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NEW LEAF INC - INSURANCE 401k Plan overview

Plan NameNEW LEAF INC - INSURANCE
Plan identification number 501

NEW LEAF INC - INSURANCE Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance

401k Sponsoring company profile

NEW LEAF INC has sponsored the creation of one or more 401k plans.

Company Name:NEW LEAF INC
Employer identification number (EIN):910847513
NAIC Classification:624310
NAIC Description:Vocational Rehabilitation Services

Additional information about NEW LEAF INC

Jurisdiction of Incorporation: Nevada Department of State
Incorporation Date: 2008-08-08
Company Identification Number: 20081101579
Legal Registered Office Address: 3263 E WARM SPRINGS RD

LAS VEGAS
United States of America (USA)
89120

More information about NEW LEAF INC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NEW LEAF INC - INSURANCE

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012021-05-01
5012020-05-01
5012019-05-01
5012018-05-01CATHY GEORGE CATHY GEORGE2019-07-15
5012017-05-01TYLER OLSON TYLER OLSON2018-06-15
5012016-05-01TYLER OLSON TYLER OLSON2017-06-07
5012015-05-01MICHELE MCKENNA
5012014-01-01MICHELE MCKENNA
5012013-05-01MICHELE MCKENNA
5012012-05-01MICHELE MCKENNA
5012011-05-01MICHELE MCKENNA

Plan Statistics for NEW LEAF INC - INSURANCE

401k plan membership statisitcs for NEW LEAF INC - INSURANCE

Measure Date Value
2021: NEW LEAF INC - INSURANCE 2021 401k membership
Total participants, beginning-of-year2021-05-01104
Total number of active participants reported on line 7a of the Form 55002021-05-0195
Total of all active and inactive participants2021-05-0195
Total participants2021-05-0195
2020: NEW LEAF INC - INSURANCE 2020 401k membership
Total participants, beginning-of-year2020-05-01106
Total number of active participants reported on line 7a of the Form 55002020-05-01104
Total of all active and inactive participants2020-05-01104
Total participants2020-05-01104
2019: NEW LEAF INC - INSURANCE 2019 401k membership
Total participants, beginning-of-year2019-05-0199
Total number of active participants reported on line 7a of the Form 55002019-05-01106
Total of all active and inactive participants2019-05-01106
Total participants2019-05-01106
2018: NEW LEAF INC - INSURANCE 2018 401k membership
Total participants, beginning-of-year2018-05-01102
Total number of active participants reported on line 7a of the Form 55002018-05-0199
Total of all active and inactive participants2018-05-0199
Total participants2018-05-0199
2017: NEW LEAF INC - INSURANCE 2017 401k membership
Total participants, beginning-of-year2017-05-0190
Total number of active participants reported on line 7a of the Form 55002017-05-01102
Total of all active and inactive participants2017-05-01102
Total participants2017-05-01102
2016: NEW LEAF INC - INSURANCE 2016 401k membership
Total participants, beginning-of-year2016-05-0198
Total number of active participants reported on line 7a of the Form 55002016-05-0190
Total of all active and inactive participants2016-05-0190
Total participants2016-05-0190
2015: NEW LEAF INC - INSURANCE 2015 401k membership
Total participants, beginning-of-year2015-05-0186
Total number of active participants reported on line 7a of the Form 55002015-05-0198
Total of all active and inactive participants2015-05-0198
Total participants2015-05-0198
2014: NEW LEAF INC - INSURANCE 2014 401k membership
Total participants, beginning-of-year2014-01-01191
Total number of active participants reported on line 7a of the Form 55002014-01-0186
Total of all active and inactive participants2014-01-0186
Total participants2014-01-0186
2013: NEW LEAF INC - INSURANCE 2013 401k membership
Total participants, beginning-of-year2013-05-01191
Total number of active participants reported on line 7a of the Form 55002013-05-01168
Total of all active and inactive participants2013-05-01168
Total participants2013-05-01168
2012: NEW LEAF INC - INSURANCE 2012 401k membership
Total participants, beginning-of-year2012-05-01204
Total number of active participants reported on line 7a of the Form 55002012-05-01191
Total of all active and inactive participants2012-05-01191
Total participants2012-05-01191
2011: NEW LEAF INC - INSURANCE 2011 401k membership
Total participants, beginning-of-year2011-05-01116
Total number of active participants reported on line 7a of the Form 55002011-05-01204
Total of all active and inactive participants2011-05-01204
Total participants2011-05-01204

