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GREATER PHILADELPHIA CHAMBER OF COMMERCE GROUP LIFE, ACCIDENT AND DISABILITY PLAN 401k Plan overview

Plan NameGREATER PHILADELPHIA CHAMBER OF COMMERCE GROUP LIFE, ACCIDENT AND DISABILITY PLAN
Plan identification number 505

GREATER PHILADELPHIA CHAMBER OF COMMERCE GROUP LIFE, ACCIDENT AND DISABILITY PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)
  • Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

THE CHAMBER OF COMMERCE FOR GREATER PHILADELPHIA has sponsored the creation of one or more 401k plans.

Company Name:THE CHAMBER OF COMMERCE FOR GREATER PHILADELPHIA
Employer identification number (EIN):230969030
NAIC Classification:812990
NAIC Description:All Other Personal Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GREATER PHILADELPHIA CHAMBER OF COMMERCE GROUP LIFE, ACCIDENT AND DISABILITY PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5052022-01-01
5052021-01-01
5052020-01-01
5052019-01-01
5052018-01-01
5052017-01-01DAVID R. HEPBURN DAVID R. HEPBURN2018-07-29
5052017-01-01DAVID R. HEPBURN DAVID R. HEPBURN2018-07-25
5052016-01-01DAVID R. HEPBURN DAVID R. HEPBURN2017-07-24
5052015-01-01DAVID R. HEPBURN DAVID R. HEPBURN2016-07-26
5052014-01-01DAVID R. HEPBURN DAVID R. HEPBURN2015-07-22
5052013-01-01DAVID R. HEPBURN DAVID R. HEPBURN2014-07-27
5052012-01-01DAVID R. HEPBURN DAVID R. HEPBURN2013-07-31
5052011-01-01DAVID R. HEPBURN DAVID R. HEPBURN2012-07-30
5052010-01-01DAVID R. HEPBURN DAVID R. HEPBURN2011-09-06
5052009-01-01DAVID R. HEPBURN DAVID R. HEPBURN2010-10-04

Plan Statistics for GREATER PHILADELPHIA CHAMBER OF COMMERCE GROUP LIFE, ACCIDENT AND DISABILITY PLAN

401k plan membership statisitcs for GREATER PHILADELPHIA CHAMBER OF COMMERCE GROUP LIFE, ACCIDENT AND DISABILITY PLAN

Measure Date Value
2022: GREATER PHILADELPHIA CHAMBER OF COMMERCE GROUP LIFE, ACCIDENT AND DISABILITY PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-0166
Total number of active participants reported on line 7a of the Form 55002022-01-0173
Total of all active and inactive participants2022-01-0173
Total participants2022-01-0173
2021: GREATER PHILADELPHIA CHAMBER OF COMMERCE GROUP LIFE, ACCIDENT AND DISABILITY PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-0165
Total number of active participants reported on line 7a of the Form 55002021-01-0166
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-0166
Total participants2021-01-0166
2020: GREATER PHILADELPHIA CHAMBER OF COMMERCE GROUP LIFE, ACCIDENT AND DISABILITY PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-0186
Total number of active participants reported on line 7a of the Form 55002020-01-0165
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-0165
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-0165
2019: GREATER PHILADELPHIA CHAMBER OF COMMERCE GROUP LIFE, ACCIDENT AND DISABILITY PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-0189
Total number of active participants reported on line 7a of the Form 55002019-01-0186
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-0186
Total participants2019-01-0186
2018: GREATER PHILADELPHIA CHAMBER OF COMMERCE GROUP LIFE, ACCIDENT AND DISABILITY PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-0192
Total number of active participants reported on line 7a of the Form 55002018-01-0189
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-0189
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-0189
2017: GREATER PHILADELPHIA CHAMBER OF COMMERCE GROUP LIFE, ACCIDENT AND DISABILITY PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-0197
Total number of active participants reported on line 7a of the Form 55002017-01-0192
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-0192
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-0192
2016: GREATER PHILADELPHIA CHAMBER OF COMMERCE GROUP LIFE, ACCIDENT AND DISABILITY PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-0195
Total number of active participants reported on line 7a of the Form 55002016-01-0197
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-0197
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-0197
2015: GREATER PHILADELPHIA CHAMBER OF COMMERCE GROUP LIFE, ACCIDENT AND DISABILITY PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-0194
Total number of active participants reported on line 7a of the Form 55002015-01-0195
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-0195
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-0195
2014: GREATER PHILADELPHIA CHAMBER OF COMMERCE GROUP LIFE, ACCIDENT AND DISABILITY PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-0197
Total number of active participants reported on line 7a of the Form 55002014-01-0194
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-0194
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-0194
2013: GREATER PHILADELPHIA CHAMBER OF COMMERCE GROUP LIFE, ACCIDENT AND DISABILITY PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-0198
Total number of active participants reported on line 7a of the Form 55002013-01-0197
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-0197
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-0197
2012: GREATER PHILADELPHIA CHAMBER OF COMMERCE GROUP LIFE, ACCIDENT AND DISABILITY PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-0199
Total number of active participants reported on line 7a of the Form 55002012-01-0198
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-0198
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-0198
2011: GREATER PHILADELPHIA CHAMBER OF COMMERCE GROUP LIFE, ACCIDENT AND DISABILITY PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01103
Total number of active participants reported on line 7a of the Form 55002011-01-0199
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-010
Total of all active and inactive participants2011-01-0199
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-0199
2010: GREATER PHILADELPHIA CHAMBER OF COMMERCE GROUP LIFE, ACCIDENT AND DISABILITY PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-01109
Total number of active participants reported on line 7a of the Form 55002010-01-01103
Number of retired or separated participants receiving benefits2010-01-010
Number of other retired or separated participants entitled to future benefits2010-01-010
Total of all active and inactive participants2010-01-01103
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-01-010
Total participants2010-01-01103
2009: GREATER PHILADELPHIA CHAMBER OF COMMERCE GROUP LIFE, ACCIDENT AND DISABILITY PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01116
Total number of active participants reported on line 7a of the Form 55002009-01-01109
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-01109
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-01109

