NEW ENGLAND WIRE TECHNOLOGIES CORP. has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan GROUP HOSPITAL SURGICAL & MAJOR MEDICAL INSURANCE
401k plan membership statisitcs for GROUP HOSPITAL SURGICAL & MAJOR MEDICAL INSURANCE
| Measure | Date | Value |
|---|
| 2022: GROUP HOSPITAL SURGICAL & MAJOR MEDICAL INSURANCE 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-01-01 | 370 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 378 |
| Total of all active and inactive participants | 2022-01-01 | 378 |
| Total participants | 2022-01-01 | 378 |
| 2021: GROUP HOSPITAL SURGICAL & MAJOR MEDICAL INSURANCE 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-01-01 | 361 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 370 |
| Total of all active and inactive participants | 2021-01-01 | 370 |
| Total participants | 2021-01-01 | 370 |
| 2020: GROUP HOSPITAL SURGICAL & MAJOR MEDICAL INSURANCE 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-01-01 | 388 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 361 |
| Total of all active and inactive participants | 2020-01-01 | 361 |
| Total participants | 2020-01-01 | 361 |
| 2019: GROUP HOSPITAL SURGICAL & MAJOR MEDICAL INSURANCE 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-01-01 | 403 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 388 |
| Total of all active and inactive participants | 2019-01-01 | 388 |
| Total participants | 2019-01-01 | 388 |
| 2018: GROUP HOSPITAL SURGICAL & MAJOR MEDICAL INSURANCE 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-01-01 | 364 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 403 |
| Total of all active and inactive participants | 2018-01-01 | 403 |
| Total participants | 2018-01-01 | 403 |
| 2017: GROUP HOSPITAL SURGICAL & MAJOR MEDICAL INSURANCE 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-01-01 | 0 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 364 |
| Total of all active and inactive participants | 2017-01-01 | 364 |
| Total participants | 2017-01-01 | 364 |
| 2016: GROUP HOSPITAL SURGICAL & MAJOR MEDICAL INSURANCE 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-01-01 | 0 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 356 |
| Total of all active and inactive participants | 2016-01-01 | 356 |
| Total participants | 2016-01-01 | 356 |
| 2015: GROUP HOSPITAL SURGICAL & MAJOR MEDICAL INSURANCE 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-01-01 | 345 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 361 |
| Total of all active and inactive participants | 2015-01-01 | 361 |
| Total participants | 2015-01-01 | 0 |
| 2014: GROUP HOSPITAL SURGICAL & MAJOR MEDICAL INSURANCE 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-01-01 | 319 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 345 |
| Total of all active and inactive participants | 2014-01-01 | 345 |
| Total participants | 2014-01-01 | 0 |
| 2013: GROUP HOSPITAL SURGICAL & MAJOR MEDICAL INSURANCE 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-01-01 | 330 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 319 |
| Total of all active and inactive participants | 2013-01-01 | 319 |
| Total participants | 2013-01-01 | 0 |
| 2012: GROUP HOSPITAL SURGICAL & MAJOR MEDICAL INSURANCE 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-01-01 | 321 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 330 |
| Total of all active and inactive participants | 2012-01-01 | 330 |
| Total participants | 2012-01-01 | 0 |
| 2011: GROUP HOSPITAL SURGICAL & MAJOR MEDICAL INSURANCE 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-01-01 | 296 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 321 |
| Total of all active and inactive participants | 2011-01-01 | 321 |
| Total participants | 2011-01-01 | 321 |
| 2010: GROUP HOSPITAL SURGICAL & MAJOR MEDICAL INSURANCE 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-01-01 | 269 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-01-01 | 296 |
| Total of all active and inactive participants | 2010-01-01 | 296 |
| Total participants | 2010-01-01 | 296 |
| 2009: GROUP HOSPITAL SURGICAL & MAJOR MEDICAL INSURANCE 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-01-01 | 337 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 269 |
| Total of all active and inactive participants | 2009-01-01 | 269 |
| Total participants | 2009-01-01 | 269 |
| 2022: GROUP HOSPITAL SURGICAL & MAJOR MEDICAL INSURANCE 2022 form 5500 responses |
|---|
| 2022-01-01 | Type of plan entity | Single employer plan |
| 2022-01-01 | Plan funding arrangement – Insurance | Yes |
| 2022-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2022-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2022-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2021: GROUP HOSPITAL SURGICAL & MAJOR MEDICAL INSURANCE 2021 form 5500 responses |
|---|
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | Submission has been amended | No |
| 2021-01-01 | This submission is the final filing | No |
| 2021-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2021-01-01 | Plan is a collectively bargained plan | No |
| 2021-01-01 | Plan funding arrangement – Insurance | Yes |
| 2021-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2021-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2021-01-01 | Plan benefit arrangement – Section 412(e)(3) insurance Contracts | Yes |
| 2021-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2020: GROUP HOSPITAL SURGICAL & MAJOR MEDICAL INSURANCE 2020 form 5500 responses |
|---|
| 2020-01-01 | Type of plan entity | Single employer plan |
| 2020-01-01 | Submission has been amended | No |
| 2020-01-01 | This submission is the final filing | No |
| 2020-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2020-01-01 | Plan is a collectively bargained plan | No |
