GENERAL HEALTH SYSTEM has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan GROUP LIFE AND AD&D INSURANCE FOR EMPLOYEES OF GENERAL HEALTH SYSTEM
401k plan membership statisitcs for GROUP LIFE AND AD&D INSURANCE FOR EMPLOYEES OF GENERAL HEALTH SYSTEM
| Measure | Date | Value |
|---|
| 2022: GROUP LIFE AND AD&D INSURANCE FOR EMPLOYEES OF GENERAL HEALTH SYSTEM 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-01-01 | 1,905 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 1,953 |
| Total of all active and inactive participants | 2022-01-01 | 1,953 |
| Total participants | 2022-01-01 | 1,953 |
| 2021: GROUP LIFE AND AD&D INSURANCE FOR EMPLOYEES OF GENERAL HEALTH SYSTEM 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-01-01 | 1,820 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 1,905 |
| Total of all active and inactive participants | 2021-01-01 | 1,905 |
| Total participants | 2021-01-01 | 1,905 |
| 2020: GROUP LIFE AND AD&D INSURANCE FOR EMPLOYEES OF GENERAL HEALTH SYSTEM 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-01-01 | 1,957 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 1,820 |
| Total of all active and inactive participants | 2020-01-01 | 1,820 |
| Total participants | 2020-01-01 | 1,820 |
| 2019: GROUP LIFE AND AD&D INSURANCE FOR EMPLOYEES OF GENERAL HEALTH SYSTEM 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-01-01 | 2,063 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 1,957 |
| Total of all active and inactive participants | 2019-01-01 | 1,957 |
| Total participants | 2019-01-01 | 1,957 |
| 2018: GROUP LIFE AND AD&D INSURANCE FOR EMPLOYEES OF GENERAL HEALTH SYSTEM 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-01-01 | 1,987 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 2,063 |
| Total of all active and inactive participants | 2018-01-01 | 2,063 |
| Total participants | 2018-01-01 | 2,063 |
| 2017: GROUP LIFE AND AD&D INSURANCE FOR EMPLOYEES OF GENERAL HEALTH SYSTEM 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-01-01 | 1,958 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 1,987 |
| Total of all active and inactive participants | 2017-01-01 | 1,987 |
| Total participants | 2017-01-01 | 1,987 |
| 2016: GROUP LIFE AND AD&D INSURANCE FOR EMPLOYEES OF GENERAL HEALTH SYSTEM 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-01-01 | 2,072 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 1,958 |
| Total of all active and inactive participants | 2016-01-01 | 1,958 |
| Total participants | 2016-01-01 | 1,958 |
| 2015: GROUP LIFE AND AD&D INSURANCE FOR EMPLOYEES OF GENERAL HEALTH SYSTEM 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-01-01 | 2,229 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 2,072 |
| Total of all active and inactive participants | 2015-01-01 | 2,072 |
| Total participants | 2015-01-01 | 2,072 |
| 2014: GROUP LIFE AND AD&D INSURANCE FOR EMPLOYEES OF GENERAL HEALTH SYSTEM 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-01-01 | 2,187 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 2,229 |
| Total of all active and inactive participants | 2014-01-01 | 2,229 |
| Total participants | 2014-01-01 | 2,229 |
| 2013: GROUP LIFE AND AD&D INSURANCE FOR EMPLOYEES OF GENERAL HEALTH SYSTEM 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-01-01 | 1,834 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 2,187 |
| Total of all active and inactive participants | 2013-01-01 | 2,187 |
| Total participants | 2013-01-01 | 2,187 |
| 2012: GROUP LIFE AND AD&D INSURANCE FOR EMPLOYEES OF GENERAL HEALTH SYSTEM 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-01-01 | 2,054 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 1,834 |
| Total of all active and inactive participants | 2012-01-01 | 1,834 |
| Total participants | 2012-01-01 | 1,834 |
| 2011: GROUP LIFE AND AD&D INSURANCE FOR EMPLOYEES OF GENERAL HEALTH SYSTEM 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-01-01 | 1,758 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 2,054 |
| Total of all active and inactive participants | 2011-01-01 | 2,054 |
| Total participants | 2011-01-01 | 2,054 |
| 2009: GROUP LIFE AND AD&D INSURANCE FOR EMPLOYEES OF GENERAL HEALTH SYSTEM 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-01-01 | 2,065 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 1,867 |
| Total of all active and inactive participants | 2009-01-01 | 1,867 |
| Total participants | 2009-01-01 | 1,867 |
| 2022: GROUP LIFE AND AD&D INSURANCE FOR EMPLOYEES OF GENERAL HEALTH SYSTEM 2022 form 5500 responses |
|---|
| 2022-01-01 | Type of plan entity | Single employer plan |
| 2022-01-01 | Submission has been amended | No |
| 2022-01-01 | This submission is the final filing | Yes |
| 2022-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2022-01-01 | Plan is a collectively bargained plan | No |
