W.D. ZWICKY & SON, INC. has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan W.D. ZWICKY & SON, INC. EMPLOYEE BENEFIT PLAN
401k plan membership statisitcs for W.D. ZWICKY & SON, INC. EMPLOYEE BENEFIT PLAN
Measure | Date | Value |
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2021: W.D. ZWICKY & SON, INC. EMPLOYEE BENEFIT PLAN 2021 401k membership |
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Total participants, beginning-of-year | 2021-12-01 | 52 |
Total number of active participants reported on line 7a of the Form 5500 | 2021-12-01 | 22 |
Number of retired or separated participants receiving benefits | 2021-12-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2021-12-01 | 0 |
Total of all active and inactive participants | 2021-12-01 | 22 |
2020: W.D. ZWICKY & SON, INC. EMPLOYEE BENEFIT PLAN 2020 401k membership |
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Total participants, beginning-of-year | 2020-12-01 | 24 |
Total number of active participants reported on line 7a of the Form 5500 | 2020-12-01 | 52 |
Number of retired or separated participants receiving benefits | 2020-12-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2020-12-01 | 0 |
Total of all active and inactive participants | 2020-12-01 | 52 |
2019: W.D. ZWICKY & SON, INC. EMPLOYEE BENEFIT PLAN 2019 401k membership |
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Total participants, beginning-of-year | 2019-12-01 | 33 |
Total number of active participants reported on line 7a of the Form 5500 | 2019-12-01 | 22 |
Number of retired or separated participants receiving benefits | 2019-12-01 | 2 |
Number of other retired or separated participants entitled to future benefits | 2019-12-01 | 0 |
Total of all active and inactive participants | 2019-12-01 | 24 |
2018: W.D. ZWICKY & SON, INC. EMPLOYEE BENEFIT PLAN 2018 401k membership |
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Total participants, beginning-of-year | 2018-12-01 | 31 |
Total number of active participants reported on line 7a of the Form 5500 | 2018-12-01 | 33 |
Number of retired or separated participants receiving benefits | 2018-12-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2018-12-01 | 0 |
Total of all active and inactive participants | 2018-12-01 | 33 |
2017: W.D. ZWICKY & SON, INC. EMPLOYEE BENEFIT PLAN 2017 401k membership |
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Total participants, beginning-of-year | 2017-12-01 | 29 |
Total number of active participants reported on line 7a of the Form 5500 | 2017-12-01 | 31 |
Number of retired or separated participants receiving benefits | 2017-12-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2017-12-01 | 0 |
Total of all active and inactive participants | 2017-12-01 | 31 |
Measure | Date | Value |
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2022 : W.D. ZWICKY & SON, INC. EMPLOYEE BENEFIT PLAN 2022 401k financial data |
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Total plan liabilities at end of year | 2022-11-30 | $15,727 |
Total plan liabilities at beginning of year | 2022-11-30 | $27,865 |
Total income from all sources | 2022-11-30 | $329,765 |
Expenses. Total of all expenses incurred | 2022-11-30 | $295,810 |
Benefits paid (including direct rollovers) | 2022-11-30 | $152,449 |
Total plan assets at end of year | 2022-11-30 | $75,826 |
Total plan assets at beginning of year | 2022-11-30 | $54,009 |
Value of fidelity bond covering the plan | 2022-11-30 | $100,000 |
Total contributions received or receivable from participants | 2022-11-30 | $13,312 |
Expenses. Other expenses not covered elsewhere | 2022-11-30 | $141,342 |
Contributions received from other sources (not participants or employers) | 2022-11-30 | $0 |
Other income received | 2022-11-30 | $437 |
Net income (gross income less expenses) | 2022-11-30 | $33,955 |
Net plan assets at end of year (total assets less liabilities) | 2022-11-30 | $60,099 |
Net plan assets at beginning of year (total assets less liabilities) | 2022-11-30 | $26,144 |
Total contributions received or receivable from employer(s) | 2022-11-30 | $316,016 |
Value of corrective distributions | 2022-11-30 | $0 |
Expenses. Administrative service providers (salaries,fees and commissions) | 2022-11-30 | $2,019 |
2021 : W.D. ZWICKY & SON, INC. EMPLOYEE BENEFIT PLAN 2021 401k financial data |
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Total plan liabilities at end of year | 2021-11-30 | $27,865 |
Total plan liabilities at beginning of year | 2021-11-30 | $54,771 |
Total income from all sources | 2021-11-30 | $314,640 |
Expenses. Total of all expenses incurred | 2021-11-30 | $234,218 |
Benefits paid (including direct rollovers) | 2021-11-30 | $93,583 |
Total plan assets at end of year | 2021-11-30 | $54,009 |
Total plan assets at beginning of year | 2021-11-30 | $493 |
Value of fidelity bond covering the plan | 2021-11-30 | $100,000 |
Total contributions received or receivable from participants | 2021-11-30 | $22,685 |
