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FIRST FEDERAL SAVINGS BANK GROUP BENEFIT PLAN 401k Plan overview

Plan NameFIRST FEDERAL SAVINGS BANK GROUP BENEFIT PLAN
Plan identification number 502

FIRST FEDERAL SAVINGS BANK GROUP BENEFIT PLAN Benefits

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

401k Sponsoring company profile

FIRST FEDERAL SAVINGS BANK OF TWIN FALLS has sponsored the creation of one or more 401k plans.

Company Name:FIRST FEDERAL SAVINGS BANK OF TWIN FALLS
Employer identification number (EIN):820172244
NAIC Classification:522110
NAIC Description:Commercial Banking

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FIRST FEDERAL SAVINGS BANK GROUP BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022022-01-01
5022021-01-01
5022020-01-01
5022019-01-01
5022018-01-01
5022017-01-01JAY DODDS
5022016-01-01JAY DODDS
5022015-01-01JAY DODDS
5022014-01-01JAY DODDS
5022013-01-01JAY DODDS
5022012-01-01JAY DODDS JAY DODDS2016-06-29
5022011-01-01JAY DODDS
5022010-01-01JAY DODDS
5022009-01-01JAY DODDS
5022008-01-01JAY DODDS
5022007-01-01JAY DODDS
5022006-01-01JAY DODDS
5022005-01-01JAY DODDS

Plan Statistics for FIRST FEDERAL SAVINGS BANK GROUP BENEFIT PLAN

401k plan membership statisitcs for FIRST FEDERAL SAVINGS BANK GROUP BENEFIT PLAN

Measure Date Value
2022: FIRST FEDERAL SAVINGS BANK GROUP BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01262
Total number of active participants reported on line 7a of the Form 55002022-01-01248
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-01248
2021: FIRST FEDERAL SAVINGS BANK GROUP BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01250
Total number of active participants reported on line 7a of the Form 55002021-01-01262
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-01262
2020: FIRST FEDERAL SAVINGS BANK GROUP BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01248
Total number of active participants reported on line 7a of the Form 55002020-01-01247
Number of retired or separated participants receiving benefits2020-01-013
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-01250
2019: FIRST FEDERAL SAVINGS BANK GROUP BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01206
Total number of active participants reported on line 7a of the Form 55002019-01-01240
Number of retired or separated participants receiving benefits2019-01-018
Total of all active and inactive participants2019-01-01248
2018: FIRST FEDERAL SAVINGS BANK GROUP BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01193
Total number of active participants reported on line 7a of the Form 55002018-01-01202
Number of retired or separated participants receiving benefits2018-01-014
Total of all active and inactive participants2018-01-01206
2017: FIRST FEDERAL SAVINGS BANK GROUP BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01205
Total number of active participants reported on line 7a of the Form 55002017-01-01198
Number of other retired or separated participants entitled to future benefits2017-01-011
Total of all active and inactive participants2017-01-01199
2016: FIRST FEDERAL SAVINGS BANK GROUP BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01188
Total number of active participants reported on line 7a of the Form 55002016-01-01192
Number of retired or separated participants receiving benefits2016-01-011
Total of all active and inactive participants2016-01-01193
2015: FIRST FEDERAL SAVINGS BANK GROUP BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01181
Total number of active participants reported on line 7a of the Form 55002015-01-01184
Number of retired or separated participants receiving benefits2015-01-013
Total of all active and inactive participants2015-01-01187
2014: FIRST FEDERAL SAVINGS BANK GROUP BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01194
Total number of active participants reported on line 7a of the Form 55002014-01-01199
Number of retired or separated participants receiving benefits2014-01-010
Total of all active and inactive participants2014-01-01199
2013: FIRST FEDERAL SAVINGS BANK GROUP BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01190
Total number of active participants reported on line 7a of the Form 55002013-01-01193
Number of retired or separated participants receiving benefits2013-01-011
Total of all active and inactive participants2013-01-01194
2012: FIRST FEDERAL SAVINGS BANK GROUP BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01185
Total number of active participants reported on line 7a of the Form 55002012-01-01189
Number of retired or separated participants receiving benefits2012-01-011
Total of all active and inactive participants2012-01-01190
2011: FIRST FEDERAL SAVINGS BANK GROUP BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01184
Total number of active participants reported on line 7a of the Form 55002011-01-01185
Total of all active and inactive participants2011-01-01185
2010: FIRST FEDERAL SAVINGS BANK GROUP BENEFIT PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-01190
Total number of active participants reported on line 7a of the Form 55002010-01-01181
Number of retired or separated participants receiving benefits2010-01-013
Total of all active and inactive participants2010-01-01184
2009: FIRST FEDERAL SAVINGS BANK GROUP BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01188
Total number of active participants reported on line 7a of the Form 55002009-01-01189
Number of retired or separated participants receiving benefits2009-01-011
Total of all active and inactive participants2009-01-01190
2008: FIRST FEDERAL SAVINGS BANK GROUP BENEFIT PLAN 2008 401k membership
Total participants, beginning-of-year2008-01-01175
Total number of active participants reported on line 7a of the Form 55002008-01-01186
Number of retired or separated participants receiving benefits2008-01-012
Total of all active and inactive participants2008-01-01188
2007: FIRST FEDERAL SAVINGS BANK GROUP BENEFIT PLAN 2007 401k membership
Total participants, beginning-of-year2007-01-01157
Total number of active participants reported on line 7a of the Form 55002007-01-01174
Number of retired or separated participants receiving benefits2007-01-011
Total of all active and inactive participants2007-01-01175
2006: FIRST FEDERAL SAVINGS BANK GROUP BENEFIT PLAN 2006 401k membership
Total participants, beginning-of-year2006-01-01151
Total number of active participants reported on line 7a of the Form 55002006-01-01155
Number of retired or separated participants receiving benefits2006-01-012
Total of all active and inactive participants2006-01-01157
2005: FIRST FEDERAL SAVINGS BANK GROUP BENEFIT PLAN 2005 401k membership
Total participants, beginning-of-year2005-01-01113
Total number of active participants reported on line 7a of the Form 55002005-01-01150
Number of retired or separated participants receiving benefits2005-01-011
Total of all active and inactive participants2005-01-01151