Financial Data on NEW LEAF INC - INSURANCE

Measure Date Value
2022 : NEW LEAF INC - INSURANCE 2022 401k financial data
Total income from all sources2022-04-30$15,994
Expenses. Total of all expenses incurred2022-04-30$15,994
Benefits paid (including direct rollovers)2022-04-30$15,233
Net income (gross income less expenses)2022-04-30$0
Total contributions received or receivable from employer(s)2022-04-30$15,994
Expenses. Administrative service providers (salaries,fees and commissions)2022-04-30$761
2021 : NEW LEAF INC - INSURANCE 2021 401k financial data
Total income from all sources2021-04-30$16,450
Expenses. Total of all expenses incurred2021-04-30$16,450
Benefits paid (including direct rollovers)2021-04-30$15,667
Net income (gross income less expenses)2021-04-30$0
Total contributions received or receivable from employer(s)2021-04-30$16,450
Expenses. Administrative service providers (salaries,fees and commissions)2021-04-30$783
2020 : NEW LEAF INC - INSURANCE 2020 401k financial data
Total income from all sources2020-04-30$15,518
Expenses. Total of all expenses incurred2020-04-30$15,518
Benefits paid (including direct rollovers)2020-04-30$14,658
Net income (gross income less expenses)2020-04-30$0
Total contributions received or receivable from employer(s)2020-04-30$15,518
Expenses. Administrative service providers (salaries,fees and commissions)2020-04-30$860
2019 : NEW LEAF INC - INSURANCE 2019 401k financial data
Total income from all sources2019-04-30$17,651
Expenses. Total of all expenses incurred2019-04-30$17,651
Benefits paid (including direct rollovers)2019-04-30$16,871
Net income (gross income less expenses)2019-04-30$0
Total contributions received or receivable from employer(s)2019-04-30$17,651
Expenses. Administrative service providers (salaries,fees and commissions)2019-04-30$780
2018 : NEW LEAF INC - INSURANCE 2018 401k financial data
Total income from all sources2018-04-30$15,369
Expenses. Total of all expenses incurred2018-04-30$15,369
Benefits paid (including direct rollovers)2018-04-30$14,637
Net income (gross income less expenses)2018-04-30$0
Total contributions received or receivable from employer(s)2018-04-30$15,369
Expenses. Administrative service providers (salaries,fees and commissions)2018-04-30$732
2017 : NEW LEAF INC - INSURANCE 2017 401k financial data
Total income from all sources2017-04-30$14,849
Expenses. Total of all expenses incurred2017-04-30$14,849
Benefits paid (including direct rollovers)2017-04-30$14,142
Net income (gross income less expenses)2017-04-30$0
Total contributions received or receivable from employer(s)2017-04-30$14,849
Expenses. Administrative service providers (salaries,fees and commissions)2017-04-30$707
2016 : NEW LEAF INC - INSURANCE 2016 401k financial data
Total income from all sources2016-04-30$15,059
Expenses. Total of all expenses incurred2016-04-30$15,059
Benefits paid (including direct rollovers)2016-04-30$14,342
Net income (gross income less expenses)2016-04-30$0
Total contributions received or receivable from employer(s)2016-04-30$15,059
Expenses. Administrative service providers (salaries,fees and commissions)2016-04-30$717
2014 : NEW LEAF INC - INSURANCE 2014 401k financial data
Total income from all sources2014-12-31$13,889
Expenses. Total of all expenses incurred2014-12-31$13,889
Benefits paid (including direct rollovers)2014-12-31$13,228
Net income (gross income less expenses)2014-12-31$0
Net plan assets at end of year (total assets less liabilities)2014-12-31$0
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$0
Total contributions received or receivable from employer(s)2014-12-31$13,889
Expenses. Administrative service providers (salaries,fees and commissions)2014-12-31$661
Total income from all sources2014-04-30$16,157
Expenses. Total of all expenses incurred2014-04-30$16,157
Benefits paid (including direct rollovers)2014-04-30$15,388
Net income (gross income less expenses)2014-04-30$0
Total contributions received or receivable from employer(s)2014-04-30$16,157
Expenses. Administrative service providers (salaries,fees and commissions)2014-04-30$769
2013 : NEW LEAF INC - INSURANCE 2013 401k financial data
Total income from all sources2013-04-30$13,920
Expenses. Total of all expenses incurred2013-04-30$13,920
Benefits paid (including direct rollovers)2013-04-30$13,257
Net income (gross income less expenses)2013-04-30$0
Total contributions received or receivable from employer(s)2013-04-30$13,920
Expenses. Administrative service providers (salaries,fees and commissions)2013-04-30$663
2012 : NEW LEAF INC - INSURANCE 2012 401k financial data
Total income from all sources2012-04-30$16,503
Expenses. Total of all expenses incurred2012-04-30$16,503
Benefits paid (including direct rollovers)2012-04-30$15,717
Net income (gross income less expenses)2012-04-30$0
Total contributions received or receivable from employer(s)2012-04-30$16,503
Expenses. Administrative service providers (salaries,fees and commissions)2012-04-30$786
2011 : NEW LEAF INC - INSURANCE 2011 401k financial data
Total income from all sources2011-04-30$18,292
Expenses. Total of all expenses incurred2011-04-30$18,292
Benefits paid (including direct rollovers)2011-04-30$17,421
Net income (gross income less expenses)2011-04-30$0
Total contributions received or receivable from employer(s)2011-04-30$18,292
Expenses. Administrative service providers (salaries,fees and commissions)2011-04-30$871

