SELECTIVE INSURANCE COMPANY OF AMERICA has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan SELECTIVE INSURANCE COMPANY OF AMERICA WELFARE BENEFITS PLAN
401k plan membership statisitcs for SELECTIVE INSURANCE COMPANY OF AMERICA WELFARE BENEFITS PLAN
| Measure | Date | Value |
|---|
| 2022: SELECTIVE INSURANCE COMPANY OF AMERICA WELFARE BENEFITS PLAN 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-01-01 | 2,754 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 2,522 |
| Number of retired or separated participants receiving benefits | 2022-01-01 | 29 |
| Number of other retired or separated participants entitled to future benefits | 2022-01-01 | 267 |
| Total of all active and inactive participants | 2022-01-01 | 2,818 |
| Total participants | 2022-01-01 | 2,818 |
| 2021: SELECTIVE INSURANCE COMPANY OF AMERICA WELFARE BENEFITS PLAN 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-01-01 | 2,743 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 2,440 |
| Number of retired or separated participants receiving benefits | 2021-01-01 | 28 |
| Number of other retired or separated participants entitled to future benefits | 2021-01-01 | 286 |
| Total of all active and inactive participants | 2021-01-01 | 2,754 |
| Total participants | 2021-01-01 | 2,754 |
| 2020: SELECTIVE INSURANCE COMPANY OF AMERICA WELFARE BENEFITS PLAN 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-01-01 | 2,710 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 2,413 |
| Number of retired or separated participants receiving benefits | 2020-01-01 | 31 |
| Number of other retired or separated participants entitled to future benefits | 2020-01-01 | 299 |
| Total of all active and inactive participants | 2020-01-01 | 2,743 |
| Total participants | 2020-01-01 | 2,743 |
| 2019: SELECTIVE INSURANCE COMPANY OF AMERICA WELFARE BENEFITS PLAN 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-01-01 | 2,642 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 2,342 |
| Number of retired or separated participants receiving benefits | 2019-01-01 | 33 |
| Number of other retired or separated participants entitled to future benefits | 2019-01-01 | 335 |
| Total of all active and inactive participants | 2019-01-01 | 2,710 |
| Total participants | 2019-01-01 | 2,710 |
| 2018: SELECTIVE INSURANCE COMPANY OF AMERICA WELFARE BENEFITS PLAN 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-01-01 | 2,629 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 2,236 |
| Number of retired or separated participants receiving benefits | 2018-01-01 | 52 |
| Number of other retired or separated participants entitled to future benefits | 2018-01-01 | 354 |
| Total of all active and inactive participants | 2018-01-01 | 2,642 |
| Total participants | 2018-01-01 | 2,642 |
| 2017: SELECTIVE INSURANCE COMPANY OF AMERICA WELFARE BENEFITS PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-01-01 | 2,631 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 2,201 |
| Number of retired or separated participants receiving benefits | 2017-01-01 | 68 |
| Number of other retired or separated participants entitled to future benefits | 2017-01-01 | 360 |
| Total of all active and inactive participants | 2017-01-01 | 2,629 |
| Total participants | 2017-01-01 | 2,629 |
| 2016: SELECTIVE INSURANCE COMPANY OF AMERICA WELFARE BENEFITS PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-01-01 | 2,199 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 2,219 |
| Number of retired or separated participants receiving benefits | 2016-01-01 | 31 |
| Number of other retired or separated participants entitled to future benefits | 2016-01-01 | 381 |
| Total of all active and inactive participants | 2016-01-01 | 2,631 |
| Total participants | 2016-01-01 | 2,631 |
| 2015: SELECTIVE INSURANCE COMPANY OF AMERICA WELFARE BENEFITS PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-01-01 | 2,135 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 1,776 |
| Number of retired or separated participants receiving benefits | 2015-01-01 | 29 |
| Number of other retired or separated participants entitled to future benefits | 2015-01-01 | 394 |
| Total of all active and inactive participants | 2015-01-01 | 2,199 |
| Total participants | 2015-01-01 | 2,199 |
| 2014: SELECTIVE INSURANCE COMPANY OF AMERICA WELFARE BENEFITS PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-01-01 | 2,127 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 1,678 |
| Number of retired or separated participants receiving benefits | 2014-01-01 | 51 |
| Number of other retired or separated participants entitled to future benefits | 2014-01-01 | 406 |
| Total of all active and inactive participants | 2014-01-01 | 2,135 |
| Total participants | 2014-01-01 | 2,135 |
| 2013: SELECTIVE INSURANCE COMPANY OF AMERICA WELFARE BENEFITS PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-01-01 | 1,988 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 1,647 |
| Number of retired or separated participants receiving benefits | 2013-01-01 | 52 |
| Number of other retired or separated participants entitled to future benefits | 2013-01-01 | 428 |
| Total of all active and inactive participants | 2013-01-01 | 2,127 |
| Total participants | 2013-01-01 | 2,127 |
| 2012: SELECTIVE INSURANCE COMPANY OF AMERICA WELFARE BENEFITS PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-01-01 | 2,304 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 1,471 |
