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TUFTS ASSOCIATED HEALTH PLANS, INC DISABILITY INSURANCE 401k Plan overview

Plan NameTUFTS ASSOCIATED HEALTH PLANS, INC DISABILITY INSURANCE
Plan identification number 503

TUFTS ASSOCIATED HEALTH PLANS, INC DISABILITY INSURANCE Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Temporary disability (accident and sickness)
  • Long-term disability cover

401k Sponsoring company profile

POINT32HEALTH has sponsored the creation of one or more 401k plans.

Company Name:POINT32HEALTH
Employer identification number (EIN):042985923
NAIC Classification:524140

Additional information about POINT32HEALTH

Jurisdiction of Incorporation: State of Delaware Division of Corporations
Incorporation Date:
Company Identification Number: 2144150

More information about POINT32HEALTH

Form 5500 Filing Information

Submission information for form 5500 for 401k plan TUFTS ASSOCIATED HEALTH PLANS, INC DISABILITY INSURANCE

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5032021-01-01GREGORY FUNK2022-10-05
5032020-01-01MARIANNE GAFFNEY2021-07-22
5032019-01-01KRISTINE MARTEL2020-10-07
5032018-01-01KRISTINE M. MARTEL2019-10-02
5032017-01-01
5032016-01-01KRISTINE MARTEL
5032015-01-01LISA HARLOW
5032014-01-01LYDIA GREENE LYDIA GREENE2015-07-22
5032014-01-01LYDIA GREENE LYDIA GREENE2015-07-22
5032013-01-01LYDIA GREENE LYDIA GREENE2014-07-22
5032012-01-01LYDIA GREENE LYDIA GREENE2013-07-31
5032011-01-01LYDIA GREENE LYDIA GREENE2012-07-12
5032010-01-01LYDIA GREENE LYDIA GREENE2011-07-15

Plan Statistics for TUFTS ASSOCIATED HEALTH PLANS, INC DISABILITY INSURANCE

401k plan membership statisitcs for TUFTS ASSOCIATED HEALTH PLANS, INC DISABILITY INSURANCE

Measure Date Value
2021: TUFTS ASSOCIATED HEALTH PLANS, INC DISABILITY INSURANCE 2021 401k membership
Total participants, beginning-of-year2021-01-012,993
Total number of active participants reported on line 7a of the Form 55002021-01-010
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-010
2020: TUFTS ASSOCIATED HEALTH PLANS, INC DISABILITY INSURANCE 2020 401k membership
Total participants, beginning-of-year2020-01-012,874
Total number of active participants reported on line 7a of the Form 55002020-01-013,915
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-013,915
Number of employers contributing to the scheme2020-01-010
2019: TUFTS ASSOCIATED HEALTH PLANS, INC DISABILITY INSURANCE 2019 401k membership
Total participants, beginning-of-year2019-01-012,760
Total number of active participants reported on line 7a of the Form 55002019-01-012,874
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-012,874
Number of employers contributing to the scheme2019-01-010
2018: TUFTS ASSOCIATED HEALTH PLANS, INC DISABILITY INSURANCE 2018 401k membership
Total participants, beginning-of-year2018-01-012,567
Total number of active participants reported on line 7a of the Form 55002018-01-012,760
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-012,760
Number of employers contributing to the scheme2018-01-010
2017: TUFTS ASSOCIATED HEALTH PLANS, INC DISABILITY INSURANCE 2017 401k membership
Total participants, beginning-of-year2017-01-012,528
Total number of active participants reported on line 7a of the Form 55002017-01-012,567
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-012,567
2016: TUFTS ASSOCIATED HEALTH PLANS, INC DISABILITY INSURANCE 2016 401k membership
Total participants, beginning-of-year2016-01-012,374
Total number of active participants reported on line 7a of the Form 55002016-01-012,528
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-012,528
2015: TUFTS ASSOCIATED HEALTH PLANS, INC DISABILITY INSURANCE 2015 401k membership
Total participants, beginning-of-year2015-01-012,349
Total number of active participants reported on line 7a of the Form 55002015-01-012,374
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-012,374
2014: TUFTS ASSOCIATED HEALTH PLANS, INC DISABILITY INSURANCE 2014 401k membership
Total participants, beginning-of-year2014-01-012,156
Total number of active participants reported on line 7a of the Form 55002014-01-012,349
Total of all active and inactive participants2014-01-012,349
2013: TUFTS ASSOCIATED HEALTH PLANS, INC DISABILITY INSURANCE 2013 401k membership
Total participants, beginning-of-year2013-01-011,663
Total number of active participants reported on line 7a of the Form 55002013-01-012,156
Total of all active and inactive participants2013-01-012,156
Total participants2013-01-012,156
2012: TUFTS ASSOCIATED HEALTH PLANS, INC DISABILITY INSURANCE 2012 401k membership
Total participants, beginning-of-year2012-01-011,642
Total number of active participants reported on line 7a of the Form 55002012-01-011,663
Total of all active and inactive participants2012-01-011,663
Total participants2012-01-011,663
2011: TUFTS ASSOCIATED HEALTH PLANS, INC DISABILITY INSURANCE 2011 401k membership
Total participants, beginning-of-year2011-01-011,622
Total number of active participants reported on line 7a of the Form 55002011-01-011,642
Number of retired or separated participants receiving benefits2011-01-010
Total of all active and inactive participants2011-01-011,642
Total participants2011-01-011,642
2010: TUFTS ASSOCIATED HEALTH PLANS, INC DISABILITY INSURANCE 2010 401k membership
Total participants, beginning-of-year2010-01-011,601
Total number of active participants reported on line 7a of the Form 55002010-01-011,622
Total of all active and inactive participants2010-01-011,622
Total participants2010-01-011,622