| 2020-01-01 | Plan funding arrangement – Insurance | Yes |
| 2020-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2020-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2020-01-01 | Plan benefit arrangement – Section 412(e)(3) insurance Contracts | Yes |
| 2020-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2019: GROUP HOSPITAL SURGICAL & MAJOR MEDICAL INSURANCE 2019 form 5500 responses |
|---|
| 2019-01-01 | Type of plan entity | Single employer plan |
| 2019-01-01 | Plan funding arrangement – Insurance | Yes |
| 2019-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2019-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2019-01-01 | Plan benefit arrangement – Section 412(e)(3) insurance Contracts | Yes |
| 2019-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2018: GROUP HOSPITAL SURGICAL & MAJOR MEDICAL INSURANCE 2018 form 5500 responses |
|---|
| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | Plan funding arrangement – Insurance | Yes |
| 2018-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2018-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2018-01-01 | Plan benefit arrangement – Section 412(e)(3) insurance Contracts | Yes |
| 2018-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2017: GROUP HOSPITAL SURGICAL & MAJOR MEDICAL INSURANCE 2017 form 5500 responses |
|---|
| 2017-01-01 | Type of plan entity | Single employer plan |
| 2017-01-01 | Plan funding arrangement – Insurance | Yes |
| 2017-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2017-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2017-01-01 | Plan benefit arrangement – Section 412(e)(3) insurance Contracts | Yes |
| 2017-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2016: GROUP HOSPITAL SURGICAL & MAJOR MEDICAL INSURANCE 2016 form 5500 responses |
|---|
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | Plan funding arrangement – Insurance | Yes |
| 2016-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2016-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2016-01-01 | Plan benefit arrangement – Section 412(e)(3) insurance Contracts | Yes |
| 2016-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2015: GROUP HOSPITAL SURGICAL & MAJOR MEDICAL INSURANCE 2015 form 5500 responses |
|---|
| 2015-01-01 | Type of plan entity | Single employer plan |
| 2015-01-01 | Plan funding arrangement – Insurance | Yes |
| 2015-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2015-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2015-01-01 | Plan benefit arrangement – Section 412(e)(3) insurance Contracts | Yes |
| 2015-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2014: GROUP HOSPITAL SURGICAL & MAJOR MEDICAL INSURANCE 2014 form 5500 responses |
|---|
| 2014-01-01 | Type of plan entity | Single employer plan |
| 2014-01-01 | Plan funding arrangement – Insurance | Yes |
| 2014-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2014-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2014-01-01 | Plan benefit arrangement – Section 412(e)(3) insurance Contracts | Yes |
| 2014-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2013: GROUP HOSPITAL SURGICAL & MAJOR MEDICAL INSURANCE 2013 form 5500 responses |
|---|
| 2013-01-01 | Type of plan entity | Single employer plan |
| 2013-01-01 | Plan funding arrangement – Insurance | Yes |
| 2013-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2013-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2013-01-01 | Plan benefit arrangement – Section 412(e)(3) insurance Contracts | Yes |
| 2013-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2012: GROUP HOSPITAL SURGICAL & MAJOR MEDICAL INSURANCE 2012 form 5500 responses |
|---|
| 2012-01-01 | Type of plan entity | Single employer plan |
| 2012-01-01 | Plan funding arrangement – Insurance | Yes |
| 2012-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2012-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2012-01-01 | Plan benefit arrangement – Section 412(e)(3) insurance Contracts | Yes |
| 2012-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2011: GROUP HOSPITAL SURGICAL & MAJOR MEDICAL INSURANCE 2011 form 5500 responses |
|---|
| 2011-01-01 | Type of plan entity | Single employer plan |
| 2011-01-01 | Plan funding arrangement – Insurance | Yes |
| 2011-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2011-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2011-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2010: GROUP HOSPITAL SURGICAL & MAJOR MEDICAL INSURANCE 2010 form 5500 responses |
|---|
| 2010-01-01 | Type of plan entity | Single employer plan |
| 2010-01-01 | Plan funding arrangement – Insurance | Yes |
| 2010-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: GROUP HOSPITAL SURGICAL & MAJOR MEDICAL INSURANCE 2009 form 5500 responses |
|---|
| 2009-01-01 | Type of plan entity | Single employer plan |
| 2009-01-01 | Plan funding arrangement – Insurance | Yes |
| 2009-01-01 | Plan benefit arrangement – Insurance | Yes |
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
| Policy contract number | 758616 |
| Policy instance | 2 |
| Insurance contract or identification number | 758616 | | Insurance policy start date | 2021-10-01 | | Insurance policy end date | 2022-09-30 | | Total amount of commissions paid to insurance broker | USD $5,192 | | Total amount of fees paid to insurance company | USD $1,944 | | Life Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,556 | | Amount paid for insurance broker fees | 1944 | | Additional information about fees paid to insurance broker | ADMINISTRATION | | Insurance broker organization code? | 3 |
|
| US FIRE (National Association of Insurance Commissioners NAIC id number: 21113 ) |
| Policy contract number | US1181650 |
| Policy instance | 1 |
