BROCKWAY-SMITH COMPANY has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan BROCKWAY-SMITH COMPANY GROUP LIFE INSURANCE
| Measure | Date | Value |
|---|
| 2022: BROCKWAY-SMITH COMPANY GROUP LIFE INSURANCE 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-11-20 | 112 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-11-20 | 111 |
| Number of retired or separated participants receiving benefits | 2022-11-20 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2022-11-20 | 0 |
| Total of all active and inactive participants | 2022-11-20 | 111 |
| Number of employers contributing to the scheme | 2022-11-20 | 0 |
| 2021: BROCKWAY-SMITH COMPANY GROUP LIFE INSURANCE 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-11-20 | 125 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-11-20 | 112 |
| Number of retired or separated participants receiving benefits | 2021-11-20 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2021-11-20 | 0 |
| Total of all active and inactive participants | 2021-11-20 | 112 |
| 2020: BROCKWAY-SMITH COMPANY GROUP LIFE INSURANCE 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-11-20 | 119 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-11-20 | 125 |
| Number of retired or separated participants receiving benefits | 2020-11-20 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2020-11-20 | 0 |
| Total of all active and inactive participants | 2020-11-20 | 125 |
| 2019: BROCKWAY-SMITH COMPANY GROUP LIFE INSURANCE 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-11-20 | 116 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-11-20 | 119 |
| Number of retired or separated participants receiving benefits | 2019-11-20 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2019-11-20 | 0 |
| Total of all active and inactive participants | 2019-11-20 | 119 |
| 2018: BROCKWAY-SMITH COMPANY GROUP LIFE INSURANCE 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-11-20 | 113 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-11-20 | 116 |
| Total of all active and inactive participants | 2018-11-20 | 116 |
| Total participants | 2018-11-20 | 116 |
| 2017: BROCKWAY-SMITH COMPANY GROUP LIFE INSURANCE 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-11-20 | 107 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-11-20 | 113 |
| Total of all active and inactive participants | 2017-11-20 | 113 |
| Total participants | 2017-11-20 | 113 |
| 2016: BROCKWAY-SMITH COMPANY GROUP LIFE INSURANCE 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-11-20 | 102 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-11-20 | 107 |
| Number of retired or separated participants receiving benefits | 2016-11-20 | 0 |
| Total of all active and inactive participants | 2016-11-20 | 107 |
| Total participants | 2016-11-20 | 107 |
| 2015: BROCKWAY-SMITH COMPANY GROUP LIFE INSURANCE 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-11-20 | 108 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-11-20 | 102 |
| Number of retired or separated participants receiving benefits | 2015-11-20 | 0 |
| Total of all active and inactive participants | 2015-11-20 | 102 |
| Total participants | 2015-11-20 | 102 |
| 2014: BROCKWAY-SMITH COMPANY GROUP LIFE INSURANCE 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-11-20 | 106 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-11-20 | 108 |
| Total of all active and inactive participants | 2014-11-20 | 108 |
| Total participants | 2014-11-20 | 108 |
| 2013: BROCKWAY-SMITH COMPANY GROUP LIFE INSURANCE 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-11-20 | 102 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-11-20 | 106 |
| Total of all active and inactive participants | 2013-11-20 | 106 |
| Total participants | 2013-11-20 | 106 |
| 2012: BROCKWAY-SMITH COMPANY GROUP LIFE INSURANCE 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-11-20 | 308 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-11-20 | 102 |
| Total of all active and inactive participants | 2012-11-20 | 102 |
| Total participants | 2012-11-20 | 102 |
| 2011: BROCKWAY-SMITH COMPANY GROUP LIFE INSURANCE 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-11-20 | 326 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-11-20 | 308 |
| Total of all active and inactive participants | 2011-11-20 | 308 |
