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GROUP BASIC TERM LIFE, SUPPLEMENTAL DEPENDENT LIFE, SUPPLEMENTAL TERM LIFE PLAN FOR EMPLOYEES OF PREMIER DISTRIBUTING COMPANY 401k Plan overview

Plan NameGROUP BASIC TERM LIFE, SUPPLEMENTAL DEPENDENT LIFE, SUPPLEMENTAL TERM LIFE PLAN FOR EMPLOYEES OF PREMIER DISTRIBUTING COMPANY
Plan identification number 501

GROUP BASIC TERM LIFE, SUPPLEMENTAL DEPENDENT LIFE, SUPPLEMENTAL TERM LIFE PLAN FOR EMPLOYEES OF PREMIER DISTRIBUTING COMPANY Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental

401k Sponsoring company profile

PREMIER DISTRIBUTING COMPANY has sponsored the creation of one or more 401k plans.

Company Name:PREMIER DISTRIBUTING COMPANY
Employer identification number (EIN):850301940
NAIC Classification:424800

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GROUP BASIC TERM LIFE, SUPPLEMENTAL DEPENDENT LIFE, SUPPLEMENTAL TERM LIFE PLAN FOR EMPLOYEES OF PREMIER DISTRIBUTING COMPANY

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-03-01
5012021-03-01
5012020-03-01
5012019-03-01
5012018-03-01
5012017-03-01
5012016-03-01
5012015-03-01
5012014-03-01MICHAEL ORIANS
5012013-03-01MICHAEL ORIANS
5012012-03-01MICHAEL ORIANS
5012011-03-01MICHAEL ORIANS MICHAEL ORIANS2013-01-16
5012009-03-01MICHAEL ORIANS
5012009-03-01MICHAEL ORIANS

Plan Statistics for GROUP BASIC TERM LIFE, SUPPLEMENTAL DEPENDENT LIFE, SUPPLEMENTAL TERM LIFE PLAN FOR EMPLOYEES OF PREMIER DISTRIBUTING COMPANY

401k plan membership statisitcs for GROUP BASIC TERM LIFE, SUPPLEMENTAL DEPENDENT LIFE, SUPPLEMENTAL TERM LIFE PLAN FOR EMPLOYEES OF PREMIER DISTRIBUTING COMPANY

