401k Plan data: TEACHERS FEDERAL CREDIT UNION INSURANCE PLAN plan

TEACHERS FEDERAL CREDIT UNION INSURANCE PLAN 401k Plan overview

Plan Name	TEACHERS FEDERAL CREDIT UNION INSURANCE PLAN
Plan identification number	501

TEACHERS FEDERAL CREDIT UNION INSURANCE PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Temporary disability (accident and sickness) Long-term disability cover

401k Sponsoring company profile

TEACHERS FEDERAL CREDIT UNION has sponsored the creation of one or more 401k plans.

Company Name: TEACHERS FEDERAL CREDIT UNION

Employer identification number (EIN): 111751016

NAIC Classification: 522130
NAIC Description: Credit Unions

Form 5500 Filing Information

Submission information for form 5500 for 401k plan TEACHERS FEDERAL CREDIT UNION INSURANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2022-01-01
501 2021-01-01
501 2020-01-01
501 2019-01-01
501 2018-01-01 BEN ALESSI
501 2017-01-01 THOMAS FALLON
501 2016-01-01 THOMAS FALLON
501 2015-01-01 THOMAS FALLON
501 2014-01-01 THOMAS FALLON
501 2013-01-01 THOMAS FALLON
501 2012-01-01 THOMAS FALLON
501 2011-01-01 THOMAS FALLON
501 2009-01-01 THOMAS FALLON ROBERT ALLEN 2010-07-30
501 2009-01-01 THOMAS FALLON ROBERT ALLEN 2010-07-29

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
501	2022-01-01
501	2021-01-01
501	2020-01-01
501	2019-01-01
501	2018-01-01	BEN ALESSI
501	2017-01-01	THOMAS FALLON
501	2016-01-01	THOMAS FALLON
501	2015-01-01	THOMAS FALLON
501	2014-01-01	THOMAS FALLON
501	2013-01-01	THOMAS FALLON
501	2012-01-01	THOMAS FALLON
501	2011-01-01	THOMAS FALLON
501	2009-01-01	THOMAS FALLON	ROBERT ALLEN	2010-07-30
501	2009-01-01	THOMAS FALLON	ROBERT ALLEN	2010-07-29

Plan Statistics for TEACHERS FEDERAL CREDIT UNION INSURANCE PLAN

401k plan membership statisitcs for TEACHERS FEDERAL CREDIT UNION INSURANCE PLAN

Measure Date Value
2022: TEACHERS FEDERAL CREDIT UNION INSURANCE PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 872
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 597
Number of retired or separated participants receiving benefits 2022-01-01 58
Number of other retired or separated participants entitled to future benefits 2022-01-01 41
Total of all active and inactive participants 2022-01-01 696
2021: TEACHERS FEDERAL CREDIT UNION INSURANCE PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 850
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 566
Number of retired or separated participants receiving benefits 2021-01-01 46
Number of other retired or separated participants entitled to future benefits 2021-01-01 35
Total of all active and inactive participants 2021-01-01 647
2020: TEACHERS FEDERAL CREDIT UNION INSURANCE PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 624
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 657
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 0
Total of all active and inactive participants 2020-01-01 657
2019: TEACHERS FEDERAL CREDIT UNION INSURANCE PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 1,263
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 1,324
Number of retired or separated participants receiving benefits 2019-01-01 38
Number of other retired or separated participants entitled to future benefits 2019-01-01 0
Total of all active and inactive participants 2019-01-01 1,362
2018: TEACHERS FEDERAL CREDIT UNION INSURANCE PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 1,164
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 1,233
Number of retired or separated participants receiving benefits 2018-01-01 30
Total of all active and inactive participants 2018-01-01 1,263
2017: TEACHERS FEDERAL CREDIT UNION INSURANCE PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 1,174
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 1,138
Number of retired or separated participants receiving benefits 2017-01-01 26
Total of all active and inactive participants 2017-01-01 1,164
Total participants 2017-01-01 1,164
2016: TEACHERS FEDERAL CREDIT UNION INSURANCE PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 1,195
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 1,149
Number of retired or separated participants receiving benefits 2016-01-01 25
Total of all active and inactive participants 2016-01-01 1,174
Total participants 2016-01-01 1,174
2015: TEACHERS FEDERAL CREDIT UNION INSURANCE PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 1,113
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 1,183
Number of retired or separated participants receiving benefits 2015-01-01 12
Total of all active and inactive participants 2015-01-01 1,195
Total participants 2015-01-01 1,195
2014: TEACHERS FEDERAL CREDIT UNION INSURANCE PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 1,124
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 1,095
Number of retired or separated participants receiving benefits 2014-01-01 18
Total of all active and inactive participants 2014-01-01 1,113
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 1,113
2013: TEACHERS FEDERAL CREDIT UNION INSURANCE PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 1,071
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 1,113
Number of retired or separated participants receiving benefits 2013-01-01 11
Total of all active and inactive participants 2013-01-01 1,124
Total participants 2013-01-01 1,124
2012: TEACHERS FEDERAL CREDIT UNION INSURANCE PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 1,056
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 1,060
Number of retired or separated participants receiving benefits 2012-01-01 11
Total of all active and inactive participants 2012-01-01 1,071
Total participants 2012-01-01 1,071
2011: TEACHERS FEDERAL CREDIT UNION INSURANCE PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 481
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 1,047
Number of retired or separated participants receiving benefits 2011-01-01 9
Total of all active and inactive participants 2011-01-01 1,056
Total participants 2011-01-01 1,056
2009: TEACHERS FEDERAL CREDIT UNION INSURANCE PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 540
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 571
Number of retired or separated participants receiving benefits 2009-01-01 7
Total of all active and inactive participants 2009-01-01 578
Total participants 2009-01-01 578