Form 5500 Responses for TUFTS ASSOCIATED HEALTH PLANS, INC DISABILITY INSURANCE

2021: TUFTS ASSOCIATED HEALTH PLANS, INC DISABILITY INSURANCE 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 filingYes
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 funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: TUFTS ASSOCIATED HEALTH PLANS, INC DISABILITY INSURANCE 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – InsuranceYes
2019: TUFTS ASSOCIATED HEALTH PLANS, INC DISABILITY INSURANCE 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: TUFTS ASSOCIATED HEALTH PLANS, INC DISABILITY INSURANCE 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: TUFTS ASSOCIATED HEALTH PLANS, INC DISABILITY INSURANCE 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: TUFTS ASSOCIATED HEALTH PLANS, INC DISABILITY INSURANCE 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: TUFTS ASSOCIATED HEALTH PLANS, INC DISABILITY INSURANCE 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: TUFTS ASSOCIATED HEALTH PLANS, INC DISABILITY INSURANCE 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: TUFTS ASSOCIATED HEALTH PLANS, INC DISABILITY INSURANCE 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: TUFTS ASSOCIATED HEALTH PLANS, INC DISABILITY INSURANCE 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: TUFTS ASSOCIATED HEALTH PLANS, INC DISABILITY INSURANCE 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: TUFTS ASSOCIATED HEALTH PLANS, INC DISABILITY INSURANCE 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