Measure Date Value
2022: GROUP BASIC TERM LIFE, SUPPLEMENTAL DEPENDENT LIFE, SUPPLEMENTAL TERM LIFE PLAN FOR EMPLOYEES OF PREMIER DISTRIBUTING COMPANY 2022 401k membership
Total participants, beginning-of-year2022-03-01367
Total number of active participants reported on line 7a of the Form 55002022-03-01457
Number of retired or separated participants receiving benefits2022-03-010
Number of other retired or separated participants entitled to future benefits2022-03-010
Total of all active and inactive participants2022-03-01457
2021: GROUP BASIC TERM LIFE, SUPPLEMENTAL DEPENDENT LIFE, SUPPLEMENTAL TERM LIFE PLAN FOR EMPLOYEES OF PREMIER DISTRIBUTING COMPANY 2021 401k membership
Total participants, beginning-of-year2021-03-01293
Total number of active participants reported on line 7a of the Form 55002021-03-01293
Number of retired or separated participants receiving benefits2021-03-010
Number of other retired or separated participants entitled to future benefits2021-03-010
Total of all active and inactive participants2021-03-01293
2020: GROUP BASIC TERM LIFE, SUPPLEMENTAL DEPENDENT LIFE, SUPPLEMENTAL TERM LIFE PLAN FOR EMPLOYEES OF PREMIER DISTRIBUTING COMPANY 2020 401k membership
Total participants, beginning-of-year2020-03-01303
Total number of active participants reported on line 7a of the Form 55002020-03-01293
Number of retired or separated participants receiving benefits2020-03-010
Number of other retired or separated participants entitled to future benefits2020-03-010
Total of all active and inactive participants2020-03-01293
2019: GROUP BASIC TERM LIFE, SUPPLEMENTAL DEPENDENT LIFE, SUPPLEMENTAL TERM LIFE PLAN FOR EMPLOYEES OF PREMIER DISTRIBUTING COMPANY 2019 401k membership
Total participants, beginning-of-year2019-03-01304
Total number of active participants reported on line 7a of the Form 55002019-03-01303
Number of retired or separated participants receiving benefits2019-03-010
Number of other retired or separated participants entitled to future benefits2019-03-010
Total of all active and inactive participants2019-03-01303
2018: GROUP BASIC TERM LIFE, SUPPLEMENTAL DEPENDENT LIFE, SUPPLEMENTAL TERM LIFE PLAN FOR EMPLOYEES OF PREMIER DISTRIBUTING COMPANY 2018 401k membership
Total participants, beginning-of-year2018-03-01302
Total number of active participants reported on line 7a of the Form 55002018-03-01304
Number of retired or separated participants receiving benefits2018-03-010
Number of other retired or separated participants entitled to future benefits2018-03-010
Total of all active and inactive participants2018-03-01304
2017: GROUP BASIC TERM LIFE, SUPPLEMENTAL DEPENDENT LIFE, SUPPLEMENTAL TERM LIFE PLAN FOR EMPLOYEES OF PREMIER DISTRIBUTING COMPANY 2017 401k membership
Total participants, beginning-of-year2017-03-01311
Total number of active participants reported on line 7a of the Form 55002017-03-01302
Number of retired or separated participants receiving benefits2017-03-010
Number of other retired or separated participants entitled to future benefits2017-03-010
Total of all active and inactive participants2017-03-01302
2016: GROUP BASIC TERM LIFE, SUPPLEMENTAL DEPENDENT LIFE, SUPPLEMENTAL TERM LIFE PLAN FOR EMPLOYEES OF PREMIER DISTRIBUTING COMPANY 2016 401k membership
