding arrangement – Insurance | Yes |
| 2017-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: LIFE, ACCIDENTAL DEALTH & DISMEMBERMENT, DEPENDENT LIFE FOR EMPLOYEES OF CEMC 2016 form 5500 responses |
|---|
| 2016-03-01 | Type of plan entity | Single employer plan |
| 2016-03-01 | Submission has been amended | No |
| 2016-03-01 | This submission is the final filing | No |
| 2016-03-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-03-01 | Plan is a collectively bargained plan | No |
| 2016-03-01 | Plan funding arrangement – Insurance | Yes |
| 2016-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: LIFE, ACCIDENTAL DEALTH & DISMEMBERMENT, DEPENDENT LIFE FOR EMPLOYEES OF CEMC 2015 form 5500 responses |
|---|
| 2015-03-01 | Type of plan entity | Single employer plan |
| 2015-03-01 | Submission has been amended | No |
| 2015-03-01 | This submission is the final filing | No |
| 2015-03-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-03-01 | Plan is a collectively bargained plan | No |
| 2015-03-01 | Plan funding arrangement – Insurance | Yes |
| 2015-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: LIFE, ACCIDENTAL DEALTH & DISMEMBERMENT, DEPENDENT LIFE FOR EMPLOYEES OF CEMC 2014 form 5500 responses |
|---|
| 2014-03-01 | Type of plan entity | Single employer plan |
| 2014-03-01 | Submission has been amended | No |
| 2014-03-01 | This submission is the final filing | No |
| 2014-03-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2014-03-01 | Plan is a collectively bargained plan | No |
| 2014-03-01 | Plan funding arrangement – Insurance | Yes |
| 2014-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: LIFE, ACCIDENTAL DEALTH & DISMEMBERMENT, DEPENDENT LIFE FOR EMPLOYEES OF CEMC 2013 form 5500 responses |
|---|
| 2013-01-01 | Type of plan entity | Single employer plan |
| 2013-01-01 | Submission has been amended | No |
| 2013-01-01 | This submission is the final filing | No |
| 2013-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2013-01-01 | Plan is a collectively bargained plan | No |
| 2013-01-01 | Plan funding arrangement – Insurance | Yes |
| 2013-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: LIFE, ACCIDENTAL DEALTH & DISMEMBERMENT, DEPENDENT LIFE FOR EMPLOYEES OF CEMC 2012 form 5500 responses |
|---|
| 2012-03-01 | Type of plan entity | Single employer plan |
| 2012-03-01 | Submission has been amended | No |
| 2012-03-01 | This submission is the final filing | No |
| 2012-03-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2012-03-01 | Plan is a collectively bargained plan | No |
| 2012-03-01 | Plan funding arrangement – Insurance | Yes |
| 2012-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: LIFE, ACCIDENTAL DEALTH & DISMEMBERMENT, DEPENDENT LIFE FOR EMPLOYEES OF CEMC 2011 form 5500 responses |
|---|
| 2011-03-01 | Type of plan entity | Single employer plan |
| 2011-03-01 | Submission has been amended | No |
| 2011-03-01 | This submission is the final filing | No |
| 2011-03-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2011-03-01 | Plan is a collectively bargained plan | No |
| 2011-03-01 | Plan funding arrangement – Insurance | Yes |
| 2011-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2010: LIFE, ACCIDENTAL DEALTH & DISMEMBERMENT, DEPENDENT LIFE FOR EMPLOYEES OF CEMC 2010 form 5500 responses |
|---|
| 2010-03-01 | Type of plan entity | Single employer plan |
| 2010-03-01 | Submission has been amended | No |
| 2010-03-01 | This submission is the final filing | No |
| 2010-03-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2010-03-01 | Plan is a collectively bargained plan | No |
| 2010-03-01 | Plan funding arrangement – Insurance | Yes |
| 2010-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: LIFE, ACCIDENTAL DEALTH & DISMEMBERMENT, DEPENDENT LIFE FOR EMPLOYEES OF CEMC 2009 form 5500 responses |
|---|
| 2009-03-01 | Type of plan entity | Single employer plan |
| 2009-03-01 | Submission has been amended | No |
| 2009-03-01 | This submission is the final filing | No |
| 2009-03-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2009-03-01 | Plan is a collectively bargained plan | No |
| 2009-03-01 | Plan funding arrangement – Insurance | Yes |
| 2009-03-01 | Plan benefit arrangement – Insurance | Yes |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 271718 |
| Policy instance | 1 |
| Insurance contract or identification number | 271718 | | Number of Individuals Covered | 88 | | Insurance policy start date | 2021-03-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $1,116 | | Total amount of fees paid to insurance company | USD $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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | AD&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 Carrier | USD $37,708 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $943 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | N/A | | Insurance broker organization code? | 3 |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | G271718 |
| Policy instance | 1 |
