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LIFE INSURANCE ACCIDENTAL DEATH AND DISMEMBERMENT AND LONG TERM DISABILITY 401k Plan overview

Plan NameLIFE INSURANCE ACCIDENTAL DEATH AND DISMEMBERMENT AND LONG TERM DISABILITY
Plan identification number 502

LIFE INSURANCE ACCIDENTAL DEATH AND DISMEMBERMENT AND LONG TERM DISABILITY Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

BENNETT LUMBER PRODUCTS, INC. has sponsored the creation of one or more 401k plans.

Company Name:BENNETT LUMBER PRODUCTS, INC.
Employer identification number (EIN):910726966
NAIC Classification:321110

Form 5500 Filing Information

Submission information for form 5500 for 401k plan LIFE INSURANCE ACCIDENTAL DEATH AND DISMEMBERMENT AND LONG TERM DISABILITY

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022022-07-01
5022021-07-01
5022020-07-01
5022019-07-01
5022018-07-01
5022017-07-01JONATHAN OWNBEY JONATHAN OWNBEY2018-08-09
5022016-07-01JONATHAN OWNBEY JONATHAN OWNBEY2017-10-03
5022015-07-01JONATHAN OWNBEY JONATHAN OWNBEY2016-09-01
5022014-07-01STEFFANI ANDERSON STEFFANI ANDERSON2015-08-31
5022013-07-01STEFFANI ANDERSON STEFFANI ANDERSON2014-08-26
5022012-07-01STEFFANI ANDERSON STEFFANI ANDERSON2013-09-19
5022011-07-01TOM WOLNY
5022010-07-01TOM WOLNY
5022009-07-01TOM WOLNY

Plan Statistics for LIFE INSURANCE ACCIDENTAL DEATH AND DISMEMBERMENT AND LONG TERM DISABILITY

401k plan membership statisitcs for LIFE INSURANCE ACCIDENTAL DEATH AND DISMEMBERMENT AND LONG TERM DISABILITY

Measure Date Value
2022: LIFE INSURANCE ACCIDENTAL DEATH AND DISMEMBERMENT AND LONG TERM DISABILITY 2022 401k membership
Total participants, beginning-of-year2022-07-01242
Total number of active participants reported on line 7a of the Form 55002022-07-01250
Total of all active and inactive participants2022-07-01250
Total participants2022-07-01250
2021: LIFE INSURANCE ACCIDENTAL DEATH AND DISMEMBERMENT AND LONG TERM DISABILITY 2021 401k membership
Total participants, beginning-of-year2021-07-01245
Total number of active participants reported on line 7a of the Form 55002021-07-01242
Total of all active and inactive participants2021-07-01242
Total participants2021-07-01242
2020: LIFE INSURANCE ACCIDENTAL DEATH AND DISMEMBERMENT AND LONG TERM DISABILITY 2020 401k membership
Total participants, beginning-of-year2020-07-01250
Total number of active participants reported on line 7a of the Form 55002020-07-01245
Total of all active and inactive participants2020-07-01245
Total participants2020-07-01245
2019: LIFE INSURANCE ACCIDENTAL DEATH AND DISMEMBERMENT AND LONG TERM DISABILITY 2019 401k membership
Total participants, beginning-of-year2019-07-01257
Total number of active participants reported on line 7a of the Form 55002019-07-01250
Total of all active and inactive participants2019-07-01250
Total participants2019-07-01250
2018: LIFE INSURANCE ACCIDENTAL DEATH AND DISMEMBERMENT AND LONG TERM DISABILITY 2018 401k membership
Total participants, beginning-of-year2018-07-01246
Total number of active participants reported on line 7a of the Form 55002018-07-01257
Total of all active and inactive participants2018-07-01257
Total participants2018-07-01257
2017: LIFE INSURANCE ACCIDENTAL DEATH AND DISMEMBERMENT AND LONG TERM DISABILITY 2017 401k membership
Total participants, beginning-of-year2017-07-01243
Total number of active participants reported on line 7a of the Form 55002017-07-01246
Total of all active and inactive participants2017-07-01246
Total participants2017-07-01246
2016: LIFE INSURANCE ACCIDENTAL DEATH AND DISMEMBERMENT AND LONG TERM DISABILITY 2016 401k membership
Total participants, beginning-of-year2016-07-01242
Total number of active participants reported on line 7a of the Form 55002016-07-01243
Total of all active and inactive participants2016-07-01243
Total participants2016-07-01243
2015: LIFE INSURANCE ACCIDENTAL DEATH AND DISMEMBERMENT AND LONG TERM DISABILITY 2015 401k membership
Total participants, beginning-of-year2015-07-01235
Total number of active participants reported on line 7a of the Form 55002015-07-01242
Total of all active and inactive participants2015-07-01242
Total participants2015-07-01242
2014: LIFE INSURANCE ACCIDENTAL DEATH AND DISMEMBERMENT AND LONG TERM DISABILITY 2014 401k membership
Total participants, beginning-of-year2014-07-01178
Total number of active participants reported on line 7a of the Form 55002014-07-01235
Total of all active and inactive participants2014-07-01235
Total participants2014-07-01235
2013: LIFE INSURANCE ACCIDENTAL DEATH AND DISMEMBERMENT AND LONG TERM DISABILITY 2013 401k membership
Total participants, beginning-of-year2013-07-01186
Total number of active participants reported on line 7a of the Form 55002013-07-01178
Total of all active and inactive participants2013-07-01178
Total participants2013-07-01178
2012: LIFE INSURANCE ACCIDENTAL DEATH AND DISMEMBERMENT AND LONG TERM DISABILITY 2012 401k membership
Total participants, beginning-of-year2012-07-01168
Total number of active participants reported on line 7a of the Form 55002012-07-01162
Total of all active and inactive participants2012-07-01162
Total participants2012-07-01162
2011: LIFE INSURANCE ACCIDENTAL DEATH AND DISMEMBERMENT AND LONG TERM DISABILITY 2011 401k membership
Total participants, beginning-of-year2011-07-01156
Total number of active participants reported on line 7a of the Form 55002011-07-01154
Total of all active and inactive participants2011-07-01154
Total participants2011-07-01154
2010: LIFE INSURANCE ACCIDENTAL DEATH AND DISMEMBERMENT AND LONG TERM DISABILITY 2010 401k membership
Total participants, beginning-of-year2010-07-01138
Total number of active participants reported on line 7a of the Form 55002010-07-01156
Total of all active and inactive participants2010-07-01156
Total participants2010-07-01156
2009: LIFE INSURANCE ACCIDENTAL DEATH AND DISMEMBERMENT AND LONG TERM DISABILITY 2009 401k membership
Total participants, beginning-of-year2009-07-01171
Total number of active participants reported on line 7a of the Form 55002009-07-01138
Total of all active and inactive participants2009-07-01138
Total participants2009-07-01138

