UTLRAMAR TRAVEL MANAGEMENT, INC has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan ULTRAMAR TRAVEL BUREAU GROUP LIFE AND AD&D PLAN
401k plan membership statisitcs for ULTRAMAR TRAVEL BUREAU GROUP LIFE AND AD&D PLAN
Measure | Date | Value |
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2013: ULTRAMAR TRAVEL BUREAU GROUP LIFE AND AD&D PLAN 2013 401k membership |
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Total participants, beginning-of-year | 2013-03-01 | 276 |
Total number of active participants reported on line 7a of the Form 5500 | 2013-03-01 | 0 |
Number of retired or separated participants receiving benefits | 2013-03-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2013-03-01 | 0 |
Total of all active and inactive participants | 2013-03-01 | 0 |
2012: ULTRAMAR TRAVEL BUREAU GROUP LIFE AND AD&D PLAN 2012 401k membership |
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Total participants, beginning-of-year | 2012-03-01 | 258 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-03-01 | 276 |
Number of retired or separated participants receiving benefits | 2012-03-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2012-03-01 | 0 |
Total of all active and inactive participants | 2012-03-01 | 276 |
2011: ULTRAMAR TRAVEL BUREAU GROUP LIFE AND AD&D PLAN 2011 401k membership |
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Total participants, beginning-of-year | 2011-03-01 | 203 |
Total number of active participants reported on line 7a of the Form 5500 | 2011-03-01 | 258 |
Number of retired or separated participants receiving benefits | 2011-03-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2011-03-01 | 0 |
Total of all active and inactive participants | 2011-03-01 | 258 |
2009: ULTRAMAR TRAVEL BUREAU GROUP LIFE AND AD&D PLAN 2009 401k membership |
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Total participants, beginning-of-year | 2009-03-01 | 204 |
Total number of active participants reported on line 7a of the Form 5500 | 2009-03-01 | 179 |
Number of retired or separated participants receiving benefits | 2009-03-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2009-03-01 | 0 |
Total of all active and inactive participants | 2009-03-01 | 179 |
2008: ULTRAMAR TRAVEL BUREAU GROUP LIFE AND AD&D PLAN 2008 401k membership |
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Total participants, beginning-of-year | 2008-03-01 | 151 |
Total number of active participants reported on line 7a of the Form 5500 | 2008-03-01 | 204 |
Number of retired or separated participants receiving benefits | 2008-03-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2008-03-01 | 0 |
Total of all active and inactive participants | 2008-03-01 | 204 |
2007: ULTRAMAR TRAVEL BUREAU GROUP LIFE AND AD&D PLAN 2007 401k membership |
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Total participants, beginning-of-year | 2007-03-01 | 127 |
Total number of active participants reported on line 7a of the Form 5500 | 2007-03-01 | 151 |
Number of retired or separated participants receiving benefits | 2007-03-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2007-03-01 | 0 |
Total of all active and inactive participants | 2007-03-01 | 151 |
2006: ULTRAMAR TRAVEL BUREAU GROUP LIFE AND AD&D PLAN 2006 401k membership |
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Total participants, beginning-of-year | 2006-03-01 | 120 |
Total number of active participants reported on line 7a of the Form 5500 | 2006-03-01 | 127 |
Number of retired or separated participants receiving benefits | 2006-03-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2006-03-01 | 0 |
Total of all active and inactive participants | 2006-03-01 | 127 |
2013: ULTRAMAR TRAVEL BUREAU GROUP LIFE AND AD&D PLAN 2013 form 5500 responses |
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2013-03-01 | Type of plan entity | Single employer plan |
2013-03-01 | Submission has been amended | No |
2013-03-01 | This submission is the final filing | Yes |
2013-03-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
2013-03-01 | Plan is a collectively bargained plan | No |
2013-03-01 | Plan funding arrangement – Insurance | Yes |
2013-03-01 | Plan benefit arrangement – Insurance | Yes |
2012: ULTRAMAR TRAVEL BUREAU GROUP LIFE AND AD&D PLAN 2012 form 5500 responses |
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2012-03-01 | Type of plan entity | Single employer plan |
2012-03-01 | Submission has been amended | No |
2012-03-01 | This submission is the final filing | No |
2012-03-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2012-03-01 | Plan is a collectively bargained plan | No |