| Insurance contract or identification number | G271718 | | Number of Individuals Covered | 92 | | Insurance policy start date | 2020-03-01 | | Insurance policy end date | 2021-02-28 | | Total amount of commissions paid to insurance broker | USD $1,322 | | Total amount of fees paid to insurance company | USD $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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $49,117 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,322 | | Insurance broker organization code? | 3 |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | G271718 |
| Policy instance | 1 |
| Insurance contract or identification number | G271718 | | Number of Individuals Covered | 100 | | Insurance policy start date | 2019-03-01 | | Insurance policy end date | 2020-02-29 | | Total amount of commissions paid to insurance broker | USD $1,326 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $49,312 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,326 | | Insurance broker organization code? | 3 |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | G271718 |
| Policy instance | 1 |
| Insurance contract or identification number | G271718 | | Number of Individuals Covered | 116 | | Insurance policy start date | 2017-03-01 | | Insurance policy end date | 2018-02-28 | | Total amount of commissions paid to insurance broker | USD $1,415 | | Total amount of fees paid to insurance company | USD $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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $54,992 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,415 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 | | Insurance broker name | JEFF M CATES |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | G271718 |
| Policy instance | 1 |
| Insurance contract or identification number | G271718 | | Number of Individuals Covered | 126 | | Insurance policy start date | 2015-03-01 | | Insurance policy end date | 2016-02-29 | | Total amount of commissions paid to insurance broker | USD $1,401 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $54,095 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,401 | | Insurance broker organization code? | 3 | | Insurance broker name | JEFF M. CATES |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | G271718 |
| Policy instance | 1 |
| Insurance contract or identification number | G271718 | | Number of Individuals Covered | 143 | | Insurance policy start date | 2014-03-01 | | Insurance policy end date | 2015-02-28 | | Total amount of commissions paid to insurance broker | USD $1,498 | | Total amount of fees paid to insurance company | USD $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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $60,556 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,498 | | Insurance broker organization code? | 3 | | Insurance broker name | JEFF M. CATES |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | G271718 |
| Policy instance | 1 |
| Insurance contract or identification number | G271718 | | Number of Individuals Covered | 142 | | Insurance policy start date | 2013-03-01 | | Insurance policy end date | 2014-04-28 | | Total amount of commissions paid to insurance broker | USD $1,457 | | Total amount of fees paid to insurance company | USD $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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $62,416 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $-69 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 0 | | Insurance broker name | JEFF M. CATES |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | G271718 |
| Policy instance | 1 |
| Insurance contract or identification number | G271718 | | Number of Individuals Covered | 154 | | Insurance policy start date | 2012-03-01 | | Insurance policy end date | 2013-02-28 | | Total amount of commissions paid to insurance broker | USD $1,754 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $66,955 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,594 | | Insurance broker organization code? | 3 | | Insurance broker name | EARL B. TALLY |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | G271718 |
| Policy instance | 1 |
| Insurance contract or identification number | G271718 | | Number of Individuals Covered | 159 | | Insurance policy start date | 2011-03-01 | | Insurance policy end date | 2012-02-29 | | Total amount of commissions paid to insurance broker | USD $1,761 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $67,410 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | G271718 |
| Policy instance | 1 |
| Insurance contract or identification number | G271718 | | Number of Individuals Covered | 164 | | Insurance policy start date | 2010-03-01 | | Insurance policy end date | 2011-02-28 | | Total amount of commissions paid to insurance broker | USD $1,702 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $63,840 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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