| 2022-01-01 | Plan funding arrangement – Insurance | Yes |
| 2022-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2021: GROUP LIFE AND AD&D INSURANCE FOR EMPLOYEES OF GENERAL HEALTH SYSTEM 2021 form 5500 responses |
|---|
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | Submission has been amended | No |
| 2021-01-01 | This submission is the final filing | No |
| 2021-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2021-01-01 | Plan is a collectively bargained plan | No |
| 2021-01-01 | Plan funding arrangement – Insurance | Yes |
| 2021-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2020: GROUP LIFE AND AD&D INSURANCE FOR EMPLOYEES OF GENERAL HEALTH SYSTEM 2020 form 5500 responses |
|---|
| 2020-01-01 | Type of plan entity | Single employer plan |
| 2020-01-01 | Submission has been amended | No |
| 2020-01-01 | This submission is the final filing | No |
| 2020-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2020-01-01 | Plan is a collectively bargained plan | No |
| 2020-01-01 | Plan funding arrangement – Insurance | Yes |
| 2020-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2019: GROUP LIFE AND AD&D INSURANCE FOR EMPLOYEES OF GENERAL HEALTH SYSTEM 2019 form 5500 responses |
|---|
| 2019-01-01 | Type of plan entity | Single employer plan |
| 2019-01-01 | Submission has been amended | No |
| 2019-01-01 | This submission is the final filing | No |
| 2019-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2019-01-01 | Plan is a collectively bargained plan | No |
| 2019-01-01 | Plan funding arrangement – Insurance | Yes |
| 2019-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: GROUP LIFE AND AD&D INSURANCE FOR EMPLOYEES OF GENERAL HEALTH SYSTEM 2018 form 5500 responses |
|---|
| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | Submission has been amended | No |
| 2018-01-01 | This submission is the final filing | No |
| 2018-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2018-01-01 | Plan is a collectively bargained plan | No |
| 2018-01-01 | Plan funding arrangement – Insurance | Yes |
| 2018-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: GROUP LIFE AND AD&D INSURANCE FOR EMPLOYEES OF GENERAL HEALTH SYSTEM 2017 form 5500 responses |
|---|
| 2017-01-01 | Type of plan entity | Single employer plan |
| 2017-01-01 | Submission has been amended | No |
| 2017-01-01 | This submission is the final filing | No |
| 2017-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2017-01-01 | Plan is a collectively bargained plan | No |
| 2017-01-01 | Plan funding arrangement – Insurance | Yes |
| 2017-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: GROUP LIFE AND AD&D INSURANCE FOR EMPLOYEES OF GENERAL HEALTH SYSTEM 2016 form 5500 responses |
|---|
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | Submission has been amended | No |
| 2016-01-01 | This submission is the final filing | No |
| 2016-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-01-01 | Plan is a collectively bargained plan | No |
| 2016-01-01 | Plan funding arrangement – Insurance | Yes |
| 2016-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: GROUP LIFE AND AD&D INSURANCE FOR EMPLOYEES OF GENERAL HEALTH SYSTEM 2015 form 5500 responses |
|---|
| 2015-01-01 | Type of plan entity | Single employer plan |
| 2015-01-01 | Submission has been amended | No |
| 2015-01-01 | This submission is the final filing | No |
| 2015-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-01-01 | Plan is a collectively bargained plan | No |
| 2015-01-01 | Plan funding arrangement – Insurance | Yes |
| 2015-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: GROUP LIFE AND AD&D INSURANCE FOR EMPLOYEES OF GENERAL HEALTH SYSTEM 2014 form 5500 responses |
|---|
| 2014-01-01 | Type of plan entity | Single employer plan |
| 2014-01-01 | Submission has been amended | No |
| 2014-01-01 | This submission is the final filing | No |
| 2014-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2014-01-01 | Plan is a collectively bargained plan | No |
| 2014-01-01 | Plan funding arrangement – Insurance | Yes |
| 2014-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: GROUP LIFE AND AD&D INSURANCE FOR EMPLOYEES OF GENERAL HEALTH SYSTEM 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: GROUP LIFE AND AD&D INSURANCE FOR EMPLOYEES OF GENERAL HEALTH SYSTEM 2012 form 5500 responses |
|---|
| 2012-01-01 | Type of plan entity | Single employer plan |
| 2012-01-01 | Submission has been amended | No |
| 2012-01-01 | This submission is the final filing | No |
| 2012-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2012-01-01 | Plan is a collectively bargained plan | No |
| 2012-01-01 | Plan funding arrangement – Insurance | Yes |
| 2012-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: GROUP LIFE AND AD&D INSURANCE FOR EMPLOYEES OF GENERAL HEALTH SYSTEM 2011 form 5500 responses |