Form 5500 Responses for LIFE INSURANCE ACCIDENTAL DEATH AND DISMEMBERMENT AND LONG TERM DISABILITY

2022: LIFE INSURANCE ACCIDENTAL DEATH AND DISMEMBERMENT AND LONG TERM DISABILITY 2022 form 5500 responses
2022-07-01Type of plan entitySingle employer plan
2022-07-01Submission has been amendedNo
2022-07-01This submission is the final filingNo
2022-07-01This return/report is a short plan year return/report (less than 12 months)No
2022-07-01Plan is a collectively bargained planNo
2022-07-01Plan funding arrangement – InsuranceYes
2022-07-01Plan funding arrangement – General assets of the sponsorYes
2022-07-01Plan benefit arrangement – InsuranceYes
2021: LIFE INSURANCE ACCIDENTAL DEATH AND DISMEMBERMENT AND LONG TERM DISABILITY 2021 form 5500 responses
2021-07-01Type of plan entitySingle employer plan
2021-07-01Submission has been amendedNo
2021-07-01This submission is the final filingNo
2021-07-01This return/report is a short plan year return/report (less than 12 months)No
2021-07-01Plan is a collectively bargained planNo
2021-07-01Plan funding arrangement – InsuranceYes
2021-07-01Plan funding arrangement – General assets of the sponsorYes
2021-07-01Plan benefit arrangement – InsuranceYes
2020: LIFE INSURANCE ACCIDENTAL DEATH AND DISMEMBERMENT AND LONG TERM DISABILITY 2020 form 5500 responses
2020-07-01Type of plan entitySingle employer plan
2020-07-01Submission has been amendedNo
2020-07-01This submission is the final filingNo
2020-07-01This return/report is a short plan year return/report (less than 12 months)No
2020-07-01Plan is a collectively bargained planNo
2020-07-01Plan funding arrangement – InsuranceYes
2020-07-01Plan funding arrangement – General assets of the sponsorYes
2020-07-01Plan benefit arrangement – InsuranceYes
2019: LIFE INSURANCE ACCIDENTAL DEATH AND DISMEMBERMENT AND LONG TERM DISABILITY 2019 form 5500 responses
2019-07-01Type of plan entitySingle employer plan
2019-07-01Submission has been amendedNo
2019-07-01This submission is the final filingNo
2019-07-01This return/report is a short plan year return/report (less than 12 months)No
2019-07-01Plan is a collectively bargained planNo
2019-07-01Plan funding arrangement – InsuranceYes
2019-07-01Plan funding arrangement – General assets of the sponsorYes
2019-07-01Plan benefit arrangement – InsuranceYes
2018: LIFE INSURANCE ACCIDENTAL DEATH AND DISMEMBERMENT AND LONG TERM DISABILITY 2018 form 5500 responses
2018-07-01Type of plan entitySingle employer plan
2018-07-01Submission has been amendedNo
2018-07-01This submission is the final filingNo
2018-07-01This return/report is a short plan year return/report (less than 12 months)No
2018-07-01Plan is a collectively bargained planNo
2018-07-01Plan funding arrangement – InsuranceYes
2018-07-01Plan funding arrangement – General assets of the sponsorYes
2018-07-01Plan benefit arrangement – InsuranceYes
2017: LIFE INSURANCE ACCIDENTAL DEATH AND DISMEMBERMENT AND LONG TERM DISABILITY 2017 form 5500 responses
2017-07-01Type of plan entitySingle employer plan
2017-07-01Submission has been amendedNo
2017-07-01This submission is the final filingNo
2017-07-01This return/report is a short plan year return/report (less than 12 months)No
2017-07-01Plan is a collectively bargained planNo
2017-07-01Plan funding arrangement – InsuranceYes
2017-07-01Plan funding arrangement – General assets of the sponsorYes
2017-07-01Plan benefit arrangement – InsuranceYes
2016: LIFE INSURANCE ACCIDENTAL DEATH AND DISMEMBERMENT AND LONG TERM DISABILITY 2016 form 5500 responses
2016-07-01Type of plan entitySingle employer plan
2016-07-01Submission has been amendedNo
2016-07-01This submission is the final filingNo
2016-07-01This return/report is a short plan year return/report (less than 12 months)No
2016-07-01Plan is a collectively bargained planNo
2016-07-01Plan funding arrangement – InsuranceYes
2016-07-01Plan funding arrangement – General assets of the sponsorYes
2016-07-01Plan benefit arrangement – InsuranceYes
2015: LIFE INSURANCE ACCIDENTAL DEATH AND DISMEMBERMENT AND LONG TERM DISABILITY 2015 form 5500 responses
2015-07-01Type of plan entitySingle employer plan
2015-07-01Submission has been amendedNo
