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KAJIMA U.S.A. INC. LONG TERM DISABILITY PLAN 401k Plan overview

Plan NameKAJIMA U.S.A. INC. LONG TERM DISABILITY PLAN
Plan identification number 502

KAJIMA U.S.A. INC. LONG TERM DISABILITY PLAN Benefits

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

401k Sponsoring company profile

KAJIMA U.S.A. INC. has sponsored the creation of one or more 401k plans.

Company Name:KAJIMA U.S.A. INC.
Employer identification number (EIN):133381982
NAIC Classification:236200

Additional information about KAJIMA U.S.A. INC.

Jurisdiction of Incorporation: State of Delaware Division of Corporations
Incorporation Date:
Company Identification Number: 2107972

More information about KAJIMA U.S.A. INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan KAJIMA U.S.A. INC. LONG TERM DISABILITY PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022022-01-01
5022021-01-01
5022020-01-01
5022019-01-01
5022018-01-01ROBERT BROWN
5022017-01-01ROBERT BROWN
5022016-01-01ROBERT BROWN
5022015-01-01ROBERT BROWN
5022014-07-01SHOHEI GONDA
5022013-07-01SHOHEI GONDA
5022012-07-01SHOHEI GONDA
5022011-07-01SHOHEI GONDA
5022010-07-01SHOHEI GONDA
5022009-07-01KENT STOLTZMAN

Plan Statistics for KAJIMA U.S.A. INC. LONG TERM DISABILITY PLAN

401k plan membership statisitcs for KAJIMA U.S.A. INC. LONG TERM DISABILITY PLAN

Measure Date Value
2022: KAJIMA U.S.A. INC. LONG TERM DISABILITY PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01589
Total number of active participants reported on line 7a of the Form 55002022-01-01528
Total of all active and inactive participants2022-01-01528
Total participants2022-01-01528
2021: KAJIMA U.S.A. INC. LONG TERM DISABILITY PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01473
Total number of active participants reported on line 7a of the Form 55002021-01-01589
Total of all active and inactive participants2021-01-01589
Total participants2021-01-01589
2020: KAJIMA U.S.A. INC. LONG TERM DISABILITY PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01491
Total number of active participants reported on line 7a of the Form 55002020-01-01473
Total of all active and inactive participants2020-01-01473
Total participants2020-01-01473
2019: KAJIMA U.S.A. INC. LONG TERM DISABILITY PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01469
Total number of active participants reported on line 7a of the Form 55002019-01-01491
Total of all active and inactive participants2019-01-01491
Total participants2019-01-01491
Number of participants with account balances2019-01-010
2018: KAJIMA U.S.A. INC. LONG TERM DISABILITY PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01551
Total number of active participants reported on line 7a of the Form 55002018-01-01469
Total of all active and inactive participants2018-01-01469
Total participants2018-01-01469
2017: KAJIMA U.S.A. INC. LONG TERM DISABILITY PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01323
Total number of active participants reported on line 7a of the Form 55002017-01-01551
Total of all active and inactive participants2017-01-01551
Total participants2017-01-01551
2016: KAJIMA U.S.A. INC. LONG TERM DISABILITY PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01389
Total number of active participants reported on line 7a of the Form 55002016-01-01323
Total of all active and inactive participants2016-01-01323
Total participants2016-01-01323
2015: KAJIMA U.S.A. INC. LONG TERM DISABILITY PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01291
Total number of active participants reported on line 7a of the Form 55002015-01-01389
Total of all active and inactive participants2015-01-01389
Total participants2015-01-010
2014: KAJIMA U.S.A. INC. LONG TERM DISABILITY PLAN 2014 401k membership
Total participants, beginning-of-year2014-07-01268
Total number of active participants reported on line 7a of the Form 55002014-07-01291
Total of all active and inactive participants2014-07-01291
Total participants2014-07-010
2013: KAJIMA U.S.A. INC. LONG TERM DISABILITY PLAN 2013 401k membership
Total participants, beginning-of-year2013-07-01404
Total number of active participants reported on line 7a of the Form 55002013-07-01268
Total of all active and inactive participants2013-07-01268
Total participants2013-07-010
2012: KAJIMA U.S.A. INC. LONG TERM DISABILITY PLAN 2012 401k membership
Total participants, beginning-of-year2012-07-01387
Total number of active participants reported on line 7a of the Form 55002012-07-01404
Number of retired or separated participants receiving benefits2012-07-010
Number of other retired or separated participants entitled to future benefits2012-07-010
Total of all active and inactive participants2012-07-01404
2011: KAJIMA U.S.A. INC. LONG TERM DISABILITY PLAN 2011 401k membership
Total participants, beginning-of-year2011-07-01400
Total number of active participants reported on line 7a of the Form 55002011-07-01387
Number of retired or separated participants receiving benefits2011-07-010
Number of other retired or separated participants entitled to future benefits2011-07-010
Total of all active and inactive participants2011-07-01387
2010: KAJIMA U.S.A. INC. LONG TERM DISABILITY PLAN 2010 401k membership
Total participants, beginning-of-year2010-07-01415
Total number of active participants reported on line 7a of the Form 55002010-07-01400
Number of retired or separated participants receiving benefits2010-07-010
Number of other retired or separated participants entitled to future benefits2010-07-010
Total of all active and inactive participants2010-07-01400
2009: KAJIMA U.S.A. INC. LONG TERM DISABILITY PLAN 2009 401k membership
Total participants, beginning-of-year2009-07-01481
Total number of active participants reported on line 7a of the Form 55002009-07-01415
Number of retired or separated participants receiving benefits2009-07-010
Number of other retired or separated participants entitled to future benefits2009-07-010
Total of all active and inactive participants2009-07-01415