| Total participants | 2011-11-20 | 308 |
| 2010: BROCKWAY-SMITH COMPANY GROUP LIFE INSURANCE 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-11-20 | 428 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-11-20 | 326 |
| Total of all active and inactive participants | 2010-11-20 | 326 |
| Total participants | 2010-11-20 | 326 |
| 2009: BROCKWAY-SMITH COMPANY GROUP LIFE INSURANCE 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-11-20 | 463 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-11-20 | 428 |
| Number of retired or separated participants receiving benefits | 2009-11-20 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2009-11-20 | 0 |
| Total of all active and inactive participants | 2009-11-20 | 428 |
| Total participants | 2009-11-20 | 428 |
| 2022: BROCKWAY-SMITH COMPANY GROUP LIFE INSURANCE 2022 form 5500 responses |
|---|
| 2022-11-20 | Type of plan entity | Single employer plan |
| 2022-11-20 | Plan funding arrangement – Insurance | Yes |
| 2022-11-20 | Plan benefit arrangement – Insurance | Yes |
| 2021: BROCKWAY-SMITH COMPANY GROUP LIFE INSURANCE 2021 form 5500 responses |
|---|
| 2021-11-20 | Type of plan entity | Single employer plan |
| 2021-11-20 | Submission has been amended | No |
| 2021-11-20 | This submission is the final filing | No |
| 2021-11-20 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2021-11-20 | Plan is a collectively bargained plan | No |
| 2021-11-20 | Plan funding arrangement – Insurance | Yes |
| 2021-11-20 | Plan benefit arrangement – Insurance | Yes |
| 2020: BROCKWAY-SMITH COMPANY GROUP LIFE INSURANCE 2020 form 5500 responses |
|---|
| 2020-11-20 | Type of plan entity | Single employer plan |
| 2020-11-20 | Submission has been amended | No |
| 2020-11-20 | This submission is the final filing | No |
| 2020-11-20 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2020-11-20 | Plan is a collectively bargained plan | No |
| 2020-11-20 | Plan funding arrangement – Insurance | Yes |
| 2020-11-20 | Plan benefit arrangement – Insurance | Yes |
| 2019: BROCKWAY-SMITH COMPANY GROUP LIFE INSURANCE 2019 form 5500 responses |
|---|
| 2019-11-20 | Type of plan entity | Single employer plan |
| 2019-11-20 | Submission has been amended | No |
| 2019-11-20 | This submission is the final filing | No |
| 2019-11-20 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2019-11-20 | Plan is a collectively bargained plan | No |
| 2019-11-20 | Plan funding arrangement – Insurance | Yes |
| 2019-11-20 | Plan benefit arrangement – Insurance | Yes |
| 2018: BROCKWAY-SMITH COMPANY GROUP LIFE INSURANCE 2018 form 5500 responses |
|---|
| 2018-11-20 | Type of plan entity | Single employer plan |
| 2018-11-20 | Submission has been amended | No |
| 2018-11-20 | This submission is the final filing | No |
| 2018-11-20 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2018-11-20 | Plan is a collectively bargained plan | No |
| 2018-11-20 | Plan funding arrangement – Insurance | Yes |
| 2018-11-20 | Plan benefit arrangement – Insurance | Yes |
| 2017: BROCKWAY-SMITH COMPANY GROUP LIFE INSURANCE 2017 form 5500 responses |
|---|
| 2017-11-20 | Type of plan entity | Single employer plan |
| 2017-11-20 | Submission has been amended | No |
| 2017-11-20 | This submission is the final filing | No |
| 2017-11-20 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2017-11-20 | Plan is a collectively bargained plan | No |
| 2017-11-20 | Plan funding arrangement – Insurance | Yes |
| 2017-11-20 | Plan benefit arrangement – Insurance | Yes |
| 2016: BROCKWAY-SMITH COMPANY GROUP LIFE INSURANCE 2016 form 5500 responses |
|---|
| 2016-11-20 | Type of plan entity | Single employer plan |
| 2016-11-20 | Submission has been amended | No |
| 2016-11-20 | This submission is the final filing | No |
| 2016-11-20 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-11-20 | Plan is a collectively bargained plan | No |
| 2016-11-20 | Plan funding arrangement – Insurance | Yes |
| 2016-11-20 | Plan benefit arrangement – Insurance | Yes |
| 2015: BROCKWAY-SMITH COMPANY GROUP LIFE INSURANCE 2015 form 5500 responses |
|---|
| 2015-11-20 | Type of plan entity | Single employer plan |
| 2015-11-20 | Submission has been amended | No |
| 2015-11-20 | This submission is the final filing | No |
| 2015-11-20 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-11-20 | Plan is a collectively bargained plan | No |
