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GROUP LIFE AD&D FOR WEEKLY AND SALARIED EMPLOYEES 401k Plan overview

Plan NameGROUP LIFE AD&D FOR WEEKLY AND SALARIED EMPLOYEES
Plan identification number 502

GROUP LIFE AD&D FOR WEEKLY AND SALARIED EMPLOYEES Benefits

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

401k Sponsoring company profile

BOSTON MUTUAL LIFE INSURANCE COMPANY has sponsored the creation of one or more 401k plans.

Company Name:BOSTON MUTUAL LIFE INSURANCE COMPANY
Employer identification number (EIN):041106240
NAIC Classification:524140

Additional information about BOSTON MUTUAL LIFE INSURANCE COMPANY

Jurisdiction of Incorporation: Georgia Department of States Corporations Division
Incorporation Date:
Company Identification Number: 734335

More information about BOSTON MUTUAL LIFE INSURANCE COMPANY

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GROUP LIFE AD&D FOR WEEKLY AND SALARIED EMPLOYEES

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022022-01-01
5022021-01-01
5022020-01-01
5022019-01-01
5022018-01-01
5022017-01-01CHRISTINE COUGHLIN SUSAN GARDNER2018-09-14
5022016-01-01KIM BROSNAN CHRISTINE COUGHLIN2017-09-15
5022015-01-01KIM BROSNAN CHRISTINE COUGHLIN2016-09-15
5022014-01-01KIM BROSNAN CHRISTINE COUGHLIN2015-09-15
5022013-01-01CHRISTINE COUGHLIN KIM BROSNAN2014-09-15
5022012-01-01KIM BROSNAN CHRISTINE COUGHLIN2013-09-16
5022011-01-01ELEANOR GRANT CHRISTINE COUGHLIN2012-09-13
5022010-01-01ELEANOR GRANT CHRISTINE COUGHLIN2011-09-15
5022009-01-01ELEANOR GRANT CHRISTINE COUGHLIN2010-09-14

Plan Statistics for GROUP LIFE AD&D FOR WEEKLY AND SALARIED EMPLOYEES

401k plan membership statisitcs for GROUP LIFE AD&D FOR WEEKLY AND SALARIED EMPLOYEES

Measure Date Value
2022: GROUP LIFE AD&D FOR WEEKLY AND SALARIED EMPLOYEES 2022 401k membership
Total participants, beginning-of-year2022-01-01380
Total number of active participants reported on line 7a of the Form 55002022-01-01309
Number of retired or separated participants receiving benefits2022-01-0194
Total of all active and inactive participants2022-01-01403
Total participants2022-01-01403
2021: GROUP LIFE AD&D FOR WEEKLY AND SALARIED EMPLOYEES 2021 401k membership
Total participants, beginning-of-year2021-01-01355
Total number of active participants reported on line 7a of the Form 55002021-01-01282
Number of retired or separated participants receiving benefits2021-01-0198
Total of all active and inactive participants2021-01-01380
Total participants2021-01-01380
2020: GROUP LIFE AD&D FOR WEEKLY AND SALARIED EMPLOYEES 2020 401k membership
Total participants, beginning-of-year2020-01-01354
Total number of active participants reported on line 7a of the Form 55002020-01-01251
Number of retired or separated participants receiving benefits2020-01-01104
Total of all active and inactive participants2020-01-01355
Total participants2020-01-01355
2019: GROUP LIFE AD&D FOR WEEKLY AND SALARIED EMPLOYEES 2019 401k membership
Total participants, beginning-of-year2019-01-01337
Total number of active participants reported on line 7a of the Form 55002019-01-01245
Number of retired or separated participants receiving benefits2019-01-01109
Total of all active and inactive participants2019-01-01354
Total participants2019-01-01354
2018: GROUP LIFE AD&D FOR WEEKLY AND SALARIED EMPLOYEES 2018 401k membership
Total participants, beginning-of-year2018-01-01354
Total number of active participants reported on line 7a of the Form 55002018-01-01228
Number of retired or separated participants receiving benefits2018-01-01109
Total of all active and inactive participants2018-01-01337
Total participants2018-01-01337
2017: GROUP LIFE AD&D FOR WEEKLY AND SALARIED EMPLOYEES 2017 401k membership
Total participants, beginning-of-year2017-01-01366
Total number of active participants reported on line 7a of the Form 55002017-01-01238
Number of retired or separated participants receiving benefits2017-01-01116
Total of all active and inactive participants2017-01-01354
Total participants2017-01-01354
2016: GROUP LIFE AD&D FOR WEEKLY AND SALARIED EMPLOYEES 2016 401k membership
Total participants, beginning-of-year2016-01-01387
Total number of active participants reported on line 7a of the Form 55002016-01-01239
Number of retired or separated participants receiving benefits2016-01-01127
Total of all active and inactive participants2016-01-01366
Total participants2016-01-01366
2015: GROUP LIFE AD&D FOR WEEKLY AND SALARIED EMPLOYEES 2015 401k membership
Total participants, beginning-of-year2015-01-01379
Total number of active participants reported on line 7a of the Form 55002015-01-01260
Number of retired or separated participants receiving benefits2015-01-01127
Total of all active and inactive participants2015-01-01387
Total participants2015-01-01387
2014: GROUP LIFE AD&D FOR WEEKLY AND SALARIED EMPLOYEES 2014 401k membership
Total participants, beginning-of-year2014-01-01379
Total number of active participants reported on line 7a of the Form 55002014-01-01262
Number of retired or separated participants receiving benefits2014-01-01127
Total of all active and inactive participants2014-01-01389
Total participants2014-01-01389
2013: GROUP LIFE AD&D FOR WEEKLY AND SALARIED EMPLOYEES 2013 401k membership
Total participants, beginning-of-year2013-01-01376
Total number of active participants reported on line 7a of the Form 55002013-01-01255
Number of retired or separated participants receiving benefits2013-01-01124
Total of all active and inactive participants2013-01-01379
Total participants2013-01-01379
2012: GROUP LIFE AD&D FOR WEEKLY AND SALARIED EMPLOYEES 2012 401k membership
Total participants, beginning-of-year2012-01-01372
Total number of active participants reported on line 7a of the Form 55002012-01-01252
Number of retired or separated participants receiving benefits2012-01-01124
Total of all active and inactive participants2012-01-01376
Total participants2012-01-01376
2011: GROUP LIFE AD&D FOR WEEKLY AND SALARIED EMPLOYEES 2011 401k membership
Total participants, beginning-of-year2011-01-01376
Total number of active participants reported on line 7a of the Form 55002011-01-01246
Number of retired or separated participants receiving benefits2011-01-01126
Total of all active and inactive participants2011-01-01372
Total participants2011-01-01372
2010: GROUP LIFE AD&D FOR WEEKLY AND SALARIED EMPLOYEES 2010 401k membership
Total participants, beginning-of-year2010-01-01411
Total number of active participants reported on line 7a of the Form 55002010-01-01251
Number of other retired or separated participants entitled to future benefits2010-01-01125
Total of all active and inactive participants2010-01-01376
Total participants2010-01-01376
2009: GROUP LIFE AD&D FOR WEEKLY AND SALARIED EMPLOYEES 2009 401k membership
Total participants, beginning-of-year2009-01-01429
Total number of active participants reported on line 7a of the Form 55002009-01-01280
Number of other retired or separated participants entitled to future benefits2009-01-01131
Total of all active and inactive participants2009-01-01411
Total participants2009-01-01411