Expenses. Other expenses not covered elsewhere | 2021-11-30 | $133,597 |
Other income received | 2021-11-30 | $210 |
Net income (gross income less expenses) | 2021-11-30 | $80,422 |
Net plan assets at end of year (total assets less liabilities) | 2021-11-30 | $26,144 |
Net plan assets at beginning of year (total assets less liabilities) | 2021-11-30 | $-54,278 |
Total contributions received or receivable from employer(s) | 2021-11-30 | $291,745 |
Expenses. Administrative service providers (salaries,fees and commissions) | 2021-11-30 | $7,038 |
2020 : W.D. ZWICKY & SON, INC. EMPLOYEE BENEFIT PLAN 2020 401k financial data |
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Total plan liabilities at end of year | 2020-11-30 | $54,771 |
Total plan liabilities at beginning of year | 2020-11-30 | $103,169 |
Total income from all sources | 2020-11-30 | $303,227 |
Expenses. Total of all expenses incurred | 2020-11-30 | $271,664 |
Benefits paid (including direct rollovers) | 2020-11-30 | $123,246 |
Total plan assets at end of year | 2020-11-30 | $493 |
Total plan assets at beginning of year | 2020-11-30 | $17,328 |
Value of fidelity bond covering the plan | 2020-11-30 | $100,000 |
Total contributions received or receivable from participants | 2020-11-30 | $16,972 |
Expenses. Other expenses not covered elsewhere | 2020-11-30 | $127,215 |
Other income received | 2020-11-30 | $199 |
Net income (gross income less expenses) | 2020-11-30 | $31,563 |
Net plan assets at end of year (total assets less liabilities) | 2020-11-30 | $-54,278 |
Net plan assets at beginning of year (total assets less liabilities) | 2020-11-30 | $-85,841 |
Total contributions received or receivable from employer(s) | 2020-11-30 | $286,056 |
Value of corrective distributions | 2020-11-30 | $13,121 |
Expenses. Administrative service providers (salaries,fees and commissions) | 2020-11-30 | $8,082 |
2019 : W.D. ZWICKY & SON, INC. EMPLOYEE BENEFIT PLAN 2019 401k financial data |
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Total plan liabilities at end of year | 2019-11-30 | $103,169 |
Total plan liabilities at beginning of year | 2019-11-30 | $11,204 |
Total income from all sources | 2019-11-30 | $294,655 |
Expenses. Total of all expenses incurred | 2019-11-30 | $405,794 |
Benefits paid (including direct rollovers) | 2019-11-30 | $256,471 |
Total plan assets at end of year | 2019-11-30 | $17,328 |
Total plan assets at beginning of year | 2019-11-30 | $36,502 |
Value of fidelity bond covering the plan | 2019-11-30 | $100,000 |
Total contributions received or receivable from participants | 2019-11-30 | $16,581 |
Expenses. Other expenses not covered elsewhere | 2019-11-30 | $124,202 |
Contributions received from other sources (not participants or employers) | 2019-11-30 | $0 |
Other income received | 2019-11-30 | $280 |
Noncash contributions received | 2019-11-30 | $0 |
Net income (gross income less expenses) | 2019-11-30 | $-111,139 |
Net plan assets at end of year (total assets less liabilities) | 2019-11-30 | $-85,841 |
Net plan assets at beginning of year (total assets less liabilities) | 2019-11-30 | $25,298 |
Total contributions received or receivable from employer(s) | 2019-11-30 | $277,794 |
Value of certain deemed distributions of participant loans | 2019-11-30 | $0 |
Value of corrective distributions | 2019-11-30 | $13,121 |
Expenses. Administrative service providers (salaries,fees and commissions) | 2019-11-30 | $12,000 |
2021: W.D. ZWICKY & SON, INC. EMPLOYEE BENEFIT PLAN 2021 form 5500 responses |
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2021-12-01 | Type of plan entity | Single employer plan |
2021-12-01 | Submission has been amended | No |
2021-12-01 | This submission is the final filing | No |
2021-12-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2021-12-01 | Plan is a collectively bargained plan | No |
2021-12-01 | Plan funding arrangement – Insurance | Yes |
2021-12-01 | Plan funding arrangement – Trust | Yes |
2021-12-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2021-12-01 | Plan benefit arrangement – Insurance | Yes |
2021-12-01 | Plan benefit arrangement - Trust | Yes |
2021-12-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2020: W.D. ZWICKY & SON, INC. EMPLOYEE BENEFIT PLAN 2020 form 5500 responses |
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2020-12-01 | Type of plan entity | Single employer plan |
2020-12-01 | Submission has been amended | No |
2020-12-01 | This submission is the final filing | No |
2020-12-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2020-12-01 | Plan is a collectively bargained plan | No |
2020-12-01 | Plan funding arrangement – Insurance | Yes |
2020-12-01 | Plan funding arrangement – Trust | Yes |
2020-12-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2020-12-01 | Plan benefit arrangement – Insurance | Yes |
2020-12-01 | Plan benefit arrangement - Trust | Yes |
2020-12-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2019: W.D. ZWICKY & SON, INC. EMPLOYEE BENEFIT PLAN 2019 form 5500 responses |