Form 5500 Responses for KAJIMA U.S.A. INC. LONG TERM DISABILITY PLAN

2022: KAJIMA U.S.A. INC. LONG TERM DISABILITY PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – InsuranceYes
2021: KAJIMA U.S.A. INC. LONG TERM DISABILITY PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – InsuranceYes
2020: KAJIMA U.S.A. INC. LONG TERM DISABILITY PLAN 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: KAJIMA U.S.A. INC. LONG TERM DISABILITY PLAN 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: KAJIMA U.S.A. INC. LONG TERM DISABILITY PLAN 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: KAJIMA U.S.A. INC. LONG TERM DISABILITY PLAN 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: KAJIMA U.S.A. INC. LONG TERM DISABILITY PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: KAJIMA U.S.A. INC. LONG TERM DISABILITY PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: KAJIMA U.S.A. INC. LONG TERM DISABILITY PLAN 2014 form 5500 responses
2014-07-01Type of plan entitySingle employer plan
2014-07-01This return/report is a short plan year return/report (less than 12 months)Yes
2014-07-01Plan funding arrangement – InsuranceYes
2014-07-01Plan benefit arrangement – InsuranceYes
2013: KAJIMA U.S.A. INC. LONG TERM DISABILITY PLAN 2013 form 5500 responses
2013-07-01Type of plan entitySingle employer plan
2013-07-01Plan funding arrangement – InsuranceYes
2013-07-01Plan benefit arrangement – InsuranceYes
2012: KAJIMA U.S.A. INC. LONG TERM DISABILITY PLAN 2012 form 5500 responses
2012-07-01Type of plan entitySingle employer plan
2012-07-01Submission has been amendedNo
2012-07-01This submission is the final filingNo
2012-07-01This return/report is a short plan year return/report (less than 12 months)No
2012-07-01Plan is a collectively bargained planNo
2012-07-01Plan funding arrangement – InsuranceYes
2012-07-01Plan benefit arrangement – InsuranceYes
2011: KAJIMA U.S.A. INC. LONG TERM DISABILITY PLAN 2011 form 5500 responses
2011-07-01Type of plan entitySingle employer plan
2011-07-01Submission has been amendedNo
2011-07-01This submission is the final filingNo
2011-07-01This return/report is a short plan year return/report (less than 12 months)No
2011-07-01Plan is a collectively bargained planNo
2011-07-01Plan funding arrangement – InsuranceYes
2011-07-01Plan benefit arrangement – InsuranceYes
2010: KAJIMA U.S.A. INC. LONG TERM DISABILITY PLAN 2010 form 5500 responses
2010-07-01Type of plan entitySingle employer plan
2010-07-01Submission has been amendedNo
2010-07-01This submission is the final filingNo
2010-07-01This return/report is a short plan year return/report (less than 12 months)No
2010-07-01Plan is a collectively bargained planNo
2010-07-01Plan funding arrangement – InsuranceYes
2010-07-01Plan benefit arrangement – InsuranceYes
2009: KAJIMA U.S.A. INC. LONG TERM DISABILITY PLAN 2009 form 5500 responses
2009-07-01Type of plan entitySingle employer plan
2009-07-01Submission has been amendedNo
2009-07-01This submission is the final filingNo
2009-07-01This return/report is a short plan year return/report (less than 12 months)No
2009-07-01Plan is a collectively bargained planNo
2009-07-01Plan funding arrangement – InsuranceYes
2009-07-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10252682-00000
Policy instance 5
Insurance contract or identification number10252682-00000
Number of Individuals Covered329
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $16,402
Total amount of fees paid to insurance companyUSD $2,833
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $109,352
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,402
Amount paid for insurance broker fees2833
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number403007319-00000
Policy instance 4
Insurance contract or identification number403007319-00000
Number of Individuals Covered204
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $2,137
Total amount of fees paid to insurance companyUSD $376
Life Insurance Welfare BenefitYes
Other welfare benefits providedVOLUNTARY CHILD & SPOUSE AD&D
Welfare Benefit Premiums Paid to CarrierUSD $14,246
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,137
Amount paid for insurance broker fees376
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number40000100025127
Policy instance 3
Insurance contract or identification number40000100025127
Number of Individuals Covered213
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $15,495
Total amount of fees paid to insurance companyUSD $2,750
Life Insurance Welfare BenefitYes
Other welfare benefits providedVOLUNTARY LIFE
Welfare Benefit Premiums Paid to CarrierUSD $103,295
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,495
Amount paid for insurance broker fees2750
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10252684-00000
Policy instance 2
Insurance contract or identification number10252684-00000
Number of Individuals Covered528
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $39,402
Total amount of fees paid to insurance companyUSD $7,111
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $262,681