| 2015-11-20 | Plan funding arrangement – Insurance | Yes |
| 2015-11-20 | Plan benefit arrangement – Insurance | Yes |
| 2014: BROCKWAY-SMITH COMPANY GROUP LIFE INSURANCE 2014 form 5500 responses |
|---|
| 2014-11-20 | Type of plan entity | Single employer plan |
| 2014-11-20 | Submission has been amended | No |
| 2014-11-20 | This submission is the final filing | No |
| 2014-11-20 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2014-11-20 | Plan is a collectively bargained plan | No |
| 2014-11-20 | Plan funding arrangement – Insurance | Yes |
| 2014-11-20 | Plan benefit arrangement – Insurance | Yes |
| 2013: BROCKWAY-SMITH COMPANY GROUP LIFE INSURANCE 2013 form 5500 responses |
|---|
| 2013-11-20 | Type of plan entity | Single employer plan |
| 2013-11-20 | Submission has been amended | No |
| 2013-11-20 | This submission is the final filing | No |
| 2013-11-20 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2013-11-20 | Plan is a collectively bargained plan | No |
| 2013-11-20 | Plan funding arrangement – Insurance | Yes |
| 2013-11-20 | Plan benefit arrangement – Insurance | Yes |
| 2012: BROCKWAY-SMITH COMPANY GROUP LIFE INSURANCE 2012 form 5500 responses |
|---|
| 2012-11-20 | Type of plan entity | Single employer plan |
| 2012-11-20 | Submission has been amended | No |
| 2012-11-20 | This submission is the final filing | No |
| 2012-11-20 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2012-11-20 | Plan is a collectively bargained plan | No |
| 2012-11-20 | Plan funding arrangement – Insurance | Yes |
| 2012-11-20 | Plan benefit arrangement – Insurance | Yes |
| 2011: BROCKWAY-SMITH COMPANY GROUP LIFE INSURANCE 2011 form 5500 responses |
|---|
| 2011-11-20 | Type of plan entity | Single employer plan |
| 2011-11-20 | Submission has been amended | No |
| 2011-11-20 | This submission is the final filing | No |
| 2011-11-20 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2011-11-20 | Plan is a collectively bargained plan | No |
| 2011-11-20 | Plan funding arrangement – Insurance | Yes |
| 2011-11-20 | Plan benefit arrangement – Insurance | Yes |
| 2010: BROCKWAY-SMITH COMPANY GROUP LIFE INSURANCE 2010 form 5500 responses |
|---|
| 2010-11-20 | Type of plan entity | Single employer plan |
| 2010-11-20 | Submission has been amended | No |
| 2010-11-20 | This submission is the final filing | No |
| 2010-11-20 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2010-11-20 | Plan is a collectively bargained plan | No |
| 2010-11-20 | Plan funding arrangement – Insurance | Yes |
| 2010-11-20 | Plan benefit arrangement – Insurance | Yes |
| 2009: BROCKWAY-SMITH COMPANY GROUP LIFE INSURANCE 2009 form 5500 responses |
|---|
| 2009-11-20 | Type of plan entity | Single employer plan |
| 2009-11-20 | Submission has been amended | No |
| 2009-11-20 | This submission is the final filing | No |
| 2009-11-20 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2009-11-20 | Plan is a collectively bargained plan | No |
| 2009-11-20 | Plan funding arrangement – Insurance | Yes |
| 2009-11-20 | Plan benefit arrangement – Insurance | Yes |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | VAR210007 |
| Policy instance | 1 |
| Insurance contract or identification number | VAR210007 | | Number of Individuals Covered | 132 | | Insurance policy start date | 2022-07-01 | | Insurance policy end date | 2023-06-30 | | Total amount of commissions paid to insurance broker | USD $7,220 | | Total amount of fees paid to insurance company | USD $2,889 | | 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 | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $72,199 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $7,220 | | Amount paid for insurance broker fees | 2889 | | Additional information about fees paid to insurance broker | ADMINISTRATIVE AND OTHER FEES | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 517541 |
| Policy instance | 1 |
| Insurance contract or identification number | 517541 | | Number of Individuals Covered | 119 | | Insurance policy start date | 2021-07-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $5,004 | | Total amount of fees paid to insurance company | USD $667 | | 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 | | Other welfare benefits provided | LIFESTYLE ADD, LIFESTYLE LIFE | | 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 $33,356 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,004 | | Amount paid for insurance broker fees | 667 | | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | | Insurance broker organization code? | 3 |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | GL165227 |