Total participants, beginning-of-year2016-03-01321
Total number of active participants reported on line 7a of the Form 55002016-03-01311
Number of retired or separated participants receiving benefits2016-03-010
Number of other retired or separated participants entitled to future benefits2016-03-010
Total of all active and inactive participants2016-03-01311
2015: GROUP BASIC TERM LIFE, SUPPLEMENTAL DEPENDENT LIFE, SUPPLEMENTAL TERM LIFE PLAN FOR EMPLOYEES OF PREMIER DISTRIBUTING COMPANY 2015 401k membership
Total participants, beginning-of-year2015-03-01348
Total number of active participants reported on line 7a of the Form 55002015-03-01321
Number of retired or separated participants receiving benefits2015-03-010
Number of other retired or separated participants entitled to future benefits2015-03-010
Total of all active and inactive participants2015-03-01321
2014: GROUP BASIC TERM LIFE, SUPPLEMENTAL DEPENDENT LIFE, SUPPLEMENTAL TERM LIFE PLAN FOR EMPLOYEES OF PREMIER DISTRIBUTING COMPANY 2014 401k membership
Total participants, beginning-of-year2014-03-01353
Total number of active participants reported on line 7a of the Form 55002014-03-01348
Total of all active and inactive participants2014-03-01348
Total participants2014-03-01348
2013: GROUP BASIC TERM LIFE, SUPPLEMENTAL DEPENDENT LIFE, SUPPLEMENTAL TERM LIFE PLAN FOR EMPLOYEES OF PREMIER DISTRIBUTING COMPANY 2013 401k membership
Total participants, beginning-of-year2013-03-01363
Total number of active participants reported on line 7a of the Form 55002013-03-01353
Total of all active and inactive participants2013-03-01353
Total participants2013-03-01353
2012: GROUP BASIC TERM LIFE, SUPPLEMENTAL DEPENDENT LIFE, SUPPLEMENTAL TERM LIFE PLAN FOR EMPLOYEES OF PREMIER DISTRIBUTING COMPANY 2012 401k membership
Total participants, beginning-of-year2012-03-01361
Total number of active participants reported on line 7a of the Form 55002012-03-01363
Total of all active and inactive participants2012-03-01363
Total participants2012-03-01363
2011: GROUP BASIC TERM LIFE, SUPPLEMENTAL DEPENDENT LIFE, SUPPLEMENTAL TERM LIFE PLAN FOR EMPLOYEES OF PREMIER DISTRIBUTING COMPANY 2011 401k membership
Total participants, beginning-of-year2011-03-01371
Total number of active participants reported on line 7a of the Form 55002011-03-01361
Number of retired or separated participants receiving benefits2011-03-010
Number of other retired or separated participants entitled to future benefits2011-03-010
Total of all active and inactive participants2011-03-01361
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-03-010
Total participants2011-03-01361
2009: GROUP BASIC TERM LIFE, SUPPLEMENTAL DEPENDENT LIFE, SUPPLEMENTAL TERM LIFE PLAN FOR EMPLOYEES OF PREMIER DISTRIBUTING COMPANY 2009 401k membership
Total participants, beginning-of-year2009-03-01323
Total number of active participants reported on line 7a of the Form 55002009-03-01345
Number of retired or separated participants receiving benefits2009-03-010
Number of other retired or separated participants entitled to future benefits2009-03-010
Total of all active and inactive participants2009-03-01345
Total participants2009-03-01345

