SOUTHERN OREGON CHILD AND FAMILY COUNCIL, INC. has sponsored the creation of one or more 401k plans.
Additional information about SOUTHERN OREGON CHILD AND FAMILY COUNCIL, INC.
Submission information for form 5500 for 401k plan SOUTHERN OREGON CHILD & FAMILY COUNCIL, INC. DBA SOUTHERN OREGON HEAD START
401k plan membership statisitcs for SOUTHERN OREGON CHILD & FAMILY COUNCIL, INC. DBA SOUTHERN OREGON HEAD START
| Measure | Date | Value |
|---|
| 2022: SOUTHERN OREGON CHILD & FAMILY COUNCIL, INC. DBA SOUTHERN OREGON HEAD START 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-09-01 | 264 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-09-01 | 214 |
| Number of retired or separated participants receiving benefits | 2022-09-01 | 1 |
| Number of other retired or separated participants entitled to future benefits | 2022-09-01 | 0 |
| Total of all active and inactive participants | 2022-09-01 | 215 |
| Number of employers contributing to the scheme | 2022-09-01 | 0 |
| 2021: SOUTHERN OREGON CHILD & FAMILY COUNCIL, INC. DBA SOUTHERN OREGON HEAD START 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-09-01 | 255 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-09-01 | 213 |
| Number of retired or separated participants receiving benefits | 2021-09-01 | 1 |
| Number of other retired or separated participants entitled to future benefits | 2021-09-01 | 0 |
| Total of all active and inactive participants | 2021-09-01 | 214 |
| Number of employers contributing to the scheme | 2021-09-01 | 1 |
| 2020: SOUTHERN OREGON CHILD & FAMILY COUNCIL, INC. DBA SOUTHERN OREGON HEAD START 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-09-01 | 308 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-09-01 | 261 |
| Number of retired or separated participants receiving benefits | 2020-09-01 | 1 |
| Number of other retired or separated participants entitled to future benefits | 2020-09-01 | 0 |
| Total of all active and inactive participants | 2020-09-01 | 262 |
| 2019: SOUTHERN OREGON CHILD & FAMILY COUNCIL, INC. DBA SOUTHERN OREGON HEAD START 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-09-01 | 295 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-09-01 | 282 |
| Number of retired or separated participants receiving benefits | 2019-09-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2019-09-01 | 0 |
| Total of all active and inactive participants | 2019-09-01 | 282 |
| 2018: SOUTHERN OREGON CHILD & FAMILY COUNCIL, INC. DBA SOUTHERN OREGON HEAD START 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-09-01 | 287 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-09-01 | 263 |
| Number of retired or separated participants receiving benefits | 2018-09-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2018-09-01 | 0 |
| Total of all active and inactive participants | 2018-09-01 | 263 |
| 2017: SOUTHERN OREGON CHILD & FAMILY COUNCIL, INC. DBA SOUTHERN OREGON HEAD START 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-09-01 | 289 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-09-01 | 284 |
| Number of retired or separated participants receiving benefits | 2017-09-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2017-09-01 | 0 |
| Total of all active and inactive participants | 2017-09-01 | 284 |
| 2016: SOUTHERN OREGON CHILD & FAMILY COUNCIL, INC. DBA SOUTHERN OREGON HEAD START 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-09-01 | 299 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-09-01 | 289 |
| Number of retired or separated participants receiving benefits | 2016-09-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2016-09-01 | 0 |
| Total of all active and inactive participants | 2016-09-01 | 289 |
| 2015: SOUTHERN OREGON CHILD & FAMILY COUNCIL, INC. DBA SOUTHERN OREGON HEAD START 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-09-01 | 281 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-09-01 | 262 |
| Number of retired or separated participants receiving benefits | 2015-09-01 | 1 |
| Number of other retired or separated participants entitled to future benefits | 2015-09-01 | 0 |
| Total of all active and inactive participants | 2015-09-01 | 263 |
| 2014: SOUTHERN OREGON CHILD & FAMILY COUNCIL, INC. DBA SOUTHERN OREGON HEAD START 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-09-01 | 224 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-09-01 | 256 |
| Total of all active and inactive participants | 2014-09-01 | 256 |
| 2013: SOUTHERN OREGON CHILD & FAMILY COUNCIL, INC. DBA SOUTHERN OREGON HEAD START 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-09-01 | 281 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-09-01 | 224 |
| Total of all active and inactive participants | 2013-09-01 | 224 |
| 2012: SOUTHERN OREGON CHILD & FAMILY COUNCIL, INC. DBA SOUTHERN OREGON HEAD START 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-09-01 | 288 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-09-01 | 281 |