| Insurance contract or identification number | US1181650 | | Insurance policy start date | 2021-10-01 | | Insurance policy end date | 2022-09-30 | | Welfare Benefit Premiums Paid to Carrier | USD $451,470 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| US FIRE (National Association of Insurance Commissioners NAIC id number: 21113 ) |
| Policy contract number | US1181504 |
| Policy instance | 1 |
| Insurance contract or identification number | US1181504 | | Number of Individuals Covered | 370 | | Insurance policy start date | 2020-10-01 | | Insurance policy end date | 2021-09-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $422,682 | | 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 number | 758616 |
| Policy instance | 2 |
| Insurance contract or identification number | 758616 | | Number of Individuals Covered | 370 | | Insurance policy start date | 2020-10-01 | | Insurance policy end date | 2021-09-30 | | Total amount of commissions paid to insurance broker | USD $4,094 | | Total amount of fees paid to insurance company | USD $2,621 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Broker | USD $3,788 | | Amount paid for insurance broker fees | 2621 | | Additional information about fees paid to insurance broker | ADMINISTRATION | | Insurance broker organization code? | 3 |
|
| US FIRE (National Association of Insurance Commissioners NAIC id number: 21113 ) |
| Policy contract number | US746281 |
| Policy instance | 1 |
| Insurance contract or identification number | US746281 | | Number of Individuals Covered | 361 | | Insurance policy start date | 2019-10-01 | | Insurance policy end date | 2020-09-30 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | Yes | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | No | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Carrier | USD $394,110 | | 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 number | 756816 |
| Policy instance | 2 |
| Insurance contract or identification number | 756816 | | Number of Individuals Covered | 380 | | Insurance policy start date | 2019-10-01 | | Insurance policy end date | 2020-09-30 | | Total amount of commissions paid to insurance broker | USD $8,300 | | 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 plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | 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 Benefit | No | | Dental Insurance Welfare Benefit | No | | Vision Insurance Welfare Benefit | No | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | No | | Long Term Disability Insurance Welfare Benefit | No | | Unemployment Insurance Welfare Benefit | No | | 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 Broker | USD $8,300 | | Insurance broker organization code? | 3 |
|
| ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 ) |
| Policy contract number | AL00006329 |
| Policy instance | 2 |
| Insurance contract or identification number | AL00006329 | | Number of Individuals Covered | 409 | | Insurance policy start date | 2018-10-01 | | Insurance policy end date | 2019-09-30 | | Total amount of commissions paid to insurance broker | USD $9,855 | | Total amount of fees paid to insurance company | USD $3,800 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $91,167 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $9,855 | | Amount paid for insurance broker fees | 3800 |
|
| US FIRE (National Association of Insurance Commissioners NAIC id number: 21113 ) |
| Policy contract number | US746281 |
| Policy instance | 1 |
| Insurance contract or identification number | US746281 | | Number of Individuals Covered | 388 | | Insurance policy start date | 2018-10-01 | | Insurance policy end date | 2019-09-30 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $363,016 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 ) |
| Policy contract number | AL00006329 |
| Policy instance | 2 |
| Insurance contract or identification number | AL00006329 | | Number of Individuals Covered | 403 | | Insurance policy start date | 2017-10-01 | | Insurance policy end date | 2018-09-30 | | Total amount of commissions paid to insurance broker | USD $12,026 | | Total amount of fees paid to insurance company | USD $10,236 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $96,097 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $12,026 | | Amount paid for insurance broker fees | 10236 | | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | | Insurance broker organization code? | 3 |
|
| US FIRE (National Association of Insurance Commissioners NAIC id number: 21113 ) |
| Policy contract number | US746281 |
| Policy instance | 1 |
| Insurance contract or identification number | US746281 | | Number of Individuals Covered | 386 | | Insurance policy start date | 2017-10-01 | | Insurance policy end date | 2018-09-30 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $365,290 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010183194 |
| Policy instance | 2 |
| Insurance contract or identification number | 000010183194 | | Insurance policy start date | 2016-10-01 | | Insurance policy end date | 2017-09-30 | | Total amount of commissions paid to insurance broker | USD $2,648 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $31,638 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,648 | | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | | Insurance broker organization code? | 3 | | Insurance broker name | NEW ENGLAND EMPLOYEE BENEFITS |
|
| HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 ) |
| Policy contract number | HCL18627 |
| Policy instance | 1 |
| Insurance contract or identification number | HCL18627 | | Insurance policy start date | 2016-10-01 | | Insurance policy end date | 2017-09-30 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $343,431 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010183194 |