2012-03-01 | Plan funding arrangement – Insurance | Yes |
2012-03-01 | Plan benefit arrangement – Insurance | Yes |
2011: ULTRAMAR TRAVEL BUREAU GROUP LIFE AND AD&D PLAN 2011 form 5500 responses |
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2011-03-01 | Type of plan entity | Single employer plan |
2011-03-01 | Submission has been amended | No |
2011-03-01 | This submission is the final filing | No |
2011-03-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2011-03-01 | Plan is a collectively bargained plan | No |
2011-03-01 | Plan funding arrangement – Insurance | Yes |
2011-03-01 | Plan benefit arrangement – Insurance | Yes |
2009: ULTRAMAR TRAVEL BUREAU GROUP LIFE AND AD&D PLAN 2009 form 5500 responses |
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2009-03-01 | Type of plan entity | Single employer plan |
2009-03-01 | Submission has been amended | No |
2009-03-01 | This submission is the final filing | No |
2009-03-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2009-03-01 | Plan is a collectively bargained plan | No |
2009-03-01 | Plan funding arrangement – Insurance | Yes |
2009-03-01 | Plan benefit arrangement – Insurance | Yes |
2008: ULTRAMAR TRAVEL BUREAU GROUP LIFE AND AD&D PLAN 2008 form 5500 responses |
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2008-03-01 | Type of plan entity | Single employer plan |
2008-03-01 | Submission has been amended | No |
2008-03-01 | This submission is the final filing | No |
2008-03-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2008-03-01 | Plan is a collectively bargained plan | No |
2008-03-01 | Plan funding arrangement – Insurance | Yes |
2008-03-01 | Plan benefit arrangement – Insurance | Yes |
2007: ULTRAMAR TRAVEL BUREAU GROUP LIFE AND AD&D PLAN 2007 form 5500 responses |
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2007-03-01 | Type of plan entity | Single employer plan |
2007-03-01 | Submission has been amended | No |
2007-03-01 | This submission is the final filing | No |
2007-03-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2007-03-01 | Plan is a collectively bargained plan | No |
2007-03-01 | Plan funding arrangement – Insurance | Yes |
2007-03-01 | Plan benefit arrangement – Insurance | Yes |
2006: ULTRAMAR TRAVEL BUREAU GROUP LIFE AND AD&D PLAN 2006 form 5500 responses |
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2006-03-01 | Type of plan entity | Single employer plan |
2006-03-01 | First time form 5500 has been submitted | Yes |
2006-03-01 | Submission has been amended | No |
2006-03-01 | This submission is the final filing | No |
2006-03-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2006-03-01 | Plan is a collectively bargained plan | No |
2006-03-01 | Plan funding arrangement – Insurance | Yes |
2006-03-01 | Plan benefit arrangement – Insurance | Yes |
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 ) |
Policy contract number | G000AFGM |
Policy instance | 1 |
Insurance contract or identification number | G000AFGM | Number of Individuals Covered | 0 | Insurance policy start date | 2013-03-01 | Insurance policy end date | 2013-05-31 | Total amount of commissions paid to insurance broker | USD $17 | Total amount of fees paid to insurance company | USD $29 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $170 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $17 | Amount paid for insurance broker fees | 29 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | PROFESSIONAL GROUP PLANS, INC |
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COMPANION LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62243 ) |
Policy contract number | GOOOOAFGM |
Policy instance | 2 |
Insurance contract or identification number | GOOOOAFGM | Number of Individuals Covered | 0 | Insurance policy start date | 2013-03-01 | Insurance policy end date | 2013-05-31 | Total amount of commissions paid to insurance broker | USD $116 | Total amount of fees paid to insurance company | USD $169 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $1,164 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $116 | Amount paid for insurance broker fees | 169 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | PROFESSIONAL GROUP PLANS, INC |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 ) |
Policy contract number | G000AFGM |
Policy instance | 1 |
Insurance contract or identification number | G000AFGM | Number of Individuals Covered | 276 | Insurance policy start date | 2012-03-01 | Insurance policy end date | 2013-02-28 | Total amount of commissions paid to insurance broker | USD $64 | Total amount of fees paid to insurance company | USD $62 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $642 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $64 | Amount paid for insurance broker fees | 62 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | PROFESSIONAL GROUP PLANS, INC |