| Total of all active and inactive participants | 2012-09-01 | 281 |
| 2011: SOUTHERN OREGON CHILD & FAMILY COUNCIL, INC. DBA SOUTHERN OREGON HEAD START 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-09-01 | 275 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-09-01 | 288 |
| Total of all active and inactive participants | 2011-09-01 | 288 |
| 2010: SOUTHERN OREGON CHILD & FAMILY COUNCIL, INC. DBA SOUTHERN OREGON HEAD START 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-09-01 | 280 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-09-01 | 275 |
| Total of all active and inactive participants | 2010-09-01 | 275 |
| 2009: SOUTHERN OREGON CHILD & FAMILY COUNCIL, INC. DBA SOUTHERN OREGON HEAD START 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-09-01 | 264 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-09-01 | 280 |
| Total of all active and inactive participants | 2009-09-01 | 280 |
| 2022: SOUTHERN OREGON CHILD & FAMILY COUNCIL, INC. DBA SOUTHERN OREGON HEAD START 2022 form 5500 responses |
|---|
| 2022-09-01 | Type of plan entity | Single employer plan |
| 2022-09-01 | Plan is a collectively bargained plan | Yes |
| 2022-09-01 | Plan funding arrangement – Insurance | Yes |
| 2022-09-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2022-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2022-09-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2021: SOUTHERN OREGON CHILD & FAMILY COUNCIL, INC. DBA SOUTHERN OREGON HEAD START 2021 form 5500 responses |
|---|
| 2021-09-01 | Type of plan entity | Single employer plan |
| 2021-09-01 | Plan is a collectively bargained plan | Yes |
| 2021-09-01 | Plan funding arrangement – Insurance | Yes |
| 2021-09-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2021-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2021-09-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2020: SOUTHERN OREGON CHILD & FAMILY COUNCIL, INC. DBA SOUTHERN OREGON HEAD START 2020 form 5500 responses |
|---|
| 2020-09-01 | Type of plan entity | Single employer plan |
| 2020-09-01 | Plan is a collectively bargained plan | Yes |
| 2020-09-01 | Plan funding arrangement – Insurance | Yes |
| 2020-09-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2020-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2020-09-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2019: SOUTHERN OREGON CHILD & FAMILY COUNCIL, INC. DBA SOUTHERN OREGON HEAD START 2019 form 5500 responses |
|---|
| 2019-09-01 | Type of plan entity | Single employer plan |
| 2019-09-01 | Plan is a collectively bargained plan | Yes |
| 2019-09-01 | Plan funding arrangement – Insurance | Yes |
| 2019-09-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2019-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2019-09-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2018: SOUTHERN OREGON CHILD & FAMILY COUNCIL, INC. DBA SOUTHERN OREGON HEAD START 2018 form 5500 responses |
|---|
| 2018-09-01 | Type of plan entity | Single employer plan |
| 2018-09-01 | Plan is a collectively bargained plan | Yes |
| 2018-09-01 | Plan funding arrangement – Insurance | Yes |
| 2018-09-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2018-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2018-09-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2017: SOUTHERN OREGON CHILD & FAMILY COUNCIL, INC. DBA SOUTHERN OREGON HEAD START 2017 form 5500 responses |
|---|
| 2017-09-01 | Type of plan entity | Single employer plan |
| 2017-09-01 | Plan is a collectively bargained plan | Yes |
| 2017-09-01 | Plan funding arrangement – Insurance | Yes |
| 2017-09-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2017-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2017-09-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2016: SOUTHERN OREGON CHILD & FAMILY COUNCIL, INC. DBA SOUTHERN OREGON HEAD START 2016 form 5500 responses |
|---|
| 2016-09-01 | Type of plan entity | Single employer plan |
| 2016-09-01 | Plan is a collectively bargained plan | Yes |
| 2016-09-01 | Plan funding arrangement – Insurance | Yes |
| 2016-09-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2016-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2016-09-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2015: SOUTHERN OREGON CHILD & FAMILY COUNCIL, INC. DBA SOUTHERN OREGON HEAD START 2015 form 5500 responses |
|---|
| 2015-09-01 | Type of plan entity | Single employer plan |
| 2015-09-01 | Plan is a collectively bargained plan | Yes |
| 2015-09-01 | Plan funding arrangement – Insurance | Yes |
| 2015-09-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2015-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2015-09-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2014: SOUTHERN OREGON CHILD & FAMILY COUNCIL, INC. DBA SOUTHERN OREGON HEAD START 2014 form 5500 responses |
|---|
| 2014-09-01 | Type of plan entity | Single employer plan |
| 2014-09-01 | Plan is a collectively bargained plan | Yes |