Form 5500 Responses for NEW LEAF INC - INSURANCE

2021: NEW LEAF INC - INSURANCE 2021 form 5500 responses
2021-05-01Type of plan entitySingle employer plan
2021-05-01Submission has been amendedNo
2021-05-01This submission is the final filingNo
2021-05-01This return/report is a short plan year return/report (less than 12 months)No
2021-05-01Plan is a collectively bargained planNo
2021-05-01Plan funding arrangement – InsuranceYes
2021-05-01Plan benefit arrangement – InsuranceYes
2020: NEW LEAF INC - INSURANCE 2020 form 5500 responses
2020-05-01Type of plan entitySingle employer plan
2020-05-01Submission has been amendedNo
2020-05-01This submission is the final filingNo
2020-05-01This return/report is a short plan year return/report (less than 12 months)No
2020-05-01Plan is a collectively bargained planNo
2020-05-01Plan funding arrangement – InsuranceYes
2020-05-01Plan benefit arrangement – InsuranceYes
2019: NEW LEAF INC - INSURANCE 2019 form 5500 responses
2019-05-01Type of plan entitySingle employer plan
2019-05-01Submission has been amendedNo
2019-05-01This submission is the final filingNo
2019-05-01This return/report is a short plan year return/report (less than 12 months)No
2019-05-01Plan is a collectively bargained planNo
2019-05-01Plan funding arrangement – InsuranceYes
2019-05-01Plan benefit arrangement – InsuranceYes
2018: NEW LEAF INC - INSURANCE 2018 form 5500 responses
2018-05-01Type of plan entitySingle employer plan
2018-05-01Submission has been amendedNo
2018-05-01This submission is the final filingNo
2018-05-01This return/report is a short plan year return/report (less than 12 months)No
2018-05-01Plan is a collectively bargained planNo
2018-05-01Plan funding arrangement – InsuranceYes
2018-05-01Plan benefit arrangement – InsuranceYes
2017: NEW LEAF INC - INSURANCE 2017 form 5500 responses
2017-05-01Type of plan entitySingle employer plan
2017-05-01Submission has been amendedNo
2017-05-01This submission is the final filingNo
2017-05-01This return/report is a short plan year return/report (less than 12 months)No
2017-05-01Plan is a collectively bargained planNo
2017-05-01Plan funding arrangement – InsuranceYes
2017-05-01Plan benefit arrangement – InsuranceYes
2016: NEW LEAF INC - INSURANCE 2016 form 5500 responses
2016-05-01Type of plan entitySingle employer plan
2016-05-01Submission has been amendedNo
2016-05-01This submission is the final filingNo
2016-05-01This return/report is a short plan year return/report (less than 12 months)No
2016-05-01Plan is a collectively bargained planNo
2016-05-01Plan funding arrangement – InsuranceYes
2016-05-01Plan benefit arrangement – InsuranceYes
2015: NEW LEAF INC - INSURANCE 2015 form 5500 responses
2015-05-01Type of plan entitySingle employer plan
2015-05-01Submission has been amendedNo
2015-05-01This submission is the final filingNo
2015-05-01This return/report is a short plan year return/report (less than 12 months)No
2015-05-01Plan is a collectively bargained planNo
2015-05-01Plan funding arrangement – InsuranceYes
2015-05-01Plan benefit arrangement – InsuranceYes
2014: NEW LEAF INC - INSURANCE 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: NEW LEAF INC - INSURANCE 2013 form 5500 responses
2013-05-01Type of plan entitySingle employer plan
2013-05-01Submission has been amendedNo
2013-05-01This submission is the final filingNo
2013-05-01This return/report is a short plan year return/report (less than 12 months)No
2013-05-01Plan is a collectively bargained planNo
2013-05-01Plan funding arrangement – InsuranceYes
2013-05-01Plan benefit arrangement – InsuranceYes
2012: NEW LEAF INC - INSURANCE 2012 form 5500 responses
2012-05-01Type of plan entitySingle employer plan
2012-05-01Submission has been amendedNo
2012-05-01This submission is the final filingNo
2012-05-01This return/report is a short plan year return/report (less than 12 months)No
2012-05-01Plan is a collectively bargained planNo
2012-05-01Plan funding arrangement – InsuranceYes
2012-05-01Plan benefit arrangement – InsuranceYes
2011: NEW LEAF INC - INSURANCE 2011 form 5500 responses
2011-05-01Type of plan entitySingle employer plan
2011-05-01Submission has been amendedNo
2011-05-01This submission is the final filingNo
2011-05-01This return/report is a short plan year return/report (less than 12 months)No
2011-05-01Plan is a collectively bargained planNo
2011-05-01Plan funding arrangement – InsuranceYes
2011-05-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1092860
Policy instance 1
Insurance contract or identification number1092860
Number of Individuals Covered95
Insurance policy start date2021-05-01
Insurance policy end date2022-04-30
Total amount of commissions paid to insurance brokerUSD $761
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $15,233
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $761
Amount paid for insurance broker fees0
Insurance broker organization code?3