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $39,402
Amount paid for insurance broker fees7111
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10252685-00000
Policy instance 1
Insurance contract or identification number10252685-00000
Number of Individuals Covered275
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $12,964
Total amount of fees paid to insurance companyUSD $2,147
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $86,430
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,964
Amount paid for insurance broker fees2147
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10252685-00000
Policy instance 1
Insurance contract or identification number10252685-00000
Number of Individuals Covered271
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $11,713
Total amount of fees paid to insurance companyUSD $1,314
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $78,087
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,713
Amount paid for insurance broker fees1314
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10252684-00000
Policy instance 2
Insurance contract or identification number10252684-00000
Number of Individuals Covered589
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $38,786
Total amount of fees paid to insurance companyUSD $4,203
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $258,570
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $38,786
Amount paid for insurance broker fees4203
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number40000100025127
Policy instance 3
Insurance contract or identification number40000100025127
Number of Individuals Covered184
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $15,002
Total amount of fees paid to insurance companyUSD $1,664
Life Insurance Welfare BenefitYes
Other welfare benefits providedVOLUNTARY LIFE
Welfare Benefit Premiums Paid to CarrierUSD $100,015
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,002
Amount paid for insurance broker fees1664
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number403007319-00000
Policy instance 4
Insurance contract or identification number403007319-00000
Number of Individuals Covered185
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $2,050
Total amount of fees paid to insurance companyUSD $219
Life Insurance Welfare BenefitYes
Other welfare benefits providedVOLUNTARY CHILD & SPOUSE AD&D
Welfare Benefit Premiums Paid to CarrierUSD $13,667
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,050
Amount paid for insurance broker fees219
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10252682-00000
Policy instance 5
Insurance contract or identification number10252682-00000
Number of Individuals Covered339
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $15,452
Total amount of fees paid to insurance companyUSD $1,690
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $103,013
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,452
Amount paid for insurance broker fees1690
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10252682-00000
Policy instance 5
Insurance contract or identification number10252682-00000
Number of Individuals Covered276
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $14,489
Total amount of fees paid to insurance companyUSD $4,836
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $96,595
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,820
Amount paid for insurance broker fees4836
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number403007319-00000
Policy instance 4
Insurance contract or identification number403007319-00000
Number of Individuals Covered165
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $2,271
Total amount of fees paid to insurance companyUSD $545
Life Insurance Welfare BenefitYes
Other welfare benefits providedVOLUNTARY CHILD & SPOUSE AD&D
Welfare Benefit Premiums Paid to CarrierUSD $12,521
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,878
Amount paid for insurance broker fees545
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number40000100025127
Policy instance 3
Insurance contract or identification number40000100025127
Number of Individuals Covered164
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $14,259
Total amount of fees paid to insurance companyUSD $4,204
Life Insurance Welfare BenefitYes
Other welfare benefits providedVOLUNTARY LIFE
Welfare Benefit Premiums Paid to CarrierUSD $95,065
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,126
Amount paid for insurance broker fees4204
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10252684-00000
Policy instance 2
Insurance contract or identification number10252684-00000
Number of Individuals Covered473
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $36,022
Total amount of fees paid to insurance companyUSD $12,085
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $240,151
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $26,791
Amount paid for insurance broker fees12085
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10252685-00000
Policy instance 1
Insurance contract or identification number10252685-00000