| Number of retired or separated participants receiving benefits | 2012-01-01 | 76 |
| Number of other retired or separated participants entitled to future benefits | 2012-01-01 | 441 |
| Total of all active and inactive participants | 2012-01-01 | 1,988 |
| Total participants | 2012-01-01 | 1,988 |
| 2011: SELECTIVE INSURANCE COMPANY OF AMERICA WELFARE BENEFITS PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-01-01 | 2,313 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 1,796 |
| Number of retired or separated participants receiving benefits | 2011-01-01 | 62 |
| Number of other retired or separated participants entitled to future benefits | 2011-01-01 | 446 |
| Total of all active and inactive participants | 2011-01-01 | 2,304 |
| Total participants | 2011-01-01 | 2,304 |
| 2010: SELECTIVE INSURANCE COMPANY OF AMERICA WELFARE BENEFITS PLAN 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-01-01 | 2,388 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-01-01 | 1,827 |
| Number of retired or separated participants receiving benefits | 2010-01-01 | 61 |
| Number of other retired or separated participants entitled to future benefits | 2010-01-01 | 425 |
| Total of all active and inactive participants | 2010-01-01 | 2,313 |
| Total participants | 2010-01-01 | 2,313 |
| 2009: SELECTIVE INSURANCE COMPANY OF AMERICA WELFARE BENEFITS PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-01-01 | 2,450 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 1,889 |
| Number of retired or separated participants receiving benefits | 2009-01-01 | 466 |
| Number of other retired or separated participants entitled to future benefits | 2009-01-01 | 57 |
| Total of all active and inactive participants | 2009-01-01 | 2,412 |
| Total participants | 2009-01-01 | 2,412 |
| 2022: SELECTIVE INSURANCE COMPANY OF AMERICA WELFARE BENEFITS PLAN 2022 form 5500 responses |
|---|
| 2022-01-01 | Type of plan entity | Single employer plan |
| 2022-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2022-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2021: SELECTIVE INSURANCE COMPANY OF AMERICA WELFARE BENEFITS PLAN 2021 form 5500 responses |
|---|
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2021-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2020: SELECTIVE INSURANCE COMPANY OF AMERICA WELFARE BENEFITS PLAN 2020 form 5500 responses |
|---|
| 2020-01-01 | Type of plan entity | Single employer plan |
| 2020-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2020-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2019: SELECTIVE INSURANCE COMPANY OF AMERICA WELFARE BENEFITS PLAN 2019 form 5500 responses |
|---|
| 2019-01-01 | Type of plan entity | Single employer plan |
| 2019-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2019-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2018: SELECTIVE INSURANCE COMPANY OF AMERICA WELFARE BENEFITS PLAN 2018 form 5500 responses |
|---|
| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2018-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2017: SELECTIVE INSURANCE COMPANY OF AMERICA WELFARE BENEFITS PLAN 2017 form 5500 responses |
|---|
| 2017-01-01 | Type of plan entity | Single employer plan |
| 2017-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2017-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2016: SELECTIVE INSURANCE COMPANY OF AMERICA WELFARE BENEFITS PLAN 2016 form 5500 responses |
|---|
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2016-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2015: SELECTIVE INSURANCE COMPANY OF AMERICA WELFARE BENEFITS PLAN 2015 form 5500 responses |
|---|
| 2015-01-01 | Type of plan entity | Single employer plan |
| 2015-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2015-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2014: SELECTIVE INSURANCE COMPANY OF AMERICA WELFARE BENEFITS PLAN 2014 form 5500 responses |
|---|
| 2014-01-01 | Type of plan entity | Single employer plan |
| 2014-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2014-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2013: SELECTIVE INSURANCE COMPANY OF AMERICA WELFARE BENEFITS PLAN 2013 form 5500 responses |
|---|
| 2013-01-01 | Type of plan entity | Single employer plan |
| 2013-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2013-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2012: SELECTIVE INSURANCE COMPANY OF AMERICA WELFARE BENEFITS PLAN 2012 form 5500 responses |
|---|
| 2012-01-01 | Type of plan entity | Single employer plan |
| 2012-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2012-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2011: SELECTIVE INSURANCE COMPANY OF AMERICA WELFARE BENEFITS PLAN 2011 form 5500 responses |
|---|
| 2011-01-01 | Type of plan entity | Single employer plan |
| 2011-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2011-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2010: SELECTIVE INSURANCE COMPANY OF AMERICA WELFARE BENEFITS PLAN 2010 form 5500 responses |
|---|
| 2010-01-01 | Type of plan entity | Single employer plan |
| 2010-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2010-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2009: SELECTIVE INSURANCE COMPANY OF AMERICA WELFARE BENEFITS PLAN 2009 form 5500 responses |
|---|