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2019-12-01 | Type of plan entity | Single employer plan |
2019-12-01 | Submission has been amended | No |
2019-12-01 | This submission is the final filing | No |
2019-12-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2019-12-01 | Plan is a collectively bargained plan | No |
2019-12-01 | Plan funding arrangement – Insurance | Yes |
2019-12-01 | Plan funding arrangement – Trust | Yes |
2019-12-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2019-12-01 | Plan benefit arrangement – Insurance | Yes |
2019-12-01 | Plan benefit arrangement - Trust | Yes |
2019-12-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2018: W.D. ZWICKY & SON, INC. EMPLOYEE BENEFIT PLAN 2018 form 5500 responses |
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2018-12-01 | Type of plan entity | Single employer plan |
2018-12-01 | Submission has been amended | No |
2018-12-01 | This submission is the final filing | No |
2018-12-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2018-12-01 | Plan is a collectively bargained plan | No |
2018-12-01 | Plan funding arrangement – Insurance | Yes |
2018-12-01 | Plan funding arrangement – Trust | Yes |
2018-12-01 | Plan benefit arrangement – Insurance | Yes |
2018-12-01 | Plan benefit arrangement - Trust | Yes |
2017: W.D. ZWICKY & SON, INC. EMPLOYEE BENEFIT PLAN 2017 form 5500 responses |
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2017-12-01 | Type of plan entity | Single employer plan |
2017-12-01 | First time form 5500 has been submitted | Yes |
2017-12-01 | Submission has been amended | No |
2017-12-01 | This submission is the final filing | No |
2017-12-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2017-12-01 | Plan is a collectively bargained plan | No |
2017-12-01 | Plan funding arrangement – Insurance | Yes |
2017-12-01 | Plan funding arrangement – Trust | Yes |
2017-12-01 | Plan benefit arrangement – Insurance | Yes |
2017-12-01 | Plan benefit arrangement - Trust | Yes |
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
Policy contract number | F021882 |
Policy instance | 4 |
Insurance contract or identification number | F021882 | Number of Individuals Covered | 0 | Insurance policy start date | 2021-12-01 | Insurance policy end date | 2022-11-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $0 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | Commission paid to Insurance Broker | USD $0 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | NONE | Insurance broker organization code? | 3 |
|
UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62294 ) |
Policy contract number | 258118000 |
Policy instance | 3 |
Insurance contract or identification number | 258118000 | Number of Individuals Covered | 0 | Insurance policy start date | 2021-12-01 | Insurance policy end date | 2022-11-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $0 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | Commission paid to Insurance Broker | USD $0 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | NONE | Insurance broker organization code? | 3 |
|
NVA VISION (National Association of Insurance Commissioners NAIC id number: 11686 ) |
Policy contract number | NVAI8382 |
Policy instance | 2 |
Insurance contract or identification number | NVAI8382 | Number of Individuals Covered | 0 | Insurance policy start date | 2021-12-01 | Insurance policy end date | 2022-11-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $0 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | Commission paid to Insurance Broker | USD $0 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | NONE | Insurance broker organization code? | 3 |
|
EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 30700010 |
Policy instance | 1 |
Insurance contract or identification number | 30700010 | Number of Individuals Covered | 22 | Insurance policy start date | 2021-12-01 | Insurance policy end date | 2022-11-30 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $126,635 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 30700010 |
Policy instance | 1 |
Insurance contract or identification number | 30700010 | Number of Individuals Covered | 27 | Insurance policy start date | 2020-12-01 | Insurance policy end date | 2021-11-30 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $117,056 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
NVA VISION (National Association of Insurance Commissioners NAIC id number: 11686 ) |
Policy contract number | NVAI8382 |
Policy instance | 2 |
Insurance contract or identification number | NVAI8382 | Number of Individuals Covered | 14 | Insurance policy start date | 2020-12-01 | Insurance policy end date | 2021-11-30 | Total amount of commissions paid to insurance broker | USD $108 | Total amount of fees paid to insurance company | USD $0 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $1,505 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $108 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | NONE | Insurance broker organization code? | 3 |