Number of Individuals Covered238
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $11,259
Total amount of fees paid to insurance companyUSD $3,874
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $75,061
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,328
Amount paid for insurance broker fees3874
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?4
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10252682-00000
Policy instance 10
Insurance contract or identification number10252682-00000
Number of Individuals Covered280
Insurance policy start date2019-05-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $6,213
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $41,420
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,213
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number403007319-00000
Policy instance 9
Insurance contract or identification number403007319-00000
Number of Individuals Covered146
Insurance policy start date2019-05-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $722
Life Insurance Welfare BenefitYes
Other welfare benefits providedVOLUNTARY CHILD & SPOUSE AD&D
Welfare Benefit Premiums Paid to CarrierUSD $4,814
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $722
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number40000100025127
Policy instance 8
Insurance contract or identification number40000100025127
Number of Individuals Covered129
Insurance policy start date2019-05-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $5,465
Life Insurance Welfare BenefitYes
Other welfare benefits providedVOLUNTARY LIFE
Welfare Benefit Premiums Paid to CarrierUSD $36,432
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,465
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10252684-00000
Policy instance 7
Insurance contract or identification number10252684-00000
Number of Individuals Covered491
Insurance policy start date2019-05-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $15,452
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $103,011
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,452
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10252685-00000
Policy instance 6
Insurance contract or identification number10252685-00000
Number of Individuals Covered235
Insurance policy start date2019-05-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $4,990
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $33,268
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,990
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX966897
Policy instance 5
Insurance contract or identification numberFLX966897
Number of Individuals Covered185
Insurance policy start date2019-01-01
Insurance policy end date2019-04-30
Total amount of commissions paid to insurance brokerUSD $19,544
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $132,557
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $19,544
Additional information about fees paid to insurance brokerADMINISTRATIVE
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberOK 968402
Policy instance 4
Insurance contract or identification numberOK 968402
Number of Individuals Covered185
Insurance policy start date2019-01-01
Insurance policy end date2019-04-30
Total amount of commissions paid to insurance brokerUSD $2,457
Other welfare benefits providedACCIDENTAL DEATH
Welfare Benefit Premiums Paid to CarrierUSD $16,381
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,457
Additional information about fees paid to insurance brokerADMINISTRATIVE
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberVDT961696
Policy instance 3
Insurance contract or identification numberVDT961696
Number of Individuals Covered190
Insurance policy start date2019-01-01
Insurance policy end date2019-04-30
Total amount of commissions paid to insurance brokerUSD $4,921
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $32,808
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,921
Additional information about fees paid to insurance brokerADMINISTRATIVE
Insurance broker organization code?4
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSDJ960488
Policy instance 2
Insurance contract or identification numberSDJ960488
Number of Individuals Covered185
Insurance policy start date2019-01-01
Insurance policy end date2019-04-30
Total amount of commissions paid to insurance brokerUSD $319
Other welfare benefits providedSTATUTORY DISABILITY
Welfare Benefit Premiums Paid to CarrierUSD $2,124
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $319
Additional information about fees paid to insurance brokerADMINISTRATIVE
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberVDT961697
Policy instance 1
Insurance contract or identification numberVDT961697
Number of Individuals Covered185
Insurance policy start date2019-01-01
Insurance policy end date2019-04-30
Total amount of commissions paid to insurance brokerUSD $6,089
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $40,594
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,089
Additional information about fees paid to insurance brokerADMINISTRATIVE