Form 5500 Responses for GREATER PHILADELPHIA CHAMBER OF COMMERCE GROUP LIFE, ACCIDENT AND DISABILITY PLAN

2022: GREATER PHILADELPHIA CHAMBER OF COMMERCE GROUP LIFE, ACCIDENT AND DISABILITY PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – InsuranceYes
2021: GREATER PHILADELPHIA CHAMBER OF COMMERCE GROUP LIFE, ACCIDENT AND DISABILITY PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – InsuranceYes
2020: GREATER PHILADELPHIA CHAMBER OF COMMERCE GROUP LIFE, ACCIDENT AND 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: GREATER PHILADELPHIA CHAMBER OF COMMERCE GROUP LIFE, ACCIDENT AND DISABILITY PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: GREATER PHILADELPHIA CHAMBER OF COMMERCE GROUP LIFE, ACCIDENT AND 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: GREATER PHILADELPHIA CHAMBER OF COMMERCE GROUP LIFE, ACCIDENT AND DISABILITY PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedYes
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: GREATER PHILADELPHIA CHAMBER OF COMMERCE GROUP LIFE, ACCIDENT AND 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: GREATER PHILADELPHIA CHAMBER OF COMMERCE GROUP LIFE, ACCIDENT AND 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: GREATER PHILADELPHIA CHAMBER OF COMMERCE GROUP LIFE, ACCIDENT AND DISABILITY PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: GREATER PHILADELPHIA CHAMBER OF COMMERCE GROUP LIFE, ACCIDENT AND DISABILITY PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: GREATER PHILADELPHIA CHAMBER OF COMMERCE GROUP LIFE, ACCIDENT AND DISABILITY PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: GREATER PHILADELPHIA CHAMBER OF COMMERCE GROUP LIFE, ACCIDENT AND DISABILITY PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2010: GREATER PHILADELPHIA CHAMBER OF COMMERCE GROUP LIFE, ACCIDENT AND DISABILITY PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – InsuranceYes
2009: GREATER PHILADELPHIA CHAMBER OF COMMERCE GROUP LIFE, ACCIDENT AND DISABILITY PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00543640
Policy instance 1
Insurance contract or identification number00543640
Number of Individuals Covered73
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $7,844
Total amount of fees paid to insurance companyUSD $1,659
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $44,627
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $744
Amount paid for insurance broker fees1659
Additional information about fees paid to insurance brokerSALES COMMISSIONS AND FEES
Insurance broker organization code?5
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00543640
Policy instance 1
Insurance contract or identification number00543640
Number of Individuals Covered66
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $7,296
Total amount of fees paid to insurance companyUSD $2,443
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $40,969
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,296
Amount paid for insurance broker fees2443
Additional information about fees paid to insurance brokerSALES COMMISSIONS AND FEES
Insurance broker organization code?5
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00543640
Policy instance 1
Insurance contract or identification number00543640
Number of Individuals Covered65
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $7,438
Total amount of fees paid to insurance companyUSD $1,600
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedADD
Welfare Benefit Premiums Paid to CarrierUSD $41,738
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,438
Amount paid for insurance broker fees1600
Additional information about fees paid to insurance brokerSALES COMMISSIONS AND FEES
Insurance broker organization code?5
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00543640
Policy instance 1
Insurance contract or identification number00543640
Number of Individuals Covered86
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $7,522
Total amount of fees paid to insurance companyUSD $2,026
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $42,276
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,522
Amount paid for insurance broker fees2026
Additional information about fees paid to insurance brokerSALES COMMISSIONS AND FEES
Insurance broker organization code?5
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberMG17253
Policy instance 1
Insurance contract or identification numberMG17253
Number of Individuals Covered91
Insurance policy start date2017-01-01
Insurance policy end date2017-10-31
Total amount of commissions paid to insurance brokerUSD $3,993
Total amount of fees paid to insurance companyUSD $1,029
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedADD AND PVL
Welfare Benefit Premiums Paid to CarrierUSD $49,146
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees446
Additional information about fees paid to insurance brokerADMIN FEES