Insurance Providers Used on plan

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number425544-0001
Policy instance 1
Insurance contract or identification number425544-0001
Number of Individuals Covered3688
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $17,317
Total amount of fees paid to insurance companyUSD $22,099
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 BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
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 $1,357,380
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $12,416
Amount paid for insurance broker fees13686
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number425544-0001
Policy instance 1
Insurance contract or identification number425544-0001
Number of Individuals Covered3915
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $20,629
Total amount of fees paid to insurance companyUSD $36,649
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,832,428
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $20,629
Amount paid for insurance broker fees36649
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number425544-0001
Policy instance 1
Insurance contract or identification number425544-0001
Number of Individuals Covered2874
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $19,884
Total amount of fees paid to insurance companyUSD $34,582
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,729,129
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $19,884
Amount paid for insurance broker fees34582
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number425544
Policy instance 1
Insurance contract or identification number425544
Number of Individuals Covered2760
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $18,784
Total amount of fees paid to insurance companyUSD $78,868
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,577,353
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $18,784
Amount paid for insurance broker fees78868
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLK960440
Policy instance 2
Insurance contract or identification numberFLK960440
Number of Individuals Covered2614
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $10,313
Total amount of fees paid to insurance companyUSD $0
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $631,323
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,313
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameEASTERN BENEFITS GROUP
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLK960439
Policy instance 1
Insurance contract or identification numberFLK960439
Number of Individuals Covered2614
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $7,609
Total amount of fees paid to insurance companyUSD $0
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $831,867
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,609
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameEASTERN BENEFITS GROUP
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX960439
Policy instance 1
Insurance contract or identification numberFLX960439
Number of Individuals Covered2374
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $17,560
Total amount of fees paid to insurance companyUSD $22,134
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 BenefitNo
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
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 $1,326,332
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17,560
Amount paid for insurance broker fees22134
Additional information about fees paid to insurance brokerOVERRIDE
Insurance broker organization code?3
Insurance broker nameEASTERN INSURANCE GROUP, LLC
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLK960440
Policy instance 1
Insurance contract or identification numberFLK960440
Number of Individuals Covered2349
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $11,159
Total amount of fees paid to insurance companyUSD $0
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedVOLUNTARY LTD
Welfare Benefit Premiums Paid to CarrierUSD $715,911
Commission paid to Insurance BrokerUSD $11,159
Insurance broker organization code?3
Insurance broker nameEASTERN INSURANCE GROUP LLC
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLK960439
Policy instance 2
Insurance contract or identification numberFLK960439
Number of Individuals Covered2349
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $9,793
Total amount of fees paid to insurance companyUSD $0
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedVOLUNTARY STD
Welfare Benefit Premiums Paid to CarrierUSD $652,712
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,793
Insurance broker organization code?3
Insurance broker nameEASTERN INSURANCE GROUP LLC
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLK960439
Policy instance 2
Insurance contract or identification numberFLK960439
Number of Individuals Covered2156
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $5,623
Total amount of fees paid to insurance companyUSD $0
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedVOLUNTARY STD
Welfare Benefit Premiums Paid to CarrierUSD $434,495
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,623
Insurance broker organization code?3
Insurance broker nameEASTERN INSURANCE GROUP LLC
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLK960440
Policy instance 1
Insurance contract or identification numberFLK960440
Number of Individuals Covered2101
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $8,828
Total amount of fees paid to insurance companyUSD $0
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedVOLUNTARY LTD
Welfare Benefit Premiums Paid to CarrierUSD $482,783
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,828
Insurance broker organization code?3
Insurance broker nameEASTERN INSURANCE GROUP LLC
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLK960440
Policy instance 1
Insurance contract or identification numberFLK960440
Number of Individuals Covered1612
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $8,507
Total amount of fees paid to insurance companyUSD $0
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedVOLUNTARY LTD
Welfare Benefit Premiums Paid to CarrierUSD $450,652
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,507
Insurance broker organization code?3
Insurance broker nameEASTERN INSURANCE GROUP LLC
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLK960439
Policy instance 2
Insurance contract or identification numberFLK960439
Number of Individuals Covered1663
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $5,494
Total amount of fees paid to insurance companyUSD $0
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedVOLUNTARY STD
Welfare Benefit Premiums Paid to CarrierUSD $408,712
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,494
Insurance broker organization code?3
Insurance broker nameEASTERN INSURANCE GROUP LLC
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLK960439
Policy instance 2
Insurance contract or identification numberFLK960439
Number of Individuals Covered1642
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $5,241
Total amount of fees paid to insurance companyUSD $0
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $358,245
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLK960440
Policy instance 1
Insurance contract or identification numberFLK960440
Number of Individuals Covered1596
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $7,947
Total amount of fees paid to insurance companyUSD $0
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $394,683
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLK960440
Policy instance 1
Insurance contract or identification numberFLK960440
Number of Individuals Covered1577
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $8,094
Total amount of fees paid to insurance companyUSD $12,363
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $409,385
Commission paid to Insurance BrokerUSD $8,094
Amount paid for insurance broker fees12363
Additional information about fees paid to insurance brokerCARRIER BONUS
Insurance broker organization code?3
Insurance broker nameEASTERN INSURANCE GROUP
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLK960439
Policy instance 2
Insurance contract or identification numberFLK960439
Number of Individuals Covered1622
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $5,310
Total amount of fees paid to insurance companyUSD $14,598
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $372,059
Commission paid to Insurance BrokerUSD $5,310
Amount paid for insurance broker fees14598
Additional information about fees paid to insurance brokerCARRIER BONUS
Insurance broker organization code?3
Insurance broker nameEASTERN INSURANCE GROUP

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