2015-07-01This submission is the final filingNo
2015-07-01This return/report is a short plan year return/report (less than 12 months)No
2015-07-01Plan is a collectively bargained planNo
2015-07-01Plan funding arrangement – InsuranceYes
2015-07-01Plan funding arrangement – General assets of the sponsorYes
2015-07-01Plan benefit arrangement – InsuranceYes
2014: LIFE INSURANCE ACCIDENTAL DEATH AND DISMEMBERMENT AND LONG TERM DISABILITY 2014 form 5500 responses
2014-07-01Type of plan entitySingle employer plan
2014-07-01Submission has been amendedNo
2014-07-01This submission is the final filingNo
2014-07-01This return/report is a short plan year return/report (less than 12 months)No
2014-07-01Plan is a collectively bargained planNo
2014-07-01Plan funding arrangement – InsuranceYes
2014-07-01Plan funding arrangement – General assets of the sponsorYes
2014-07-01Plan benefit arrangement – InsuranceYes
2013: LIFE INSURANCE ACCIDENTAL DEATH AND DISMEMBERMENT AND LONG TERM DISABILITY 2013 form 5500 responses
2013-07-01Type of plan entitySingle employer plan
2013-07-01Submission has been amendedNo
2013-07-01This submission is the final filingNo
2013-07-01This return/report is a short plan year return/report (less than 12 months)No
2013-07-01Plan is a collectively bargained planNo
2013-07-01Plan funding arrangement – InsuranceYes
2013-07-01Plan funding arrangement – General assets of the sponsorYes
2013-07-01Plan benefit arrangement – InsuranceYes
2012: LIFE INSURANCE ACCIDENTAL DEATH AND DISMEMBERMENT AND LONG TERM DISABILITY 2012 form 5500 responses
2012-07-01Type of plan entitySingle employer plan
2012-07-01Submission has been amendedNo
2012-07-01This submission is the final filingNo
2012-07-01This return/report is a short plan year return/report (less than 12 months)No
2012-07-01Plan is a collectively bargained planNo
2012-07-01Plan funding arrangement – InsuranceYes
2012-07-01Plan funding arrangement – General assets of the sponsorYes
2012-07-01Plan benefit arrangement – InsuranceYes
2011: LIFE INSURANCE ACCIDENTAL DEATH AND DISMEMBERMENT AND LONG TERM DISABILITY 2011 form 5500 responses
2011-07-01Type of plan entitySingle employer plan
2011-07-01Submission has been amendedNo
2011-07-01This submission is the final filingNo
2011-07-01This return/report is a short plan year return/report (less than 12 months)No
2011-07-01Plan is a collectively bargained planNo
2011-07-01Plan funding arrangement – InsuranceYes
2011-07-01Plan funding arrangement – General assets of the sponsorYes
2011-07-01Plan benefit arrangement – InsuranceYes
2010: LIFE INSURANCE ACCIDENTAL DEATH AND DISMEMBERMENT AND LONG TERM DISABILITY 2010 form 5500 responses
2010-07-01Type of plan entitySingle employer plan
2010-07-01Submission has been amendedNo
2010-07-01This submission is the final filingNo
2010-07-01This return/report is a short plan year return/report (less than 12 months)No
2010-07-01Plan is a collectively bargained planNo
2010-07-01Plan funding arrangement – InsuranceYes
2010-07-01Plan funding arrangement – General assets of the sponsorYes
2010-07-01Plan benefit arrangement – InsuranceYes
2010-07-01Plan benefit arrangement – General assets of the sponsorYes
2009: LIFE INSURANCE ACCIDENTAL DEATH AND DISMEMBERMENT AND LONG TERM DISABILITY 2009 form 5500 responses
2009-07-01Type of plan entitySingle employer plan
2009-07-01Submission has been amendedNo
2009-07-01This submission is the final filingNo
2009-07-01This return/report is a short plan year return/report (less than 12 months)No
2009-07-01Plan is a collectively bargained planNo
2009-07-01Plan funding arrangement – InsuranceYes
2009-07-01Plan funding arrangement – General assets of the sponsorYes
2009-07-01Plan benefit arrangement – InsuranceYes
2009-07-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number178160
Policy instance 1
Insurance contract or identification number178160
Number of Individuals Covered250
Insurance policy start date2022-07-01
Insurance policy end date2023-06-30
Total amount of commissions paid to insurance brokerUSD $2,056
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 providedACCIDENTAL DEATH AND DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,056
