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WELFARE BENEFIT PLAN OF COOPER/T. SMITH CORPORATION AND AFFILIATES 401k Plan overview

Plan NameWELFARE BENEFIT PLAN OF COOPER/T. SMITH CORPORATION AND AFFILIATES
Plan identification number 501

WELFARE BENEFIT PLAN OF COOPER/T. SMITH CORPORATION AND AFFILIATES Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Long-term disability cover

401k Sponsoring company profile

COOPER/T. SMITH CORPORATION has sponsored the creation of one or more 401k plans.

Company Name:COOPER/T. SMITH CORPORATION
Employer identification number (EIN):720895443
NAIC Classification:488300
NAIC Description: Support Activities for Water Transportation

Additional information about COOPER/T. SMITH CORPORATION

Jurisdiction of Incorporation: Virginia Secretary of State
Incorporation Date: 1999-05-19
Company Identification Number: F138082
Legal Registered Office Address: 4701 Cox Rd Ste 285

Glen Allen
United States of America (USA)
23060-6808

More information about COOPER/T. SMITH CORPORATION

Form 5500 Filing Information

Submission information for form 5500 for 401k plan WELFARE BENEFIT PLAN OF COOPER/T. SMITH CORPORATION AND AFFILIATES

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012021-01-01
5012020-01-01
5012019-01-01
5012018-01-01
5012017-01-01NICHOLAS VILLACAMPA NICHOLAS VILLACAMPA2018-10-09
5012016-01-01NICHOLAS VILLACAMPA NICHOLAS VILLACAMPA2017-09-25
5012015-01-01NICHOLAS VILLACAMPA NICHOLAS VILLACAMPA2016-09-16
5012014-01-01NICHOLAS VILLACAMPA NICHOLAS VILLACAMPA2015-08-27
5012013-01-01NICHOLAS VILLACAMPA
5012012-01-01NICHOLAS VILLACAMPA NICHOLAS VILLACAMPA2013-10-04
5012011-01-01NICHOLAS VILLACAMPA
5012009-01-01CARLA MORGAN

Plan Statistics for WELFARE BENEFIT PLAN OF COOPER/T. SMITH CORPORATION AND AFFILIATES

401k plan membership statisitcs for WELFARE BENEFIT PLAN OF COOPER/T. SMITH CORPORATION AND AFFILIATES

Measure Date Value
2021: WELFARE BENEFIT PLAN OF COOPER/T. SMITH CORPORATION AND AFFILIATES 2021 401k membership
Total participants, beginning-of-year2021-01-01710
Total number of active participants reported on line 7a of the Form 55002021-01-01705
Total of all active and inactive participants2021-01-01705
Total participants2021-01-01705
2020: WELFARE BENEFIT PLAN OF COOPER/T. SMITH CORPORATION AND AFFILIATES 2020 401k membership
Total participants, beginning-of-year2020-01-01702
Total number of active participants reported on line 7a of the Form 55002020-01-01710
Total of all active and inactive participants2020-01-01710
Total participants2020-01-01710
2019: WELFARE BENEFIT PLAN OF COOPER/T. SMITH CORPORATION AND AFFILIATES 2019 401k membership
Total participants, beginning-of-year2019-01-01672
Total number of active participants reported on line 7a of the Form 55002019-01-01702
Total of all active and inactive participants2019-01-01702
Total participants2019-01-01702
2018: WELFARE BENEFIT PLAN OF COOPER/T. SMITH CORPORATION AND AFFILIATES 2018 401k membership
Total participants, beginning-of-year2018-01-01710
Total number of active participants reported on line 7a of the Form 55002018-01-01672
Total of all active and inactive participants2018-01-01672
Total participants2018-01-01672
2017: WELFARE BENEFIT PLAN OF COOPER/T. SMITH CORPORATION AND AFFILIATES 2017 401k membership
Total participants, beginning-of-year2017-01-01719
Total number of active participants reported on line 7a of the Form 55002017-01-01710
Total of all active and inactive participants2017-01-01710
Total participants2017-01-01710
2016: WELFARE BENEFIT PLAN OF COOPER/T. SMITH CORPORATION AND AFFILIATES 2016 401k membership
Total participants, beginning-of-year2016-01-01732
Total number of active participants reported on line 7a of the Form 55002016-01-01719
Total of all active and inactive participants2016-01-01719
Total participants2016-01-01719
2015: WELFARE BENEFIT PLAN OF COOPER/T. SMITH CORPORATION AND AFFILIATES 2015 401k membership
Total participants, beginning-of-year2015-01-01688
Total number of active participants reported on line 7a of the Form 55002015-01-01732
Total of all active and inactive participants2015-01-01732
Total participants2015-01-01732
2014: WELFARE BENEFIT PLAN OF COOPER/T. SMITH CORPORATION AND AFFILIATES 2014 401k membership
Total participants, beginning-of-year2014-01-01654
Total number of active participants reported on line 7a of the Form 55002014-01-01688
Total of all active and inactive participants2014-01-01688
Total participants2014-01-01688
2013: WELFARE BENEFIT PLAN OF COOPER/T. SMITH CORPORATION AND AFFILIATES 2013 401k membership
Total participants, beginning-of-year2013-01-01499
Total number of active participants reported on line 7a of the Form 55002013-01-01654
Total of all active and inactive participants2013-01-01654
Total participants2013-01-01654
2012: WELFARE BENEFIT PLAN OF COOPER/T. SMITH CORPORATION AND AFFILIATES 2012 401k membership
Total participants, beginning-of-year2012-01-01496
Total number of active participants reported on line 7a of the Form 55002012-01-01499
Total of all active and inactive participants2012-01-01499
Total participants2012-01-01499
2011: WELFARE BENEFIT PLAN OF COOPER/T. SMITH CORPORATION AND AFFILIATES 2011 401k membership
Total participants, beginning-of-year2011-01-01486
Total number of active participants reported on line 7a of the Form 55002011-01-01496
Total of all active and inactive participants2011-01-01496
Total participants2011-01-01496
2009: WELFARE BENEFIT PLAN OF COOPER/T. SMITH CORPORATION AND AFFILIATES 2009 401k membership
Total participants, beginning-of-year2009-01-01549
Total number of active participants reported on line 7a of the Form 55002009-01-01483
Total of all active and inactive participants2009-01-01483
Total participants2009-01-01483