| 2014-09-01 | Plan funding arrangement – Insurance | Yes |
| 2014-09-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2014-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2014-09-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2013: SOUTHERN OREGON CHILD & FAMILY COUNCIL, INC. DBA SOUTHERN OREGON HEAD START 2013 form 5500 responses |
|---|
| 2013-09-01 | Type of plan entity | Single employer plan |
| 2013-09-01 | Plan is a collectively bargained plan | Yes |
| 2013-09-01 | Plan funding arrangement – Insurance | Yes |
| 2013-09-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2013-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2013-09-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2012: SOUTHERN OREGON CHILD & FAMILY COUNCIL, INC. DBA SOUTHERN OREGON HEAD START 2012 form 5500 responses |
|---|
| 2012-09-01 | Type of plan entity | Single employer plan |
| 2012-09-01 | Plan is a collectively bargained plan | Yes |
| 2012-09-01 | Plan funding arrangement – Insurance | Yes |
| 2012-09-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2012-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2012-09-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2011: SOUTHERN OREGON CHILD & FAMILY COUNCIL, INC. DBA SOUTHERN OREGON HEAD START 2011 form 5500 responses |
|---|
| 2011-09-01 | Type of plan entity | Single employer plan |
| 2011-09-01 | Plan is a collectively bargained plan | Yes |
| 2011-09-01 | Plan funding arrangement – Insurance | Yes |
| 2011-09-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2011-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2011-09-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2010: SOUTHERN OREGON CHILD & FAMILY COUNCIL, INC. DBA SOUTHERN OREGON HEAD START 2010 form 5500 responses |
|---|
| 2010-09-01 | Type of plan entity | Single employer plan |
| 2010-09-01 | Plan is a collectively bargained plan | Yes |
| 2010-09-01 | Plan funding arrangement – Insurance | Yes |
| 2010-09-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2010-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2010-09-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2009: SOUTHERN OREGON CHILD & FAMILY COUNCIL, INC. DBA SOUTHERN OREGON HEAD START 2009 form 5500 responses |
|---|
| 2009-09-01 | Type of plan entity | Single employer plan |
| 2009-09-01 | Submission has been amended | Yes |
| 2009-09-01 | This submission is the final filing | No |
| 2009-09-01 | Plan is a collectively bargained plan | Yes |
| 2009-09-01 | Plan funding arrangement – Insurance | Yes |
| 2009-09-01 | Plan funding arrangement – Trust | Yes |
| 2009-09-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2009-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2009-09-01 | Plan benefit arrangement - Trust | Yes |
| 2009-09-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| PROVIDENCE HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | SOCFC.EAP |
| Policy instance | 2 |
| Insurance contract or identification number | SOCFC.EAP | | Number of Individuals Covered | 314 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | EMPLOYEE ASSISTANCE PROGRAM | | Welfare Benefit Premiums Paid to Carrier | USD $8,303 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 914048 |
| Policy instance | 1 |
| Insurance contract or identification number | 914048 | | Number of Individuals Covered | 245 | | Insurance policy start date | 2022-09-01 | | Insurance policy end date | 2023-08-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $48,130 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PROVIDENCE HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | SOCFC.EAP |
| Policy instance | 2 |
| Insurance contract or identification number | SOCFC.EAP | | Number of Individuals Covered | 372 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | EMPLOYEE ASSISTANCE PROGRAM | | Welfare Benefit Premiums Paid to Carrier | USD $8,488 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 914048 |
| Policy instance | 1 |
| Insurance contract or identification number | 914048 | | Number of Individuals Covered | 239 | | Insurance policy start date | 2021-09-01 | | Insurance policy end date | 2022-08-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $52,210 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 914048 |
| Policy instance | 3 |
| Insurance contract or identification number | 914048 | | Insurance policy start date | 2020-09-01 | | Insurance policy end date | 2021-08-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ADD | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 914048 |
| Policy instance | 2 |
| Insurance contract or identification number | 914048 | | Insurance policy start date | 2020-09-01 | | Insurance policy end date | 2021-08-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 914048 |
| Policy instance | 1 |