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1092860
Policy instance 1
Insurance contract or identification number1092860
Number of Individuals Covered104
Insurance policy start date2020-05-01
Insurance policy end date2021-04-30
Total amount of commissions paid to insurance brokerUSD $783
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $15,667
Commission paid to Insurance BrokerUSD $783
Amount paid for insurance broker fees0
Insurance broker organization code?3
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1092860
Policy instance 1
Insurance contract or identification number1092860
Number of Individuals Covered106
Insurance policy start date2019-05-01
Insurance policy end date2020-04-30
Total amount of commissions paid to insurance brokerUSD $860
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $14,658
Commission paid to Insurance BrokerUSD $860
Amount paid for insurance broker fees0
Insurance broker organization code?3
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1092860
Policy instance 1
Insurance contract or identification number1092860
Number of Individuals Covered99
Insurance policy start date2018-05-01
Insurance policy end date2019-04-30
Total amount of commissions paid to insurance brokerUSD $780
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 $16,871
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $780
Insurance broker organization code?3
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberH21909
Policy instance 1
Insurance contract or identification numberH21909
Number of Individuals Covered102
Insurance policy start date2017-05-01
Insurance policy end date2018-04-30
Total amount of commissions paid to insurance brokerUSD $732
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 $14,637
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $732
Insurance broker organization code?3
Insurance broker nameDOROTHY A. RODES
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberH21909
Policy instance 1
Insurance contract or identification numberH21909
Number of Individuals Covered98
Insurance policy start date2015-05-01
Insurance policy end date2016-04-30
Total amount of commissions paid to insurance brokerUSD $717
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 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 $14,342
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $717
Insurance broker organization code?3
Insurance broker nameDOROTHY A RODES
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberH21909
Policy instance 1
Insurance contract or identification numberH21909
Number of Individuals Covered86
Insurance policy start date2014-05-01
Insurance policy end date2015-04-30
Total amount of commissions paid to insurance brokerUSD $661
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 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 $13,228
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $661
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameDOROTHY A RODES
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberH21909
Policy instance 1
Insurance contract or identification numberH21909
Number of Individuals Covered168
Insurance policy start date2013-05-01
Insurance policy end date2014-04-30
Total amount of commissions paid to insurance brokerUSD $769
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 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 $15,388
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $769
Insurance broker organization code?3
Insurance broker nameDOROTHY A. RHODES
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberH21909
Policy instance 1
Insurance contract or identification numberH21909
Number of Individuals Covered191
Insurance policy start date2012-05-01
Insurance policy end date2013-04-30
Total amount of commissions paid to insurance brokerUSD $663
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $13,257
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $663
Insurance broker organization code?3
Insurance broker nameDOROTHY A. RHODES
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberH21909
Policy instance 1
Insurance contract or identification numberH21909
Number of Individuals Covered204
Insurance policy start date2011-05-01
Insurance policy end date2012-04-30
Total amount of commissions paid to insurance brokerUSD $786
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $15,717
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberH21909
Policy instance 1
Insurance contract or identification numberH21909
Number of Individuals Covered116
Insurance policy start date2010-05-01
Insurance policy end date2011-04-30
Total amount of commissions paid to insurance brokerUSD $871
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $17,421
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $871
Insurance broker organization code?3
Insurance broker nameD&D FINANCIAL SERVICES

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