Measure	Date	Value
2022: TEACHERS FEDERAL CREDIT UNION INSURANCE PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	872
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	597
Number of retired or separated participants receiving benefits	2022-01-01	58
Number of other retired or separated participants entitled to future benefits	2022-01-01	41
Total of all active and inactive participants	2022-01-01	696
2021: TEACHERS FEDERAL CREDIT UNION INSURANCE PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	850
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	566
Number of retired or separated participants receiving benefits	2021-01-01	46
Number of other retired or separated participants entitled to future benefits	2021-01-01	35
Total of all active and inactive participants	2021-01-01	647
2020: TEACHERS FEDERAL CREDIT UNION INSURANCE PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	624
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	657
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	0
Total of all active and inactive participants	2020-01-01	657
2019: TEACHERS FEDERAL CREDIT UNION INSURANCE PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	1,263
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	1,324
Number of retired or separated participants receiving benefits	2019-01-01	38
Number of other retired or separated participants entitled to future benefits	2019-01-01	0
Total of all active and inactive participants	2019-01-01	1,362
2018: TEACHERS FEDERAL CREDIT UNION INSURANCE PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	1,164
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	1,233
Number of retired or separated participants receiving benefits	2018-01-01	30
Total of all active and inactive participants	2018-01-01	1,263
2017: TEACHERS FEDERAL CREDIT UNION INSURANCE PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	1,174
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	1,138
Number of retired or separated participants receiving benefits	2017-01-01	26
Total of all active and inactive participants	2017-01-01	1,164
Total participants	2017-01-01	1,164
2016: TEACHERS FEDERAL CREDIT UNION INSURANCE PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	1,195
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	1,149
Number of retired or separated participants receiving benefits	2016-01-01	25
Total of all active and inactive participants	2016-01-01	1,174
Total participants	2016-01-01	1,174
2015: TEACHERS FEDERAL CREDIT UNION INSURANCE PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	1,113
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	1,183
Number of retired or separated participants receiving benefits	2015-01-01	12
Total of all active and inactive participants	2015-01-01	1,195
Total participants	2015-01-01	1,195
2014: TEACHERS FEDERAL CREDIT UNION INSURANCE PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	1,124
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	1,095
Number of retired or separated participants receiving benefits	2014-01-01	18
Total of all active and inactive participants	2014-01-01	1,113
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	1,113
2013: TEACHERS FEDERAL CREDIT UNION INSURANCE PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	1,071
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	1,113
Number of retired or separated participants receiving benefits	2013-01-01	11
Total of all active and inactive participants	2013-01-01	1,124
Total participants	2013-01-01	1,124
2012: TEACHERS FEDERAL CREDIT UNION INSURANCE PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	1,056
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	1,060
Number of retired or separated participants receiving benefits	2012-01-01	11
Total of all active and inactive participants	2012-01-01	1,071
Total participants	2012-01-01	1,071
2011: TEACHERS FEDERAL CREDIT UNION INSURANCE PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	481
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	1,047
Number of retired or separated participants receiving benefits	2011-01-01	9
Total of all active and inactive participants	2011-01-01	1,056
Total participants	2011-01-01	1,056
2009: TEACHERS FEDERAL CREDIT UNION INSURANCE PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	540
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	571
Number of retired or separated participants receiving benefits	2009-01-01	7
Total of all active and inactive participants	2009-01-01	578
Total participants	2009-01-01	578