| 2009-01-01 | Type of plan entity | Single employer plan |
| 2009-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2009-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| ZURICH AMERICAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 90557 ) |
| Policy contract number | CLPEX01180 |
| Policy instance | 7 |
| Insurance contract or identification number | CLPEX01180 | | Number of Individuals Covered | 3843 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $38,606 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,819,513 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $0 | | Amount paid for insurance broker fees | 38606 |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 12156893 |
| Policy instance | 1 |
| Insurance contract or identification number | 12156893 | | Number of Individuals Covered | 1865 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $445,258 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0116473 |
| Policy instance | 2 |
| Insurance contract or identification number | 0116473 | | Number of Individuals Covered | 0 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $15,628 | | Total amount of fees paid to insurance company | USD $16,846 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | POLICY NOT INFORCE | | Welfare Benefit Premiums Paid to Carrier | USD $0 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $15,628 | | Amount paid for insurance broker fees | 16846 | | Additional information about fees paid to insurance broker | BASE COMMISSIONS & SUPPLEMENTAL COMMISSION | | Insurance broker organization code? | 3 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | GF383050992701 |
| Policy instance | 3 |
| Insurance contract or identification number | GF383050992701 | | Number of Individuals Covered | 2407 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $633 | | Total amount of fees paid to insurance company | USD $3,267 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $54,763 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $633 | | Amount paid for insurance broker fees | 3267 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMMISSION | | Insurance broker organization code? | 3 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | PD383050992703 |
| Policy instance | 4 |
| Insurance contract or identification number | PD383050992703 | | Number of Individuals Covered | 2440 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $215 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | LEAVE SERVICE | | Welfare Benefit Premiums Paid to Carrier | USD $4,294 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $215 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | | Insurance broker organization code? | 3 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | PD383050992701 |
| Policy instance | 5 |
| Insurance contract or identification number | PD383050992701 | | Number of Individuals Covered | 2380 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Other welfare benefits provided | SHORT TERM DISABILITY | | Welfare Benefit Premiums Paid to Carrier | USD $5,093 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 5193 |
| Policy instance | 6 |
| Insurance contract or identification number | 5193 | | Number of Individuals Covered | 8 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $133 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 12156893 |
| Policy instance | 1 |
| Insurance contract or identification number | 12156893 | | Number of Individuals Covered | 1866 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $415,900 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0116473 |
| Policy instance | 2 |
| Insurance contract or identification number | 0116473 | | Number of Individuals Covered | 4833 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $96,954 | | Total amount of fees paid to insurance company | USD $30,732 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $1,762,273 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $96,954 | | Amount paid for insurance broker fees | 30704 | | Additional information about fees paid to insurance broker | NON MONETARY COMPENSATION & SUPPLEMENTAL COMMISSION | | Insurance broker organization code? | 3 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | GF383050992701 |
| Policy instance | 3 |
| Insurance contract or identification number | GF383050992701 | | Number of Individuals Covered | 2407 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $7,504 | | Total amount of fees paid to insurance company | USD $10,040 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $648,041 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $7,504 | | Amount paid for insurance broker fees | 10040 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMMISSION | | Insurance broker organization code? | 3 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | PD383050992703 |
| Policy instance | 4 |
| Insurance contract or identification number | PD383050992703 | | Number of Individuals Covered | 2440 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $2,748 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | LEAVE SERVICE | | Welfare Benefit Premiums Paid to Carrier | USD $50,709 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,748 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | | Insurance broker organization code? | 3 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | PD383050992701 |