Form 5500 Responses for FIRST FEDERAL SAVINGS BANK GROUP BENEFIT PLAN

2022: FIRST FEDERAL SAVINGS BANK GROUP BENEFIT PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: FIRST FEDERAL SAVINGS BANK GROUP BENEFIT PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: FIRST FEDERAL SAVINGS BANK GROUP BENEFIT PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes
2019: FIRST FEDERAL SAVINGS BANK GROUP BENEFIT PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – General assets of the sponsorYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – General assets of the sponsorYes
2018: FIRST FEDERAL SAVINGS BANK GROUP BENEFIT PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – General assets of the sponsorYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – General assets of the sponsorYes
2017: FIRST FEDERAL SAVINGS BANK GROUP BENEFIT PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – General assets of the sponsorYes
2016: FIRST FEDERAL SAVINGS BANK GROUP BENEFIT PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – General assets of the sponsorYes
2015: FIRST FEDERAL SAVINGS BANK GROUP BENEFIT PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – General assets of the sponsorYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – General assets of the sponsorYes
2014: FIRST FEDERAL SAVINGS BANK GROUP BENEFIT PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – General assets of the sponsorYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – General assets of the sponsorYes
2013: FIRST FEDERAL SAVINGS BANK GROUP BENEFIT PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – General assets of the sponsorYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – General assets of the sponsorYes
2012: FIRST FEDERAL SAVINGS BANK GROUP BENEFIT PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – General assets of the sponsorYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – General assets of the sponsorYes
2011: FIRST FEDERAL SAVINGS BANK GROUP BENEFIT PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – General assets of the sponsorYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – General assets of the sponsorYes
2010: FIRST FEDERAL SAVINGS BANK GROUP BENEFIT PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan funding arrangement – General assets of the sponsorYes
2010-01-01Plan benefit arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – General assets of the sponsorYes
2009: FIRST FEDERAL SAVINGS BANK GROUP BENEFIT PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – General assets of the sponsorYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – General assets of the sponsorYes
2008: FIRST FEDERAL SAVINGS BANK GROUP BENEFIT PLAN 2008 form 5500 responses
2008-01-01Type of plan entitySingle employer plan
2008-01-01Plan funding arrangement – InsuranceYes
2008-01-01Plan funding arrangement – General assets of the sponsorYes
2008-01-01Plan benefit arrangement – InsuranceYes
2008-01-01Plan benefit arrangement – General assets of the sponsorYes
2007: FIRST FEDERAL SAVINGS BANK GROUP BENEFIT PLAN 2007 form 5500 responses
2007-01-01Type of plan entitySingle employer plan
2007-01-01Plan funding arrangement – InsuranceYes
2007-01-01Plan funding arrangement – General assets of the sponsorYes
2007-01-01Plan benefit arrangement – InsuranceYes
2007-01-01Plan benefit arrangement – General assets of the sponsorYes
2006: FIRST FEDERAL SAVINGS BANK GROUP BENEFIT PLAN 2006 form 5500 responses
2006-01-01Type of plan entitySingle employer plan
2006-01-01Plan funding arrangement – InsuranceYes
2006-01-01Plan funding arrangement – General assets of the sponsorYes
2006-01-01Plan benefit arrangement – InsuranceYes
2006-01-01Plan benefit arrangement – General assets of the sponsorYes
2005: FIRST FEDERAL SAVINGS BANK GROUP BENEFIT PLAN 2005 form 5500 responses
2005-01-01Type of plan entitySingle employer plan
2005-01-01First time form 5500 has been submittedYes
2005-01-01Plan funding arrangement – InsuranceYes
2005-01-01Plan funding arrangement – General assets of the sponsorYes
2005-01-01Plan benefit arrangement – InsuranceYes
2005-01-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