Form 5500 Responses for TEACHERS FEDERAL CREDIT UNION INSURANCE PLAN

2022: TEACHERS FEDERAL CREDIT UNION INSURANCE PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2021: TEACHERS FEDERAL CREDIT UNION INSURANCE PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2020: TEACHERS FEDERAL CREDIT UNION INSURANCE PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2019: TEACHERS FEDERAL CREDIT UNION INSURANCE PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2018: TEACHERS FEDERAL CREDIT UNION INSURANCE PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2017: TEACHERS FEDERAL CREDIT UNION INSURANCE PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2016: TEACHERS FEDERAL CREDIT UNION INSURANCE PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2015: TEACHERS FEDERAL CREDIT UNION INSURANCE PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2014: TEACHERS FEDERAL CREDIT UNION INSURANCE PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2013: TEACHERS FEDERAL CREDIT UNION INSURANCE PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2012: TEACHERS FEDERAL CREDIT UNION INSURANCE PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2011: TEACHERS FEDERAL CREDIT UNION INSURANCE PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2009: TEACHERS FEDERAL CREDIT UNION INSURANCE PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	Yes
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

COMPANION LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62243 )

Policy contract number

GCEL0BRL3

Policy instance

Insurance contract or identification number	GCEL0BRL3
Number of Individuals Covered	222
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $9,381
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $62,541
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $9,381
Additional information about fees paid to insurance broker	OTHER COMP
Insurance broker organization code?	3

COMPANION LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62243 )

Policy contract number

GLCL0BRL3

Policy instance

Insurance contract or identification number	GLCL0BRL3
Number of Individuals Covered	843
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $6,441
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $64,406
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $6,441
Additional information about fees paid to insurance broker	OTHER COMP
Insurance broker organization code?	3

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )

Policy contract number

MP 0BRL3

Policy instance

Insurance contract or identification number	MP 0BRL3
Number of Individuals Covered	843
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $644
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $6,441
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $644
Insurance broker organization code?	3

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )

Policy contract number

GMTD0BRL3

Policy instance

Insurance contract or identification number	GMTD0BRL3
Number of Individuals Covered	843
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $13,097
Total amount of fees paid to insurance company	USD $11,780
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $130,974
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $13,097
Additional information about fees paid to insurance broker	OTHER COMP
Insurance broker organization code?	3
Amount paid for insurance broker fees	11780

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )

Policy contract number

0880523

Policy instance

Insurance contract or identification number	0880523
Number of Individuals Covered	773
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $14,823
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $104,714
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $14,823
Insurance broker organization code?	3

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )

Policy contract number

0880523

Policy instance

Insurance contract or identification number	0880523
Number of Individuals Covered	633
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $4,642
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $83,483
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,642
Insurance broker organization code?	3

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )

Policy contract number

GMTD0BRL3

Policy instance

Insurance contract or identification number	GMTD0BRL3
Number of Individuals Covered	734
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $10,839
Total amount of fees paid to insurance company	USD $12,452
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $108,386
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	11780
Additional information about fees paid to insurance broker	ADMINISTRATION
Insurance broker organization code?	5
Commission paid to Insurance Broker	USD $10,839

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )

Policy contract number

MP 0BRL3

Policy instance

Insurance contract or identification number	MP 0BRL3
Number of Individuals Covered	734
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $521
Total amount of fees paid to insurance company	USD $33
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $5,206
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $521
Amount paid for insurance broker fees	33
Additional information about fees paid to insurance broker	OTHER COMP
Insurance broker organization code?	3