| Policy instance | 2 |
| Insurance contract or identification number | GL165227 | | Number of Individuals Covered | 114 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-06-30 | | Total amount of commissions paid to insurance broker | USD $3,487 | | 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 | 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 | | Other welfare benefits provided | DEPENDENT LIFE, SUPPLEMENT LIFE | | 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 $34,874 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,487 | | Insurance broker organization code? | 3 |
|
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) |
| Policy contract number | VAR210007 |
| Policy instance | 3 |
| Insurance contract or identification number | VAR210007 | | Number of Individuals Covered | 135 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-06-30 | | Total amount of commissions paid to insurance broker | USD $211 | | 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 | No | | 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 | | Other welfare benefits provided | VOL AD&D | | 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 $2,107 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $211 | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 517541 |
| Policy instance | 1 |
| Insurance contract or identification number | 517541 | | Number of Individuals Covered | 115 | | Insurance policy start date | 2020-07-01 | | Insurance policy end date | 2021-06-30 | | Total amount of commissions paid to insurance broker | USD $7,957 | | Total amount of fees paid to insurance company | USD $1,061 | | 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 | | Other welfare benefits provided | LIFESTYLE ADD, LIFESTYLE LIFE | | 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 $48,123 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $7,957 | | Amount paid for insurance broker fees | 1061 | | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 517541 |
| Policy instance | 1 |
| Insurance contract or identification number | 517541 | | Number of Individuals Covered | 119 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2020-06-30 | | Total amount of commissions paid to insurance broker | USD $8,942 | | Total amount of fees paid to insurance company | USD $1,192 | | 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 | | Other welfare benefits provided | LIFESTYLE ADD, LIFESTYLE LIFE | | 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 $64,532 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,942 | | Amount paid for insurance broker fees | 1192 | | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 517541 |
| Policy instance | 1 |
| Insurance contract or identification number | 517541 | | Number of Individuals Covered | 116 | | Insurance policy start date | 2018-07-01 | | Insurance policy end date | 2019-06-30 | | Total amount of commissions paid to insurance broker | USD $10,222 | | 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 | 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 | | Other welfare benefits provided | LIFESTYLE ADD, LIFESTYLE LIFE | | 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 $55,091 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $9,019 | | Amount paid for insurance broker fees | 1203 | | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 517541 |
| Policy instance | 1 |
| Insurance contract or identification number | 517541 | | Number of Individuals Covered | 110 | | Insurance policy start date | 2017-07-01 | | Insurance policy end date | 2018-06-30 | | Total amount of commissions paid to insurance broker | USD $10,534 | | 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 | 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 | | Other welfare benefits provided | LIFESTYLE LIFE, LIFESTYLE ADD | | 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 $67,001 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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