WILLAMETTE DENTAL OF IDAHO, INC. (National Association of Insurance Commissioners NAIC id number: 95819 )
Policy contract numberID516
Policy instance 3
Insurance contract or identification numberID516
Number of Individuals Covered94
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000B9N8
Policy instance 2
Insurance contract or identification numberG000B9N8
Number of Individuals Covered248
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $10,382
Total amount of fees paid to insurance companyUSD $5,086
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D, TERM-LIFE VOLUNTARY
Welfare Benefit Premiums Paid to CarrierUSD $75,070
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,382
Amount paid for insurance broker fees5086
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
LIFEMAP ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97985 )
Policy contract numberWBT000071
Policy instance 1
Insurance contract or identification numberWBT000071
Number of Individuals Covered187
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $2,579
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Other welfare benefits providedEAP
Welfare Benefit Premiums Paid to CarrierUSD $45,284
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,953
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000B9N8
Policy instance 2
Insurance contract or identification numberG000B9N8
Number of Individuals Covered262
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $10,044
Total amount of fees paid to insurance companyUSD $3,994
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D, TERM-LIFE VOLUNTARY
Welfare Benefit Premiums Paid to CarrierUSD $72,303
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,044
Amount paid for insurance broker fees3994
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
LIFEMAP ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97985 )
Policy contract numberWBT000071
Policy instance 1
Insurance contract or identification numberWBT000071
Number of Individuals Covered191
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $1,964
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $39,249
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,964
Insurance broker organization code?3
LIFEMAP ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97985 )
Policy contract numberWBT000071
Policy instance 1
Insurance contract or identification numberWBT000071
Number of Individuals Covered175
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $1,837
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $36,734
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,837
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000B9N8
Policy instance 2
Insurance contract or identification numberG000B9N8
Number of Individuals Covered250
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $9,172
Total amount of fees paid to insurance companyUSD $4,503
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D, TERM-LIFE VOLUNTARY
Welfare Benefit Premiums Paid to CarrierUSD $66,216
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,172
Amount paid for insurance broker fees4503
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000B9N8
Policy instance 2
Insurance contract or identification numberG000B9N8
Number of Individuals Covered239
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $9,033
Total amount of fees paid to insurance companyUSD $4,421
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D, TERM-LIFE VOLUNTARY
Welfare Benefit Premiums Paid to CarrierUSD $64,524
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,033
Amount paid for insurance broker fees4421
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
LIFEMAP ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97985 )
Policy contract numberWBT000071
Policy instance 1
Insurance contract or identification numberWBT000071
Number of Individuals Covered155
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $2,638
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Other welfare benefits providedTERM LIFE - VOLUNTARY
Welfare Benefit Premiums Paid to CarrierUSD $32,992
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,638
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000B9N8
Policy instance 2
Insurance contract or identification numberG000B9N8
Number of Individuals Covered232
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $8,518
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $60,276
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,518
Additional information about fees paid to insurance brokerAGENT OR BROKER OF RECORD
Insurance broker organization code?3
LIFEMAP ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97985 )
Policy contract numberWBT000071
Policy instance 1
Insurance contract or identification numberWBT000071
Number of Individuals Covered140
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $2,411
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Other welfare benefits providedTERM LIFE - VOLUNTARY
Welfare Benefit Premiums Paid to CarrierUSD $30,180
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,411
Insurance broker organization code?3
LIFEMAP ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97985 )
Policy contract numberWBT000071
Policy instance 1
Insurance contract or identification numberWBT000071
Number of Individuals Covered227
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $10,659
Total amount of fees paid to insurance companyUSD $795
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $86,217
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,889
Amount paid for insurance broker fees795
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
Insurance broker nameDALE QUIGLEY
LIFEMAP ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97985 )
Policy contract numberWBT000071
Policy instance 1
Insurance contract or identification numberWBT000071
Number of Individuals Covered216
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $8,000
Total amount of fees paid to insurance companyUSD $405
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $67,404
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,172