COMPANION LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62243 )

Policy contract number

GLCL0BRL3

Policy instance

Insurance contract or identification number	GLCL0BRL3
Number of Individuals Covered	734
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $5,230
Total amount of fees paid to insurance company	USD $331
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $52,304
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,230
Amount paid for insurance broker fees	331
Additional information about fees paid to insurance broker	OTHER COMP
Insurance broker organization code?	3

COMPANION LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62243 )

Policy contract number

GCEL0BRL3

Policy instance

Insurance contract or identification number	GCEL0BRL3
Number of Individuals Covered	158
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $6,117
Total amount of fees paid to insurance company	USD $323
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $40,779
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $6,117
Amount paid for insurance broker fees	323
Additional information about fees paid to insurance broker	OTHER COMP
Insurance broker organization code?	3

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )

Policy contract number

0880523

Policy instance

Insurance contract or identification number	0880523
Number of Individuals Covered	1358
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $9,614,448
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71005 )

Policy contract number

DBL252129

Policy instance

Insurance contract or identification number	DBL252129
Number of Individuals Covered	1615
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $5,709
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $128,042
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,320
Insurance broker organization code?	3
Additional information about fees paid to insurance broker	ADMINISTRATION

FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71005 )

Policy contract number

GL156619

Policy instance

Insurance contract or identification number	GL156619
Number of Individuals Covered	657
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $3,727
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $57,051
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,610
Insurance broker organization code?	3
Additional information about fees paid to insurance broker	ADMINISTRATION

FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71005 )

Policy contract number

LTD128023

Policy instance

Insurance contract or identification number	LTD128023
Number of Individuals Covered	645
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $6,786
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $99,813
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,776
Insurance broker organization code?	3
Additional information about fees paid to insurance broker	ADMINISTRATION

GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 )

Policy contract number

2541

Policy instance

Insurance contract or identification number	2541
Number of Individuals Covered	1328
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $38,031
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71005 )

Policy contract number

GL 161324

Policy instance

Insurance contract or identification number	GL 161324
Number of Individuals Covered	159
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $2,977
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $29,768
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,977
Insurance broker organization code?	3

COMPANION LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62243 )

Policy contract number

GCEL0BRL3

Policy instance

Insurance contract or identification number	GCEL0BRL3
Number of Individuals Covered	163
Insurance policy start date	2020-09-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $2,307
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $15,383
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,307
Insurance broker organization code?	3

COMPANION LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62243 )

Policy contract number

GLCL0BRL3

Policy instance

Insurance contract or identification number	GLCL0BRL3
Number of Individuals Covered	668
Insurance policy start date	2020-09-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $1,621
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $16,208
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,621
Insurance broker organization code?	3

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )

Policy contract number

GMTD0BRL3

Policy instance

Insurance contract or identification number	GMTD0BRL3
Number of Individuals Covered	669
Insurance policy start date	2020-09-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $3,387
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $33,866
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,387
Insurance broker organization code?	3

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )

Policy contract number

MP 0BRL3

Policy instance

Insurance contract or identification number	MP 0BRL3
Number of Individuals Covered	668
Insurance policy start date	2020-09-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $161
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $1,612
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $161
Insurance broker organization code?	3

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )

Policy contract number

0880523

Policy instance

Insurance contract or identification number	0880523
Number of Individuals Covered	1324
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $8,879,070
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71005 )

Policy contract number

DBL252129

Policy instance

Insurance contract or identification number	DBL252129
Number of Individuals Covered	1648
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $3,625
Total amount of fees paid to insurance company	USD $2,827
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $112,886
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,625
Amount paid for insurance broker fees	2827
Additional information about fees paid to insurance broker	ADMINISTRATION
Insurance broker organization code?	3

FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71005 )

Policy contract number

GL156619

Policy instance

Insurance contract or identification number	GL156619
Number of Individuals Covered	624
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $3,089
Total amount of fees paid to insurance company	USD $2,393
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $91,654
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,089
Amount paid for insurance broker fees	2393
Additional information about fees paid to insurance broker	ADMINISTRATION
Insurance broker organization code?	3

FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71005 )

Policy contract number

LTD128023

Policy instance

Insurance contract or identification number	LTD128023
Number of Individuals Covered	621
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $4,233
Total amount of fees paid to insurance company	USD $3,057
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $115,838
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,233
Amount paid for insurance broker fees	3057
Additional information about fees paid to insurance broker	ADMINISTRATION
Insurance broker organization code?	3

GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 )

Policy contract number

2541

Policy instance

Insurance contract or identification number	2541
Number of Individuals Covered	1280
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $36,707
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )

Policy contract number

0880523

Policy instance

Insurance contract or identification number	0880523
Number of Individuals Covered	1263
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $7,548,808
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71005 )

Policy contract number

GL 156619

Policy instance

Insurance contract or identification number	GL 156619
Number of Individuals Covered	610
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $3,061
Total amount of fees paid to insurance company	USD $2,101
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $79,758
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,061
Amount paid for insurance broker fees	2101
Additional information about fees paid to insurance broker	INCENTIVE
Insurance broker organization code?	3

FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71005 )

Policy contract number

LTD 128023

Policy instance

Insurance contract or identification number	LTD 128023
Number of Individuals Covered	608
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $4,453
Total amount of fees paid to insurance company	USD $2,667
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $101,878
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,453
Amount paid for insurance broker fees	2667
Additional information about fees paid to insurance broker	INCENTIVE
Insurance broker organization code?	3

FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71005 )

Policy contract number

DBL 252129

Policy instance

Insurance contract or identification number	DBL 252129
Number of Individuals Covered	788
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $4,362
Total amount of fees paid to insurance company	USD $1,509
Other welfare benefits provided	SHORT TERM DISABILITY
Welfare Benefit Premiums Paid to Carrier	USD $94,231
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,362
Amount paid for insurance broker fees	1509
Additional information about fees paid to insurance broker	INCENTIVE
Insurance broker organization code?	3

FIDELITY SECURITY LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 67288 )

Policy contract number

99207521001

Policy instance

Insurance contract or identification number	99207521001
Number of Individuals Covered	1084
Insurance policy start date	2018-01-01
Insurance policy end date	2018-05-31
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $23,816
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 )

Policy contract number

2541

Policy instance

Insurance contract or identification number	2541
Number of Individuals Covered	1322
Insurance policy start date	2018-06-01
Insurance policy end date	2018-12-31
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $19,824
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

FIDELITY SECURITY LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 67288 )

Policy contract number

99207521001

Policy instance

Insurance contract or identification number	99207521001
Number of Individuals Covered	1067
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $55,176
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71005 )

Policy contract number

DBL 252129

Policy instance

Insurance contract or identification number	DBL 252129
Number of Individuals Covered	686
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $3,797
Total amount of fees paid to insurance company	USD $520
Other welfare benefits provided	SHORT TERM DISABILITY
Welfare Benefit Premiums Paid to Carrier	USD $58,148
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,797
Amount paid for insurance broker fees	520
Additional information about fees paid to insurance broker	INCENTIVE
Insurance broker organization code?	3
Insurance broker name	KINLOCH CONSULTING GROUP, INC.

FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71005 )

Policy contract number

LTD 128023

Policy instance

Insurance contract or identification number	LTD 128023
Number of Individuals Covered	568
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $5,112
Total amount of fees paid to insurance company	USD $852
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $102,016
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,112
Amount paid for insurance broker fees	852
Additional information about fees paid to insurance broker	INCENTIVE
Insurance broker organization code?	3
Insurance broker name	KINLOCH CONSULTING GROUP, INC.

FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71005 )

Policy contract number

GL 156619

Policy instance

Insurance contract or identification number	GL 156619
Number of Individuals Covered	567
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $3,408
Total amount of fees paid to insurance company	USD $669
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $80,228
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,408
Amount paid for insurance broker fees	669
Additional information about fees paid to insurance broker	INCENTIVE
Insurance broker organization code?	3
Insurance broker name	KINLOCH CONSUTLING GROUP, INC.

