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| Plan Name | BASIC LIFE INSURANCE ACCIDENTAL DEATH AND DISMEMBERMENT |
| Plan identification number | 505 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | GREATER LAWRENCE COMMUNITY ACTION COUNCIL, INC. |
| Employer identification number (EIN): | 042397449 |
| NAIC Classification: | 624100 |
| NAIC Description: | Individual and Family Services |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 505 | 2014-07-01 | RICHARD A. ROBICHAUD | |||
| 505 | 2014-07-01 | RICHARD ROBICHAUD | |||
| 505 | 2013-07-01 | RICHARD A. ROBICHAUD | |||
| 505 | 2012-07-01 | RICHARD ROBICHAUD | RICHARD ROBICHAUD | 2014-01-30 | |
| 505 | 2011-07-01 | RICHARD ROBICHAUD | |||
| 505 | 2009-07-01 | RICHARD ROBICHAUD |
| Measure | Date | Value |
|---|---|---|
| 2014: BASIC LIFE INSURANCE ACCIDENTAL DEATH AND DISMEMBERMENT 2014 401k membership | ||
| Total participants, beginning-of-year | 2014-07-01 | 222 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-07-01 | 233 |
| Number of retired or separated participants receiving benefits | 2014-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2014-07-01 | 0 |
| Total of all active and inactive participants | 2014-07-01 | 233 |
| Total participants | 2014-07-01 | 0 |
| 2013: BASIC LIFE INSURANCE ACCIDENTAL DEATH AND DISMEMBERMENT 2013 401k membership | ||
| Total participants, beginning-of-year | 2013-07-01 | 233 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-07-01 | 222 |
| Number of retired or separated participants receiving benefits | 2013-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2013-07-01 | 0 |
| Total of all active and inactive participants | 2013-07-01 | 222 |
| 2012: BASIC LIFE INSURANCE ACCIDENTAL DEATH AND DISMEMBERMENT 2012 401k membership | ||
| Total participants, beginning-of-year | 2012-07-01 | 258 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-07-01 | 233 |
| Total of all active and inactive participants | 2012-07-01 | 233 |
| Total participants | 2012-07-01 | 233 |
| 2011: BASIC LIFE INSURANCE ACCIDENTAL DEATH AND DISMEMBERMENT 2011 401k membership | ||
| Total participants, beginning-of-year | 2011-07-01 | 266 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-07-01 | 258 |
| Total of all active and inactive participants | 2011-07-01 | 258 |
| Total participants | 2011-07-01 | 258 |
| 2009: BASIC LIFE INSURANCE ACCIDENTAL DEATH AND DISMEMBERMENT 2009 401k membership | ||
| Total participants, beginning-of-year | 2009-07-01 | 256 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-07-01 | 268 |
| Total of all active and inactive participants | 2009-07-01 | 268 |
| Total participants | 2009-07-01 | 268 |
| 2014: BASIC LIFE INSURANCE ACCIDENTAL DEATH AND DISMEMBERMENT 2014 form 5500 responses | ||
|---|---|---|
| 2014-07-01 | Type of plan entity | Single employer plan |
| 2014-07-01 | Submission has been amended | No |
| 2014-07-01 | This submission is the final filing | No |
| 2014-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2014-07-01 | Plan is a collectively bargained plan | No |
| 2014-07-01 | Plan funding arrangement – Insurance | Yes |
| 2014-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: BASIC LIFE INSURANCE ACCIDENTAL DEATH AND DISMEMBERMENT 2013 form 5500 responses | ||
| 2013-07-01 | Type of plan entity | Single employer plan |
| 2013-07-01 | Submission has been amended | No |
| 2013-07-01 | This submission is the final filing | No |
| 2013-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2013-07-01 | Plan is a collectively bargained plan | No |
| 2013-07-01 | Plan funding arrangement – Insurance | Yes |
| 2013-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: BASIC LIFE INSURANCE ACCIDENTAL DEATH AND DISMEMBERMENT 2012 form 5500 responses | ||
| 2012-07-01 | Type of plan entity | Single employer plan |
| 2012-07-01 | Submission has been amended | No |
| 2012-07-01 | This submission is the final filing | No |
| 2012-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2012-07-01 | Plan is a collectively bargained plan | No |
| 2012-07-01 | Plan funding arrangement – Insurance | Yes |
| 2012-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: BASIC LIFE INSURANCE ACCIDENTAL DEATH AND DISMEMBERMENT 2011 form 5500 responses | ||
| 2011-07-01 | Type of plan entity | Single employer plan |
| 2011-07-01 | Submission has been amended | No |
| 2011-07-01 | This submission is the final filing | No |
| 2011-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2011-07-01 | Plan is a collectively bargained plan | No |
| 2011-07-01 | Plan funding arrangement – Insurance | Yes |
| 2011-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: BASIC LIFE INSURANCE ACCIDENTAL DEATH AND DISMEMBERMENT 2009 form 5500 responses | ||
| 2009-07-01 | Type of plan entity | Single employer plan |
| 2009-07-01 | Submission has been amended | No |
| 2009-07-01 | This submission is the final filing | No |
| 2009-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2009-07-01 | Plan is a collectively bargained plan | No |
| 2009-07-01 | Plan funding arrangement – Insurance | Yes |
| 2009-07-01 | Plan benefit arrangement – Insurance | Yes |
| UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 5463538 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | MLN00511 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | MLN00511 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | MLN00511 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | MLN00511 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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