Insurance broker organization code?5
Commission paid to Insurance BrokerUSD $1,608
Insurance broker nameGPCC BENEFIT SERVICES INC.
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00543640
Policy instance 2
Insurance contract or identification number00543640
Number of Individuals Covered92
Insurance policy start date2017-11-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $1,239
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedADD
Welfare Benefit Premiums Paid to CarrierUSD $6,795
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,239
Additional information about fees paid to insurance brokerSALES COMMISSIONS
Insurance broker organization code?5
Insurance broker nameEMERSON REID LLC
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberMG17253
Policy instance 1
Insurance contract or identification numberMG17253
Number of Individuals Covered95
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $4,179
Total amount of fees paid to insurance companyUSD $1,062
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedADD AND PVL
Welfare Benefit Premiums Paid to CarrierUSD $50,046
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees456
Additional information about fees paid to insurance brokerADMIN FEES
Insurance broker organization code?5
Commission paid to Insurance BrokerUSD $1,745
Insurance broker nameGPCC BENEFIT SERVICES, INC.
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberMG17253
Policy instance 1
Insurance contract or identification numberMG17253
Number of Individuals Covered94
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $4,322
Total amount of fees paid to insurance companyUSD $1,072
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedADD AND PVL
Welfare Benefit Premiums Paid to CarrierUSD $48,960
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,861
Amount paid for insurance broker fees611
Additional information about fees paid to insurance brokerSALES COMMISSIONS AND FEES
Insurance broker organization code?3
Insurance broker nameGPCC BENEFIT SERVICES INC.
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberMG17253
Policy instance 1
Insurance contract or identification numberMG17253
Number of Individuals Covered97
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $4,219
Total amount of fees paid to insurance companyUSD $1,020
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedADD AND PVL
Welfare Benefit Premiums Paid to CarrierUSD $47,144
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees437
Additional information about fees paid to insurance brokerADMIN FEES
Insurance broker organization code?5
Commission paid to Insurance BrokerUSD $1,886
Insurance broker nameGPCC BENEFIT SERVICES, INC.
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberMG17253
Policy instance 1
Insurance contract or identification numberMG17253
Number of Individuals Covered98
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $4,077
Total amount of fees paid to insurance companyUSD $905
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedADD AND PVL
Welfare Benefit Premiums Paid to CarrierUSD $47,810
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees388
Additional information about fees paid to insurance brokerADMIN FEES
Insurance broker organization code?5
Commission paid to Insurance BrokerUSD $2,009
Insurance broker nameGPCC BENEFIT SERVICES, INC.
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberMG17253
Policy instance 1
Insurance contract or identification numberMG17253
Number of Individuals Covered99
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $2,766
Total amount of fees paid to insurance companyUSD $3,690
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedADD AND PVL
Welfare Benefit Premiums Paid to CarrierUSD $46,409
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number863467G
Policy instance 2
Insurance contract or identification number863467G
Number of Individuals Covered103
Insurance policy start date2009-11-01
Insurance policy end date2010-10-31
Total amount of commissions paid to insurance brokerUSD $3,076
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $16,420
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,076
Additional information about fees paid to insurance brokerSALES COMMISSIONS
Insurance broker nameKISTLER-TIFFANY BENE CO.
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberMG17253
Policy instance 1
Insurance contract or identification numberMG17253
Number of Individuals Covered103
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $1,862
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedADD AND PVL
Welfare Benefit Premiums Paid to CarrierUSD $35,350
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,862
Additional information about fees paid to insurance brokerSALES COMMISSIONS
Insurance broker organization code?3
Insurance broker nameAMERIHEALTH AGENCY, INC.

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