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COMPANION LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62243 ) |
Policy contract number | GOOOOAFGM |
Policy instance | 2 |
Insurance contract or identification number | GOOOOAFGM | Number of Individuals Covered | 276 | Insurance policy start date | 2012-03-01 | Insurance policy end date | 2013-02-28 | Total amount of commissions paid to insurance broker | USD $353 | Total amount of fees paid to insurance company | USD $342 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $3,532 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $353 | Amount paid for insurance broker fees | 342 | Additional information about fees paid to insurance broker | OTHER COMPENSATION | Insurance broker organization code? | 3 | Insurance broker name | PROFESSIONAL GROUP PLANS, INC |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 ) |
Policy contract number | G000AFGM |
Policy instance | 1 |
Insurance contract or identification number | G000AFGM | Number of Individuals Covered | 258 | Insurance policy start date | 2011-03-01 | Insurance policy end date | 2012-02-29 | Total amount of commissions paid to insurance broker | USD $117 | Total amount of fees paid to insurance company | USD $29 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $573 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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COMPANION LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62243 ) |
Policy contract number | GOOOAFGM |
Policy instance | 2 |
Insurance contract or identification number | GOOOAFGM | Number of Individuals Covered | 258 | Insurance policy start date | 2011-03-01 | Insurance policy end date | 2012-02-29 | Total amount of commissions paid to insurance broker | USD $645 | Total amount of fees paid to insurance company | USD $158 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $3,153 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 ) |
Policy contract number | G000AFGM |
Policy instance | 1 |
Insurance contract or identification number | G000AFGM | Number of Individuals Covered | 203 | Insurance policy start date | 2010-03-01 | Insurance policy end date | 2011-02-28 | Total amount of commissions paid to insurance broker | USD $304 | Total amount of fees paid to insurance company | USD $152 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $3,043 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 ) |
Policy contract number | SGN600255 |
Policy instance | 1 |
Insurance contract or identification number | SGN600255 | Number of Individuals Covered | 204 | Insurance policy start date | 2008-03-01 | Insurance policy end date | 2009-02-28 | Total amount of commissions paid to insurance broker | USD $338 | Total amount of fees paid to insurance company | USD $0 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $2,814 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $338 | Insurance broker organization code? | 3 | Insurance broker name | FRANK CRYSTAL & CO INC. |
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HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
Policy contract number | 682925G |
Policy instance | 1 |
Insurance contract or identification number | 682925G | Number of Individuals Covered | 151 | Insurance policy start date | 2007-03-01 | Insurance policy end date | 2008-02-29 | Total amount of commissions paid to insurance broker | USD $631 | Total amount of fees paid to insurance company | USD $0 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $3,411 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $631 | Insurance broker organization code? | 3 | Insurance broker name | FRANK CRYSTAL & CO INC. |
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HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
Policy contract number | 682925G |
Policy instance | 1 |
Insurance contract or identification number | 682925G | Number of Individuals Covered | 127 | Insurance policy start date | 2006-03-01 | Insurance policy end date | 2007-02-28 | Total amount of commissions paid to insurance broker | USD $535 | Total amount of fees paid to insurance company | USD $0 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $3,145 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $535 | Insurance broker organization code? | 3 | Insurance broker name | FRANK CRYSTAL & CO INC. |
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