| Policy instance | 2 |
| Insurance contract or identification number | 000010183194 | | Number of Individuals Covered | 361 | | Insurance policy start date | 2014-12-01 | | Insurance policy end date | 2015-11-30 | | Total amount of commissions paid to insurance broker | USD $1,987 | | Total amount of fees paid to insurance company | USD $610 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $20,444 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,987 | | Amount paid for insurance broker fees | 610 | | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | | Insurance broker organization code? | 3 | | Insurance broker name | NEW ENGLAND EMPLOYEE BENEFITS |
|
| HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 ) |
| Policy contract number | HCL18627 |
| Policy instance | 1 |
| Insurance contract or identification number | HCL18627 | | Number of Individuals Covered | 339 | | Insurance policy start date | 2014-10-01 | | Insurance policy end date | 2015-09-30 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $314,985 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| AVEMCO INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | HCL18627 |
| Policy instance | 1 |
| Insurance contract or identification number | HCL18627 | | Number of Individuals Covered | 322 | | Insurance policy start date | 2013-10-01 | | Insurance policy end date | 2014-09-30 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $271,261 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 000010183194 |
| Policy instance | 2 |
| Insurance contract or identification number | 000010183194 | | Number of Individuals Covered | 345 | | Insurance policy start date | 2013-12-01 | | Insurance policy end date | 2014-12-01 | | Total amount of commissions paid to insurance broker | USD $1,958 | | Total amount of fees paid to insurance company | USD $550 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $19,971 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,958 | | Amount paid for insurance broker fees | 550 | | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | | Insurance broker organization code? | 3 | | Insurance broker name | NEW ENGLAND EMPLOYEE BENEFITS |
|
| AVEMCO INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | HCL18627 |
| Policy instance | 1 |
| Insurance contract or identification number | HCL18627 | | Number of Individuals Covered | 319 | | Insurance policy start date | 2012-10-01 | | Insurance policy end date | 2013-09-30 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $249,043 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000AMX6 |
| Policy instance | 3 |
| Insurance contract or identification number | G000AMX6 | | Number of Individuals Covered | 331 | | Insurance policy start date | 2012-12-01 | | Insurance policy end date | 2013-12-01 | | Welfare Benefit Premiums Paid to Carrier | USD $23,217 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000AMX6 |
| Policy instance | 2 |
| Insurance contract or identification number | G000AMX6 | | Number of Individuals Covered | 297 | | Insurance policy start date | 2012-12-01 | | Insurance policy end date | 2013-12-01 | | Total amount of commissions paid to insurance broker | USD $6,297 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $49,502 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,297 | | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | | Insurance broker organization code? | 3 | | Insurance broker name | NEW ENGLAND EMPLOYEE BENEFITS |
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| AVEMCO INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 ) |
| Policy contract number | HCL18627 |
| Policy instance | 2 |
| Insurance contract or identification number | HCL18627 | | Number of Individuals Covered | 315 | | Insurance policy start date | 2011-10-01 | | Insurance policy end date | 2012-09-30 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $289,242 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 000000226496 |
| Policy instance | 1 |
| Insurance contract or identification number | 000000226496 | | Number of Individuals Covered | 330 | | Insurance policy start date | 2011-12-01 | | Insurance policy end date | 2012-12-01 | | Total amount of commissions paid to insurance broker | USD $6,343 | | Total amount of fees paid to insurance company | USD $1,268 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $84,528 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,343 | | Amount paid for insurance broker fees | 1268 | | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | | Insurance broker organization code? | 3 | | Insurance broker name | NEW ENGLAND EMPLOYEE BENEFITS |
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| PERICO LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85561 ) |
| Policy contract number | PX00901 |
| Policy instance | 1 |
| Insurance contract or identification number | PX00901 | | Insurance policy start date | 2010-10-01 | | Insurance policy end date | 2011-09-30 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $263,874 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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| PERICO LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85561 ) |
| Policy contract number | PX00901 |
| Policy instance | 1 |
| Insurance contract or identification number | PX00901 | | Number of Individuals Covered | 296 | | Insurance policy start date | 2009-10-01 | | Insurance policy end date | 2010-09-30 | | Health Insurance Welfare Benefit | Yes | | Other welfare benefits provided | MEDICAL EXCESS LOSS | | Welfare Benefit Premiums Paid to Carrier | USD $228,448 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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