Form 5500 Responses for GROUP BASIC TERM LIFE, SUPPLEMENTAL DEPENDENT LIFE, SUPPLEMENTAL TERM LIFE PLAN FOR EMPLOYEES OF PREMIER DISTRIBUTING COMPANY

2022: GROUP BASIC TERM LIFE, SUPPLEMENTAL DEPENDENT LIFE, SUPPLEMENTAL TERM LIFE PLAN FOR EMPLOYEES OF PREMIER DISTRIBUTING COMPANY 2022 form 5500 responses
2022-03-01Type of plan entitySingle employer plan
2022-03-01Submission has been amendedNo
2022-03-01This submission is the final filingNo
2022-03-01This return/report is a short plan year return/report (less than 12 months)No
2022-03-01Plan is a collectively bargained planNo
2022-03-01Plan funding arrangement – InsuranceYes
2022-03-01Plan benefit arrangement – InsuranceYes
2021: GROUP BASIC TERM LIFE, SUPPLEMENTAL DEPENDENT LIFE, SUPPLEMENTAL TERM LIFE PLAN FOR EMPLOYEES OF PREMIER DISTRIBUTING COMPANY 2021 form 5500 responses
2021-03-01Type of plan entitySingle employer plan
2021-03-01Submission has been amendedNo
2021-03-01This submission is the final filingNo
2021-03-01This return/report is a short plan year return/report (less than 12 months)No
2021-03-01Plan is a collectively bargained planNo
2021-03-01Plan funding arrangement – InsuranceYes
2021-03-01Plan benefit arrangement – InsuranceYes
2020: GROUP BASIC TERM LIFE, SUPPLEMENTAL DEPENDENT LIFE, SUPPLEMENTAL TERM LIFE PLAN FOR EMPLOYEES OF PREMIER DISTRIBUTING COMPANY 2020 form 5500 responses
2020-03-01Type of plan entitySingle employer plan
2020-03-01Submission has been amendedNo
2020-03-01This submission is the final filingNo
2020-03-01This return/report is a short plan year return/report (less than 12 months)No
2020-03-01Plan is a collectively bargained planNo
2020-03-01Plan funding arrangement – InsuranceYes
2020-03-01Plan benefit arrangement – InsuranceYes
2019: GROUP BASIC TERM LIFE, SUPPLEMENTAL DEPENDENT LIFE, SUPPLEMENTAL TERM LIFE PLAN FOR EMPLOYEES OF PREMIER DISTRIBUTING COMPANY 2019 form 5500 responses
2019-03-01Type of plan entitySingle employer plan
2019-03-01Submission has been amendedNo
2019-03-01This submission is the final filingNo
2019-03-01This return/report is a short plan year return/report (less than 12 months)No
2019-03-01Plan is a collectively bargained planNo
2019-03-01Plan funding arrangement – InsuranceYes
2019-03-01Plan benefit arrangement – InsuranceYes
2018: GROUP BASIC TERM LIFE, SUPPLEMENTAL DEPENDENT LIFE, SUPPLEMENTAL TERM LIFE PLAN FOR EMPLOYEES OF PREMIER DISTRIBUTING COMPANY 2018 form 5500 responses
2018-03-01Type of plan entitySingle employer plan
2018-03-01Submission has been amendedNo
2018-03-01This submission is the final filingNo
2018-03-01This return/report is a short plan year return/report (less than 12 months)No
2018-03-01Plan is a collectively bargained planNo
2018-03-01Plan funding arrangement – InsuranceYes
2018-03-01Plan benefit arrangement – InsuranceYes
2017: GROUP BASIC TERM LIFE, SUPPLEMENTAL DEPENDENT LIFE, SUPPLEMENTAL TERM LIFE PLAN FOR EMPLOYEES OF PREMIER DISTRIBUTING COMPANY 2017 form 5500 responses
2017-03-01Type of plan entitySingle employer plan
2017-03-01Submission has been amendedNo
2017-03-01This submission is the final filingNo
2017-03-01This return/report is a short plan year return/report (less than 12 months)No
2017-03-01Plan is a collectively bargained planNo
2017-03-01Plan funding arrangement – InsuranceYes
2017-03-01Plan benefit arrangement – InsuranceYes
2016: GROUP BASIC TERM LIFE, SUPPLEMENTAL DEPENDENT LIFE, SUPPLEMENTAL TERM LIFE PLAN FOR EMPLOYEES OF PREMIER DISTRIBUTING COMPANY 2016 form 5500 responses
2016-03-01Type of plan entitySingle employer plan
2016-03-01Submission has been amendedNo
2016-03-01This submission is the final filingNo
2016-03-01This return/report is a short plan year return/report (less than 12 months)No
2016-03-01Plan is a collectively bargained planNo
2016-03-01Plan funding arrangement – InsuranceYes
2016-03-01Plan benefit arrangement – InsuranceYes
2015: GROUP BASIC TERM LIFE, SUPPLEMENTAL DEPENDENT LIFE, SUPPLEMENTAL TERM LIFE PLAN FOR EMPLOYEES OF PREMIER DISTRIBUTING COMPANY 2015 form 5500 responses
2015-03-01Type of plan entitySingle employer plan
2015-03-01Submission has been amendedNo
2015-03-01This submission is the final filingNo
2015-03-01This return/report is a short plan year return/report (less than 12 months)No
2015-03-01Plan is a collectively bargained planNo
2015-03-01Plan funding arrangement – InsuranceYes
2015-03-01Plan benefit arrangement – InsuranceYes
2014: GROUP BASIC TERM LIFE, SUPPLEMENTAL DEPENDENT LIFE, SUPPLEMENTAL TERM LIFE PLAN FOR EMPLOYEES OF PREMIER DISTRIBUTING COMPANY 2014 form 5500 responses
2014-03-01Type of plan entitySingle employer plan
2014-03-01Submission has been amendedNo
2014-03-01This submission is the final filingNo
2014-03-01This return/report is a short plan year return/report (less than 12 months)No
2014-03-01Plan is a collectively bargained planNo
2014-03-01Plan funding arrangement – InsuranceYes
2014-03-01Plan benefit arrangement – InsuranceYes