Insurance broker organization code?3
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number178160
Policy instance 1
Insurance contract or identification number178160
Number of Individuals Covered242
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $2,271
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 providedACCIDENTAL DEATH AND DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,271
Insurance broker organization code?3
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number178160
Policy instance 1
Insurance contract or identification number178160
Number of Individuals Covered245
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $2,524
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 providedACCIDENTAL DEATH AND DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,524
Insurance broker organization code?3
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number178160
Policy instance 1
Insurance contract or identification number178160
Number of Individuals Covered250
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $2,776
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 providedACCIDENTAL DEATH AND DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,776
Insurance broker organization code?3
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number178160
Policy instance 1
Insurance contract or identification number178160
Number of Individuals Covered246
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $1,734
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 providedACCIDENTAL DEATH AND DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,734
Insurance broker organization code?3
Insurance broker nameTROY INS AGENCY
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number178160
Policy instance 1
Insurance contract or identification number178160
Number of Individuals Covered242
Insurance policy start date2015-07-01
Insurance policy end date2016-06-30
Total amount of commissions paid to insurance brokerUSD $2,548
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 BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $182
Insurance broker nameGALLAGHER BENEFIT SERVICES
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number178160
Policy instance 1
Insurance contract or identification number178160
Number of Individuals Covered235
Insurance policy start date2014-07-01
Insurance policy end date2015-06-30
Total amount of commissions paid to insurance brokerUSD $235
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,354
Amount paid for insurance broker fees0
Insurance broker nameGALLAGHER BENEFIT SERVICES
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number178160
Policy instance 1
Insurance contract or identification number178160
Number of Individuals Covered178
Insurance policy start date2013-07-01
Insurance policy end date2014-06-30
Total amount of commissions paid to insurance brokerUSD $2,055
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,055
Insurance broker nameRONALD L OSBORNE
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number178160
Policy instance 1
Insurance contract or identification number178160
Number of Individuals Covered162
Insurance policy start date2012-07-01
Insurance policy end date2013-06-30
Total amount of commissions paid to insurance brokerUSD $1,886
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,886
Insurance broker nameRONALD OSBORNE
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number178160
Policy instance 1
Insurance contract or identification number178160
Number of Individuals Covered154
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
Total amount of commissions paid to insurance brokerUSD $1,306
Dental Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number178160
Policy instance 1
Insurance contract or identification number178160
Number of Individuals Covered156
Insurance policy start date2010-07-01
Insurance policy end date2011-06-30
Total amount of commissions paid to insurance brokerUSD $1,738
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,388
Insurance broker organization code?3
Insurance broker nameWESTERN BENEFIT SOLUTIONS

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