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberVDT961697
Policy instance 1
Insurance contract or identification numberVDT961697
Number of Individuals Covered289
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $11,882
Total amount of fees paid to insurance companyUSD $1,533
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $79,212
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,882
Amount paid for insurance broker fees1533
Additional information about fees paid to insurance brokerADMINISTRATIVE
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSDJ960488
Policy instance 2
Insurance contract or identification numberSDJ960488
Number of Individuals Covered149
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $676
Total amount of fees paid to insurance companyUSD $109
Other welfare benefits providedSTATUTORY DISABILITY
Welfare Benefit Premiums Paid to CarrierUSD $4,507
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $676
Amount paid for insurance broker fees109
Additional information about fees paid to insurance brokerADMINISTRATIVE
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberVDT961696
Policy instance 3
Insurance contract or identification numberVDT961696
Number of Individuals Covered237
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $9,506
Total amount of fees paid to insurance companyUSD $1,230
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $63,370
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,506
Amount paid for insurance broker fees1230
Additional information about fees paid to insurance brokerADMINISTRATIVE
Insurance broker organization code?4
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberOK 968402
Policy instance 4
Insurance contract or identification numberOK 968402
Number of Individuals Covered469
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $4,732
Total amount of fees paid to insurance companyUSD $611
Other welfare benefits providedACCIDENTAL DEATH
Welfare Benefit Premiums Paid to CarrierUSD $31,545
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,732
Amount paid for insurance broker fees611
Additional information about fees paid to insurance brokerADMINISTRATIVE
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX966897
Policy instance 5
Insurance contract or identification numberFLX966897
Number of Individuals Covered469
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $37,001
Total amount of fees paid to insurance companyUSD $4,761
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $246,676
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $37,001
Amount paid for insurance broker fees4761
Additional information about fees paid to insurance brokerADMINISTRATIVE
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX966897
Policy instance 5
Insurance contract or identification numberFLX966897
Number of Individuals Covered551
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $34,547
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $230,314
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $34,547
Additional information about fees paid to insurance brokerADMINISTRATIVE
Insurance broker organization code?3
Insurance broker nameJ. SMITH LANIER & CO
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberOK 968402
Policy instance 4
Insurance contract or identification numberOK 968402
Number of Individuals Covered519
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $4,302
Other welfare benefits providedACCIDENTAL DEATH
Welfare Benefit Premiums Paid to CarrierUSD $29,401
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,302
Additional information about fees paid to insurance brokerADMINISTRATIVE
Insurance broker organization code?3
Insurance broker nameJ. SMITH LANIER & CO
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberVDT961696
Policy instance 3
Insurance contract or identification numberVDT961696
Number of Individuals Covered214
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $8,909
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $59,392
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,909
Insurance broker organization code?4
Insurance broker nameJ. SMITH LANIER & CO
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSDJ960488
Policy instance 2
Insurance contract or identification numberSDJ960488
Number of Individuals Covered33
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $817
Other welfare benefits providedSTATUTORY DISABILITY
Welfare Benefit Premiums Paid to CarrierUSD $5,446
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $817
Insurance broker organization code?3
Insurance broker nameJ. SMITH LANIER & CO.
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberVDT961697
Policy instance 1
Insurance contract or identification numberVDT961697
Number of Individuals Covered282
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $15,168
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $74,695
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,168
Insurance broker organization code?3
Insurance broker nameJ. SMITH LANIER & CO

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