2013: GROUP BASIC TERM LIFE, SUPPLEMENTAL DEPENDENT LIFE, SUPPLEMENTAL TERM LIFE PLAN FOR EMPLOYEES OF PREMIER DISTRIBUTING COMPANY 2013 form 5500 responses
2013-03-01Type of plan entitySingle employer plan
2013-03-01Submission has been amendedNo
2013-03-01This submission is the final filingNo
2013-03-01This return/report is a short plan year return/report (less than 12 months)No
2013-03-01Plan is a collectively bargained planNo
2013-03-01Plan funding arrangement – InsuranceYes
2013-03-01Plan benefit arrangement – InsuranceYes
2012: GROUP BASIC TERM LIFE, SUPPLEMENTAL DEPENDENT LIFE, SUPPLEMENTAL TERM LIFE PLAN FOR EMPLOYEES OF PREMIER DISTRIBUTING COMPANY 2012 form 5500 responses
2012-03-01Type of plan entitySingle employer plan
2012-03-01Submission has been amendedNo
2012-03-01This submission is the final filingNo
2012-03-01This return/report is a short plan year return/report (less than 12 months)No
2012-03-01Plan is a collectively bargained planNo
2012-03-01Plan funding arrangement – InsuranceYes
2012-03-01Plan benefit arrangement – InsuranceYes
2011: GROUP BASIC TERM LIFE, SUPPLEMENTAL DEPENDENT LIFE, SUPPLEMENTAL TERM LIFE PLAN FOR EMPLOYEES OF PREMIER DISTRIBUTING COMPANY 2011 form 5500 responses
2011-03-01Type of plan entitySingle employer plan
2011-03-01Submission has been amendedYes
2011-03-01This submission is the final filingNo
2011-03-01This return/report is a short plan year return/report (less than 12 months)No
2011-03-01Plan is a collectively bargained planNo
2011-03-01Plan funding arrangement – InsuranceYes
2011-03-01Plan benefit arrangement – InsuranceYes
2009: GROUP BASIC TERM LIFE, SUPPLEMENTAL DEPENDENT LIFE, SUPPLEMENTAL TERM LIFE PLAN FOR EMPLOYEES OF PREMIER DISTRIBUTING COMPANY 2009 form 5500 responses
2009-03-01Type of plan entitySingle employer plan
2009-03-01Submission has been amendedYes
2009-03-01This submission is the final filingNo
2009-03-01This return/report is a short plan year return/report (less than 12 months)No
2009-03-01Plan is a collectively bargained planNo
2009-03-01Plan funding arrangement – InsuranceYes
2009-03-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number706164G
Policy instance 1
Insurance contract or identification number706164G
Number of Individuals Covered360
Insurance policy start date2022-03-01
Insurance policy end date2023-02-28
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 BenefitNo
Unemployment Insurance Welfare BenefitNo
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 $55,220
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number706164G
Policy instance 1
Insurance contract or identification number706164G
Number of Individuals Covered367
Insurance policy start date2021-03-01
Insurance policy end date2022-02-28
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 BenefitNo
Unemployment Insurance Welfare BenefitNo
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 $48,267
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number706164G
Policy instance 1
Insurance contract or identification number706164G
Number of Individuals Covered353
Insurance policy start date2020-03-01
Insurance policy end date2021-02-28
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 BenefitNo
Unemployment Insurance Welfare BenefitNo
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 $42,387
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number706164G
Policy instance 1
Insurance contract or identification number706164G
Number of Individuals Covered356
Insurance policy start date2018-03-01
Insurance policy end date2019-02-28
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 BenefitNo
Unemployment Insurance Welfare BenefitNo
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 $37,870
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number706164G
Policy instance 1
Insurance contract or identification number706164G
Number of Individuals Covered357
Insurance policy start date2017-03-01
Insurance policy end date2018-02-28
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 BenefitNo
Unemployment Insurance Welfare BenefitNo
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 $50,515
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number706164G
Policy instance 1
Insurance contract or identification number706164G
Number of Individuals Covered378
Insurance policy start date2016-03-01
Insurance policy end date2017-02-28
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 BenefitNo
Unemployment Insurance Welfare BenefitNo
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 $37,219
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number706164G
Policy instance 1
Insurance contract or identification number706164G
Number of Individuals Covered398
Insurance policy start date2015-03-01
Insurance policy end date2016-02-29
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 BenefitNo
Unemployment Insurance Welfare BenefitNo
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 $43,564
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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