Form 5500 Responses for GROUP LIFE AD&D FOR WEEKLY AND SALARIED EMPLOYEES

2022: GROUP LIFE AD&D FOR WEEKLY AND SALARIED EMPLOYEES 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – InsuranceYes
2021: GROUP LIFE AD&D FOR WEEKLY AND SALARIED EMPLOYEES 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – InsuranceYes
2020: GROUP LIFE AD&D FOR WEEKLY AND SALARIED EMPLOYEES 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – InsuranceYes
2019: GROUP LIFE AD&D FOR WEEKLY AND SALARIED EMPLOYEES 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: GROUP LIFE AD&D FOR WEEKLY AND SALARIED EMPLOYEES 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: GROUP LIFE AD&D FOR WEEKLY AND SALARIED EMPLOYEES 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: GROUP LIFE AD&D FOR WEEKLY AND SALARIED EMPLOYEES 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: GROUP LIFE AD&D FOR WEEKLY AND SALARIED EMPLOYEES 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: GROUP LIFE AD&D FOR WEEKLY AND SALARIED EMPLOYEES 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: GROUP LIFE AD&D FOR WEEKLY AND SALARIED EMPLOYEES 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: GROUP LIFE AD&D FOR WEEKLY AND SALARIED EMPLOYEES 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: GROUP LIFE AD&D FOR WEEKLY AND SALARIED EMPLOYEES 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2010: GROUP LIFE AD&D FOR WEEKLY AND SALARIED EMPLOYEES 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – InsuranceYes
2009: GROUP LIFE AD&D FOR WEEKLY AND SALARIED EMPLOYEES 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

BOSTON MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61476 )
Policy contract numberG-26000
Policy instance 1
Insurance contract or identification numberG-26000
Number of Individuals Covered403
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
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 $255,207
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BOSTON MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61476 )
Policy contract numberG-26000
Policy instance 1
Insurance contract or identification numberG-26000
Number of Individuals Covered380
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
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 $223,774
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BOSTON MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61476 )
Policy contract number26000
Policy instance 1
Insurance contract or identification number26000
Number of Individuals Covered355
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
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 $190,503
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BOSTON MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61476 )
Policy contract number26000
Policy instance 1
Insurance contract or identification number26000
Number of Individuals Covered340
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
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 $176,880
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BOSTON MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61476 )
Policy contract number26000
Policy instance 1
Insurance contract or identification number26000
Number of Individuals Covered354
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
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 $192,735
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BOSTON MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61476 )
Policy contract number26000
Policy instance 1
Insurance contract or identification number26000
Number of Individuals Covered387
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
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 $231,627
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BOSTON MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61476 )
Policy contract number26000
Policy instance 1
Insurance contract or identification number26000
Number of Individuals Covered389
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
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 $233,452
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BOSTON MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61476 )
Policy contract number26000
Policy instance 1
Insurance contract or identification number26000
Number of Individuals Covered379
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
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 $235,970
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BOSTON MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61476 )
Policy contract number26000
Policy instance 1
Insurance contract or identification number26000
Number of Individuals Covered376
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $230,633
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BOSTON MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61476 )
Policy contract number26000
Policy instance 1
Insurance contract or identification number26000
Number of Individuals Covered372
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $224,934
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BOSTON MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61476 )
Policy contract number26000
Policy instance 1
Insurance contract or identification number26000
Number of Individuals Covered376
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $223,304
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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