Amount paid for insurance broker fees405
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
Insurance broker nameDALE QUIGLEY
LIFEMAP ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97985 )
Policy contract numberWBT000071
Policy instance 1
Insurance contract or identification numberWBT000071
Number of Individuals Covered199
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $7,327
Total amount of fees paid to insurance companyUSD $1,747
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $60,656
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,677
Amount paid for insurance broker fees1747
Additional information about fees paid to insurance brokerINDIRECT COMPENSATION
Insurance broker organization code?3
Insurance broker nameDALE QUIGLEY
LIFEMAP ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97985 )
Policy contract numberWBT000071
Policy instance 2
Insurance contract or identification numberWBT000071
Number of Individuals Covered193
Insurance policy start date2013-11-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $1,100
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $9,076
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $557
Insurance broker organization code?3
Insurance broker nameHUB INTERNATIONAL MTN STATES LTD
LIFEMAP ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97985 )
Policy contract numberWBT000071
Policy instance 1
Insurance contract or identification numberWBT000071
Number of Individuals Covered194
Insurance policy start date2012-11-01
Insurance policy end date2013-10-31
Total amount of commissions paid to insurance brokerUSD $7,391
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $55,054
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,127
Insurance broker organization code?3
Insurance broker nameHUB INTERNATIONAL MTN STATES LTD
LIFEMAP ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97985 )
Policy contract numberWBT000071
Policy instance 1
Insurance contract or identification numberWBT000071
Number of Individuals Covered189
Insurance policy start date2011-11-01
Insurance policy end date2012-10-31
Total amount of commissions paid to insurance brokerUSD $5,589
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $50,451
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,552
Insurance broker organization code?3
Insurance broker nameINSURSERV, INC.
LIFEMAP ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97985 )
Policy contract numberWBT000071
Policy instance 1
Insurance contract or identification numberWBT000071
Number of Individuals Covered185
Insurance policy start date2010-11-01
Insurance policy end date2011-10-31
Total amount of commissions paid to insurance brokerUSD $5,568
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $40,414
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,580
Insurance broker organization code?3
Insurance broker nameINSURSERV, INC.
LIFEMAP ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97985 )
Policy contract numberWBT000071
Policy instance 1
Insurance contract or identification numberWBT000071
Number of Individuals Covered181
Insurance policy start date2009-11-01
Insurance policy end date2010-10-31
Total amount of commissions paid to insurance brokerUSD $5,388
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $39,250
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,353
Insurance broker organization code?3
Insurance broker nameINSURSERV, INC.
LIFEMAP ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97985 )
Policy contract numberWBT000071
Policy instance 1
Insurance contract or identification numberWBT000071
Number of Individuals Covered189
Insurance policy start date2008-11-01
Insurance policy end date2009-10-31
Total amount of commissions paid to insurance brokerUSD $5,310
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $38,752
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,292
Insurance broker organization code?3
Insurance broker nameINSURSERV, INC.
LIFEMAP ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97985 )
Policy contract numberWBT000071
Policy instance 1
Insurance contract or identification numberWBT000071
Number of Individuals Covered186
Insurance policy start date2007-11-01
Insurance policy end date2008-10-31
Total amount of commissions paid to insurance brokerUSD $5,008
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $36,802
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,147
Insurance broker organization code?3
Insurance broker nameINSURSERV, INC
LIFEMAP ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97985 )
Policy contract numberWBT000071
Policy instance 1
Insurance contract or identification numberWBT000071
Number of Individuals Covered174
Insurance policy start date2006-11-01
Insurance policy end date2007-10-31
Total amount of commissions paid to insurance brokerUSD $4,626
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $33,943
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,926
Insurance broker organization code?3
Insurance broker nameINSURSERV, INC
LIFEMAP ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97985 )
Policy contract numberWBT000071
Policy instance 1
Insurance contract or identification numberWBT000071
Number of Individuals Covered155
Insurance policy start date2005-11-01
Insurance policy end date2006-10-31
Total amount of commissions paid to insurance brokerUSD $2,562
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $19,892
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,562
Insurance broker organization code?3
Insurance broker nameDALE QUIGLEY
LIFEMAP ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97985 )
Policy contract numberWBT000071
Policy instance 1
Insurance contract or identification numberWBT000071
Number of Individuals Covered150
Insurance policy start date2004-11-01
Insurance policy end date2005-10-31
Total amount of commissions paid to insurance brokerUSD $2,421
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $18,758
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,421
Insurance broker organization code?3
Insurance broker nameDALE QUIGLEY

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