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )

Policy contract number

0880523

Policy instance

Insurance contract or identification number	0880523
Number of Individuals Covered	1162
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of fees paid to insurance company	USD $74
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $6,826,208
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	74
Additional information about fees paid to insurance broker	MISCELLANEOUS
Insurance broker organization code?	3
Insurance broker name	KINLOCH CONSULTING GROUP, INC.

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

399542

Policy instance

Insurance contract or identification number	399542
Number of Individuals Covered	720
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $5,647
Other welfare benefits provided	SHORT TERM DISABILITY
Welfare Benefit Premiums Paid to Carrier	USD $51,888
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,184
Insurance broker organization code?	3
Insurance broker name	DIGITAL INSURANCE, INC.

FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )

Policy contract number

399541

Policy instance

Insurance contract or identification number	399541
Number of Individuals Covered	551
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $11,558
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $155,381
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,249
Insurance broker organization code?	3
Insurance broker name	DIGITAL INSURANCE, INC.

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )

Policy contract number

0880523

Policy instance

Insurance contract or identification number	0880523
Number of Individuals Covered	1183
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $6,148,345
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

FIDELITY SECURITY LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 67288 )

Policy contract number

9920752

Policy instance

Insurance contract or identification number	9920752
Number of Individuals Covered	1055
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $54,143
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

STANDARD SECURITY LIFE (National Association of Insurance Commissioners NAIC id number: 69078 )

Policy contract number

9727413

Policy instance

Insurance contract or identification number	9727413
Number of Individuals Covered	1006
Insurance policy start date	2014-01-01
Insurance policy end date	2014-09-30
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $39,764
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )

Policy contract number

399542

Policy instance

Insurance contract or identification number	399542
Number of Individuals Covered	672
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $6,389
Other welfare benefits provided	SHORT TERM DISABILITY
Welfare Benefit Premiums Paid to Carrier	USD $47,571
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $6,389
Insurance broker organization code?	3
Insurance broker name	DIGITAL INSURANCE, INC.

FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )

Policy contract number

399541

Policy instance

Insurance contract or identification number	399541
Number of Individuals Covered	506
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $15,688
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $148,684
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $15,688
Insurance broker organization code?	3
Insurance broker name	DIGITAL INSURANCE, INC.

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )

Policy contract number

0880523

Policy instance

Insurance contract or identification number	0880523
Number of Individuals Covered	1100
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $5,806,752
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

FIDELITY SECURITY LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 67288 )

Policy contract number

9920752

Policy instance

Insurance contract or identification number	9920752
Number of Individuals Covered	1012
Insurance policy start date	2014-10-01
Insurance policy end date	2014-12-31
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $13,363
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )

Policy contract number

399542

Policy instance

Insurance contract or identification number	399542
Number of Individuals Covered	629
Insurance policy start date	2013-10-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $2,701
Other welfare benefits provided	SHORT TERM DISABILITY
Welfare Benefit Premiums Paid to Carrier	USD $15,984
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,701
Insurance broker organization code?	3
Insurance broker name	DIGITAL INSURANCE INC

FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 )

Policy contract number

399541

Policy instance

Insurance contract or identification number	399541
Number of Individuals Covered	509
Insurance policy start date	2013-10-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $6,704
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $47,684
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $6,704
Insurance broker organization code?	3
Insurance broker name	DIGITAL INSURANCE INC

CUNA MUTUAL GROUP (National Association of Insurance Commissioners NAIC id number: 62626 )

Policy contract number

031-0679-4

Policy instance

Insurance contract or identification number	031-0679-4
Number of Individuals Covered	660
Insurance policy start date	2013-01-01
Insurance policy end date	2013-09-30
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $35,019
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

CUNA MUTUAL GROUP (National Association of Insurance Commissioners NAIC id number: 62626 )

Policy contract number

031-0679-4

Policy instance

Insurance contract or identification number	031-0679-4
Number of Individuals Covered	513
Insurance policy start date	2013-01-01
Insurance policy end date	2013-09-30
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $105,458
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

CUNA MUTUAL GROUP (National Association of Insurance Commissioners NAIC id number: 62626 )

Policy contract number

031-0679-4

Policy instance

Insurance contract or identification number	031-0679-4
Number of Individuals Covered	513
Insurance policy start date	2013-01-01
Insurance policy end date	2013-09-30
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $46,894
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )

Policy contract number

0880523

Policy instance

Insurance contract or identification number	0880523
Number of Individuals Covered	1113
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $4,935,870
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

STANDARD SECURITY LIFE (National Association of Insurance Commissioners NAIC id number: 69078 )

Policy contract number

9727413

Policy instance

Insurance contract or identification number	9727413
Number of Individuals Covered	992
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $52,564
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

STANDARD SECURITY LIFE (National Association of Insurance Commissioners NAIC id number: 69078 )

Policy contract number

9727413

Policy instance

Insurance contract or identification number	9727413
Number of Individuals Covered	963
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $50,476
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

CUNA MUTUAL GROUP (National Association of Insurance Commissioners NAIC id number: 62626 )

Policy contract number

031-0679-4

Policy instance

Insurance contract or identification number	031-0679-4
Number of Individuals Covered	635
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $44,524

CUNA MUTUAL GROUP (National Association of Insurance Commissioners NAIC id number: 62626 )

Policy contract number

031-0679-4

Policy instance

Insurance contract or identification number	031-0679-4
Number of Individuals Covered	491
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $132,259
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

CUNA MUTUAL GROUP (National Association of Insurance Commissioners NAIC id number: 62626 )

Policy contract number

031-0679-4

Policy instance

Insurance contract or identification number	031-0679-4
Number of Individuals Covered	491
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $58,692
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )

Policy contract number

880523

Policy instance

Insurance contract or identification number	880523
Number of Individuals Covered	1071
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $4,501,998
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

STANDARD SECURITY LIFE (National Association of Insurance Commissioners NAIC id number: 69078 )

Policy contract number

9727413

Policy instance

Insurance contract or identification number	9727413
Number of Individuals Covered	945
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $0
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $50,403

CUNA MUTUAL GROUP (National Association of Insurance Commissioners NAIC id number: 62626 )

Policy contract number

031-0679-4

Policy instance

Insurance contract or identification number	031-0679-4
Number of Individuals Covered	591
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $0
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $43,199

CUNA MUTUAL GROUP (National Association of Insurance Commissioners NAIC id number: 62626 )

Policy contract number

031-0679-4

Policy instance

Insurance contract or identification number	031-0679-4
Number of Individuals Covered	478
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $0
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $127,043

CUNA MUTUAL GROUP (National Association of Insurance Commissioners NAIC id number: 62626 )

Policy contract number

031-0679-4

Policy instance

Insurance contract or identification number	031-0679-4
Number of Individuals Covered	478
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $0
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $56,261

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )

Policy contract number

880523

Policy instance

Insurance contract or identification number	880523
Number of Individuals Covered	1056
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $0
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $4,463,313

CUNA MUTUAL GROUP (National Association of Insurance Commissioners NAIC id number: 62626 )

Policy contract number

031-0679-4

Policy instance

Insurance contract or identification number	031-0679-4
Number of Individuals Covered	469
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $220,772

CUNA MUTUAL GROUP (National Association of Insurance Commissioners NAIC id number: 62626 )

Policy contract number

031-0679-4

Policy instance

Insurance contract or identification number	031-0679-4
Number of Individuals Covered	601
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $79,404

STANDARD SECURITY LIFE (National Association of Insurance Commissioners NAIC id number: 69078 )

Policy contract number

9727413

Policy instance

Insurance contract or identification number	9727413
Number of Individuals Covered	952
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $48,494

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )

Policy contract number

880523

Policy instance

Insurance contract or identification number	880523
Number of Individuals Covered	1042
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $12,601
Total amount of fees paid to insurance company	USD $28,449
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $4,120,774
Commission paid to Insurance Broker	USD $12,601
Amount paid for insurance broker fees	28449
Additional information about fees paid to insurance broker	2009 DENTAL RETENTION BONUS AND 2009 MEDICAL NEW BUSINESS BONUS
Insurance broker organization code?	3
Insurance broker name	GALLAGHER BENEFIT SERVICES INC.

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Company Name:	TEACHERS FEDERAL CREDIT UNION
Employer identification number (EIN):	111751016
NAIC Classification:	522130
NAIC Description:	Credit Unions