Form 5500 Responses for WELFARE BENEFIT PLAN OF COOPER/T. SMITH CORPORATION AND AFFILIATES

2021: WELFARE BENEFIT PLAN OF COOPER/T. SMITH CORPORATION AND AFFILIATES 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – InsuranceYes
2020: WELFARE BENEFIT PLAN OF COOPER/T. SMITH CORPORATION AND AFFILIATES 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – InsuranceYes
2019: WELFARE BENEFIT PLAN OF COOPER/T. SMITH CORPORATION AND AFFILIATES 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: WELFARE BENEFIT PLAN OF COOPER/T. SMITH CORPORATION AND AFFILIATES 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: WELFARE BENEFIT PLAN OF COOPER/T. SMITH CORPORATION AND AFFILIATES 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: WELFARE BENEFIT PLAN OF COOPER/T. SMITH CORPORATION AND AFFILIATES 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: WELFARE BENEFIT PLAN OF COOPER/T. SMITH CORPORATION AND AFFILIATES 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: WELFARE BENEFIT PLAN OF COOPER/T. SMITH CORPORATION AND AFFILIATES 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: WELFARE BENEFIT PLAN OF COOPER/T. SMITH CORPORATION AND AFFILIATES 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: WELFARE BENEFIT PLAN OF COOPER/T. SMITH CORPORATION AND AFFILIATES 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: WELFARE BENEFIT PLAN OF COOPER/T. SMITH CORPORATION AND AFFILIATES 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2009: WELFARE BENEFIT PLAN OF COOPER/T. SMITH CORPORATION AND AFFILIATES 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5934785
Policy instance 1
Insurance contract or identification number5934785
Number of Individuals Covered705
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $28,415
Total amount of fees paid to insurance companyUSD $8,191
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $471,594
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees8163
Additional information about fees paid to insurance brokerSALES AND SERVICE COMPENSATION
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5934785
Policy instance 1
Insurance contract or identification number5934785
Number of Individuals Covered710
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $32,898
Total amount of fees paid to insurance companyUSD $8,234
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $460,781
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $25,809
Amount paid for insurance broker fees31
Additional information about fees paid to insurance brokerSALES AND SERVICE COMPENSATION
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5934785
Policy instance 1
Insurance contract or identification number5934785
Number of Individuals Covered702
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $39,918
Total amount of fees paid to insurance companyUSD $5,131
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $400,015
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $39,918
Amount paid for insurance broker fees5131
Additional information about fees paid to insurance brokerSALES AND SERVICE COMPENSATION
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberTM05934785
Policy instance 1
Insurance contract or identification numberTM05934785
Number of Individuals Covered672
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $41,647
Total amount of fees paid to insurance companyUSD $6,542
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $380,652
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $41,647
Amount paid for insurance broker fees6542
Additional information about fees paid to insurance brokerSALES AND SERVICE COMPENSATION
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5934785
Policy instance 1
Insurance contract or identification number5934785
Number of Individuals Covered710
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $37,781
Total amount of fees paid to insurance companyUSD $6,896
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $380,690
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $37,781
Amount paid for insurance broker fees6896
Additional information about fees paid to insurance brokerSALES AND SERVICE COMPENSATION
Insurance broker organization code?3
Insurance broker nameWILLIS OF ALABAMA
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010168046
Policy instance 1
Insurance contract or identification number000010168046
Number of Individuals Covered729
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $39,898
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $398,982
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $39,898
Additional information about fees paid to insurance brokerSALES AND SERVICE COMPENSATION
Insurance broker organization code?3
Insurance broker nameWILLIS OF ALABAMA, INC.
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010168046
Policy instance 1
Insurance contract or identification number000010168046
Number of Individuals Covered658
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $37,138
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $371,378
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $37,138
Additional information about fees paid to insurance brokerSALES AND SERVICE COMPENSATION
Insurance broker organization code?3
Insurance broker nameWILLIS OF ALABAMA, INC.
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010168046
Policy instance 1
Insurance contract or identification number000010168046
Number of Individuals Covered631
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $32,211
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $322,108
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $32,211
Additional information about fees paid to insurance brokerSALES AND SERVICE COMPENSATION
Insurance broker organization code?3
Insurance broker nameWILLIS OF ALABAMA, INC.
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number05863
Policy instance 1
Insurance contract or identification number05863
Number of Individuals Covered475
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $29,001
Total amount of fees paid to insurance companyUSD $167
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $290,014
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $29,001
Additional information about fees paid to insurance brokerSALES AND SERVICE COMPENSATION
Insurance broker organization code?3
Amount paid for insurance broker fees167
Insurance broker nameAXA ASSISTANCE, USA
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number05863
Policy instance 1
Insurance contract or identification number05863
Number of Individuals Covered458
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $28,258
Total amount of fees paid to insurance companyUSD $162
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $282,577
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 number05863
Policy instance 1
Insurance contract or identification number05863
Number of Individuals Covered446
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $27,447
Total amount of fees paid to insurance companyUSD $145
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $274,473
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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