|---|
| 2011-01-01 | Type of plan entity | Single employer plan |
| 2011-01-01 | Submission has been amended | No |
| 2011-01-01 | This submission is the final filing | No |
| 2011-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2011-01-01 | Plan is a collectively bargained plan | No |
| 2011-01-01 | Plan funding arrangement – Insurance | Yes |
| 2011-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: GROUP LIFE AND AD&D INSURANCE FOR EMPLOYEES OF GENERAL HEALTH SYSTEM 2009 form 5500 responses |
|---|
| 2009-01-01 | Type of plan entity | Single employer plan |
| 2009-01-01 | Submission has been amended | No |
| 2009-01-01 | This submission is the final filing | No |
| 2009-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2009-01-01 | Plan is a collectively bargained plan | No |
| 2009-01-01 | Plan funding arrangement – Insurance | Yes |
| 2009-01-01 | Plan benefit arrangement – Insurance | Yes |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 52946 |
| Policy instance | 1 |
| Insurance contract or identification number | 52946 | | Number of Individuals Covered | 1953 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $19,075 | | 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 $176,261 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $19,075 | | Insurance broker organization code? | 3 |
|
| ZURICH AMERICAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 90537 ) |
| Policy contract number | GLD0000024 |
| Policy instance | 2 |
| Insurance contract or identification number | GLD0000024 | | Number of Individuals Covered | 2467 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | 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 | Yes | | 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 $0 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 52946 |
| Policy instance | 1 |
| Insurance contract or identification number | 52946 | | Number of Individuals Covered | 1905 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $39,137 | | 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 $782,742 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $39,137 | | Insurance broker organization code? | 3 |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 52946 |
| Policy instance | 1 |
| Insurance contract or identification number | 52946 | | Number of Individuals Covered | 1820 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $31,786 | | 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 $498,710 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $31,786 | | Insurance broker organization code? | 3 |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 52946 |
| Policy instance | 1 |
| Insurance contract or identification number | 52946 | | Number of Individuals Covered | 1957 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $62,696 | | 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 $676,512 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $62,696 | | Insurance broker organization code? | 3 |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 52946 |
| Policy instance | 1 |
| Insurance contract or identification number | 52946 | | Number of Individuals Covered | 2063 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $33,843 | | 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 $676,859 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $33,843 | | Insurance broker organization code? | 3 |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | OK 966642 |
| Policy instance | 1 |
| Insurance contract or identification number | OK 966642 | | Number of Individuals Covered | 1987 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $1,231 | | Total amount of fees paid to insurance company | USD $428 | | 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 $24,629 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,231 | | Amount paid for insurance broker fees | 428 | | Additional information about fees paid to insurance broker | OVERRIDE | | Insurance broker organization code? | 3 | | Insurance broker name | BANCORPSOUTH INSURANCE SERVICES INC |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | FLX965041 |
| Policy instance | 2 |
| Insurance contract or identification number | FLX965041 | | Number of Individuals Covered | 1987 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $28,698 | | Total amount of fees paid to insurance company | USD $9,735 | | 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 $580,160 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $28,698 | | Amount paid for insurance broker fees | 9735 | | Additional information about fees paid to insurance broker | OVERRIDE | | Insurance broker organization code? | 3 | | Insurance broker name | BANCORPSOUTH INSURANCE SERVICES INC |
|