| Policy instance | 5 |
| Insurance contract or identification number | PD383050992701 | | Number of Individuals Covered | 2380 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $3,252 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | SHORT TERM DISABILITY | | Welfare Benefit Premiums Paid to Carrier | USD $60,027 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,252 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | | Insurance broker organization code? | 3 |
|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 5193 |
| Policy instance | 6 |
| Insurance contract or identification number | 5193 | | Number of Individuals Covered | 28 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $133 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 ) |
| Policy contract number | PD383050992701 |
| Policy instance | 5 |
| Insurance contract or identification number | PD383050992701 | | Number of Individuals Covered | 2343 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | 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 $69,306 | | 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 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | | Insurance broker organization code? | 3 |
|
| LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 ) |
| Policy contract number | PD383050992703 |
| Policy instance | 4 |
| Insurance contract or identification number | PD383050992703 | | Number of Individuals Covered | 2409 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $2,701 | | Other welfare benefits provided | LEAVE SERVICE | | Welfare Benefit Premiums Paid to Carrier | USD $58,193 | | 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 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | | Insurance broker organization code? | 3 |
|
| LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 ) |
| Policy contract number | GF383050992701 |
| Policy instance | 3 |
| Insurance contract or identification number | GF383050992701 | | Number of Individuals Covered | 2380 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $6,760 | | Total amount of fees paid to insurance company | USD $10,607 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $752,408 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,760 | | Amount paid for insurance broker fees | 7096 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMMISSION | | Insurance broker organization code? | 3 |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0116473 |
| Policy instance | 2 |
| Insurance contract or identification number | 0116473 | | Number of Individuals Covered | 4796 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $103,169 | | Total amount of fees paid to insurance company | USD $31,928 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $1,731,293 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $0 | | Amount paid for insurance broker fees | 31 | | Additional information about fees paid to insurance broker | NON MONETARY COMPENSATION | | Insurance broker organization code? | 3 |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 12156893 |
| Policy instance | 1 |
| Insurance contract or identification number | 12156893 | | Number of Individuals Covered | 1687 | | 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 $384,327 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 12156893 |
| Policy instance | 1 |
| Insurance contract or identification number | 12156893 | | Number of Individuals Covered | 1838 | | 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 $286,689 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0116473 |
| Policy instance | 2 |
| Insurance contract or identification number | 0116473 | | Number of Individuals Covered | 4734 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $86,915 | | Total amount of fees paid to insurance company | USD $20,642 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $1,703,231 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 61 | | Additional information about fees paid to insurance broker | NON MONETARY COMPENSATION | | Insurance broker organization code? | 3 | | Commission paid to Insurance Broker | USD $86,915 |
|
| LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 ) |
| Policy contract number | GF383050992701 |
| Policy instance | 3 |
| Insurance contract or identification number | GF383050992701 | | Number of Individuals Covered | 2332 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $5,030 | | Total amount of fees paid to insurance company | USD $8,399 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $568,772 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,030 | | Amount paid for insurance broker fees | 4914 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMMISION | | Insurance broker organization code? | 3 |
|
| LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 ) |
| Policy contract number | PD383050992701 |
| Policy instance | 4 |
| Insurance contract or identification number | PD383050992701 | | Number of Individuals Covered | 2340 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $2,210 | | Other welfare benefits provided | LEAVE SERVICE | | Welfare Benefit Premiums Paid to Carrier | USD $88,401 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,210 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | | Insurance broker organization code? | 3 |
|
| LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 ) |
| Policy contract number | PD383050992701 |
| Policy instance | 5 |
| Insurance contract or identification number | PD383050992701 | | Number of Individuals Covered | 2340 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $2,210 | | Other welfare benefits provided | SHORT TERM DISABILITY | | Welfare Benefit Premiums Paid to Carrier | USD $53,744 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,210 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | | Insurance broker organization code? | 3 |
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| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0116473 |
| Policy instance | 2 |
| Insurance contract or identification number | 0116473 | | Number of Individuals Covered | 4369 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $98,329 | | Total amount of fees paid to insurance company | USD $27,001 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $1,745,082 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $98,329 | | Amount paid for insurance broker fees | 26909 | | Additional information about fees paid to insurance broker | PREFERRED BROKER COMPENSATION | | Insurance broker organization code? | 3 |
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| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 12156893 |
| Policy instance | 1 |
| Insurance contract or identification number | 12156893 | | Number of Individuals Covered | 1760 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $281,889 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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| LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 ) |
| Policy contract number | GF3-83050992701 |
| Policy instance | 3 |
| Insurance contract or identification number | GF3-83050992701 | | Number of Individuals Covered | 2241 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $5,534 | | Total amount of fees paid to insurance company | USD $10,237 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $580,692 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,534 | | Amount paid for insurance broker fees | 10237 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | | Insurance broker organization code? | 3 |
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| LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 ) |
| Policy contract number | GS3-830-509927- |
| Policy instance | 4 |
| Insurance contract or identification number | GS3-830-509927- | | Number of Individuals Covered | 1 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $2 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $156 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $0 | | Amount paid for insurance broker fees | 2 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | | Insurance broker organization code? | 3 |
|
| LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 ) |
| Policy contract number | GS383050992701 |
| Policy instance | 4 |
| Insurance contract or identification number | GS383050992701 | | Number of Individuals Covered | 60 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $539 | | Total amount of fees paid to insurance company | USD $182 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $9,943 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $539 | | Amount paid for insurance broker fees | 182 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | | Insurance broker organization code? | 3 | | Insurance broker name | TOWERS WATSON DELAWARE |
|
| LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 ) |
| Policy contract number | GF3-83050992701 |
| Policy instance | 3 |
| Insurance contract or identification number | GF3-83050992701 | | Number of Individuals Covered | 2233 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $6,478 | | Total amount of fees paid to insurance company | USD $10,348 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $573,188 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,478 | | Amount paid for insurance broker fees | 10348 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMPENSATION | | Insurance broker organization code? | 3 | | Insurance broker name | TOWERS WATSON DELAWARE |
|
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) |
| Policy contract number | 0116473 |
| Policy instance | 2 |
| Insurance contract or identification number | 0116473 | | Number of Individuals Covered | 4405 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $99,092 | | Total amount of fees paid to insurance company | USD $28,894 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $1,765,597 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 95 | | Additional information about fees paid to insurance broker | PREFERRED BROKER COMPENSATION | | Insurance broker organization code? | 3 | | Commission paid to Insurance Broker | USD $99,092 | | Insurance broker name | TOWERS WATSON DELAWARE INC |
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| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) |
| Policy contract number | 12156893 |
| Policy instance | 1 |
| Insurance contract or identification number | 12156893 | | Number of Individuals Covered | 1764 | | 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 $278,593 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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