| Insurance contract or identification number | 914048 | | Number of Individuals Covered | 292 | | Insurance policy start date | 2020-09-01 | | Insurance policy end date | 2021-08-31 | | Total amount of commissions paid to insurance broker | USD $1,271 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ADD | | Welfare Benefit Premiums Paid to Carrier | USD $12,273 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,271 | | Insurance broker organization code? | 3 |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 914048 |
| Policy instance | 3 |
| Insurance contract or identification number | 914048 | | Number of Individuals Covered | 122 | | Insurance policy start date | 2019-09-01 | | Insurance policy end date | 2020-08-31 | | Total amount of commissions paid to insurance broker | USD $3,524 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ADD | | Welfare Benefit Premiums Paid to Carrier | USD $29,314 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,524 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 914048 |
| Policy instance | 2 |
| Insurance contract or identification number | 914048 | | Number of Individuals Covered | 50 | | Insurance policy start date | 2019-09-01 | | Insurance policy end date | 2020-08-31 | | Total amount of commissions paid to insurance broker | USD $2,311 | | Total amount of fees paid to insurance company | USD $0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $19,557 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,311 | | Insurance broker organization code? | 3 |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 914048 |
| Policy instance | 1 |
| Insurance contract or identification number | 914048 | | Number of Individuals Covered | 308 | | Insurance policy start date | 2019-09-01 | | Insurance policy end date | 2020-08-31 | | Total amount of commissions paid to insurance broker | USD $1,041 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ADD | | Welfare Benefit Premiums Paid to Carrier | USD $12,979 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,041 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 914048 |
| Policy instance | 3 |
| Insurance contract or identification number | 914048 | | Number of Individuals Covered | 110 | | Insurance policy start date | 2018-09-01 | | Insurance policy end date | 2019-08-31 | | Total amount of commissions paid to insurance broker | USD $4,370 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ADD | | Welfare Benefit Premiums Paid to Carrier | USD $25,584 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,370 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 914048 |
| Policy instance | 2 |
| Insurance contract or identification number | 914048 | | Number of Individuals Covered | 76 | | Insurance policy start date | 2018-09-01 | | Insurance policy end date | 2019-08-31 | | Total amount of commissions paid to insurance broker | USD $2,634 | | Total amount of fees paid to insurance company | USD $0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $16,535 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,634 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 914048 |
| Policy instance | 1 |
| Insurance contract or identification number | 914048 | | Number of Individuals Covered | 295 | | Insurance policy start date | 2018-09-01 | | Insurance policy end date | 2019-08-31 | | Total amount of commissions paid to insurance broker | USD $1,303 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ADD | | Welfare Benefit Premiums Paid to Carrier | USD $12,442 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,303 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 ) |
| Policy contract number | 5475516 |
| Policy instance | 3 |
| Insurance contract or identification number | 5475516 | | Number of Individuals Covered | 112 | | Insurance policy start date | 2017-09-01 | | Insurance policy end date | 2018-08-31 | | Total amount of commissions paid to insurance broker | USD $4,282 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ADD | | Welfare Benefit Premiums Paid to Carrier | USD $28,545 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 ) |
| Policy contract number | 5475516 |
| Policy instance | 2 |
| Insurance contract or identification number | 5475516 | | Number of Individuals Covered | 72 | | Insurance policy start date | 2017-09-01 | | Insurance policy end date | 2018-08-31 | | Total amount of commissions paid to insurance broker | USD $1,310 | | Total amount of fees paid to insurance company | USD $0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $13,097 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 ) |
| Policy contract number | 5475516 |
| Policy instance | 1 |
| Insurance contract or identification number | 5475516 | | Number of Individuals Covered | 284 | | Insurance policy start date | 2017-09-01 | | Insurance policy end date | 2018-08-31 | | Total amount of commissions paid to insurance broker | USD $1,209 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ADD | | Welfare Benefit Premiums Paid to Carrier | USD $12,091 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