|
UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62294 ) |
Policy contract number | 258118000 |
Policy instance | 3 |
Insurance contract or identification number | 258118000 | Number of Individuals Covered | 14 | Insurance policy start date | 2020-12-01 | Insurance policy end date | 2021-11-30 | Total amount of commissions paid to insurance broker | USD $672 | Total amount of fees paid to insurance company | USD $0 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $6,071 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $672 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | NONE | Insurance broker organization code? | 3 |
|
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
Policy contract number | F021882 |
Policy instance | 4 |
Insurance contract or identification number | F021882 | Number of Individuals Covered | 52 | Insurance policy start date | 2020-12-01 | Insurance policy end date | 2021-11-30 | Total amount of commissions paid to insurance broker | USD $1,073 | Total amount of fees paid to insurance company | USD $0 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $2,901 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,073 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | NONE | Insurance broker organization code? | 3 |
|
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
Policy contract number | F021882 |
Policy instance | 4 |
Insurance contract or identification number | F021882 | Number of Individuals Covered | 28 | Insurance policy start date | 2019-12-01 | Insurance policy end date | 2020-11-30 | Total amount of commissions paid to insurance broker | USD $1,045 | Total amount of fees paid to insurance company | USD $0 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $4,325 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,045 | Insurance broker organization code? | 3 |
|
UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62294 ) |
Policy contract number | 258118000 |
Policy instance | 3 |
Insurance contract or identification number | 258118000 | Number of Individuals Covered | 16 | Insurance policy start date | 2019-12-01 | Insurance policy end date | 2020-11-30 | Total amount of commissions paid to insurance broker | USD $679 | Total amount of fees paid to insurance company | USD $0 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $7,612 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $679 | Insurance broker organization code? | 3 |
|
NVA VISION (National Association of Insurance Commissioners NAIC id number: 11686 ) |
Policy contract number | NVAI8382 |
Policy instance | 2 |
Insurance contract or identification number | NVAI8382 | Number of Individuals Covered | 16 | Insurance policy start date | 2019-12-01 | Insurance policy end date | 2020-11-30 | Total amount of commissions paid to insurance broker | USD $105 | Total amount of fees paid to insurance company | USD $0 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $1,533 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $105 | Insurance broker organization code? | 3 |
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EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | 30700010 |
Policy instance | 1 |
Insurance contract or identification number | 30700010 | Number of Individuals Covered | 22 | Insurance policy start date | 2019-12-01 | Insurance policy end date | 2020-11-30 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $108,935 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62294 ) |
Policy contract number | 9809 |
Policy instance | 3 |
Insurance contract or identification number | 9809 | Number of Individuals Covered | 22 | Insurance policy start date | 2018-12-01 | Insurance policy end date | 2019-11-30 | Total amount of commissions paid to insurance broker | USD $732 | Total amount of fees paid to insurance company | USD $0 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $7,349 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $732 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | NONE | Insurance broker organization code? | 3 |
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NVA VISION (National Association of Insurance Commissioners NAIC id number: 11686 ) |
Policy contract number | 8382086194 |
Policy instance | 2 |
Insurance contract or identification number | 8382086194 | Number of Individuals Covered | 18 | Insurance policy start date | 2018-12-01 | Insurance policy end date | 2019-11-30 | Total amount of commissions paid to insurance broker | USD $107 | Total amount of fees paid to insurance company | USD $0 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $1,537 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $107 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | NONE | Insurance broker organization code? | 3 |
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DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
Policy contract number | F021882 |
Policy instance | 4 |
Insurance contract or identification number | F021882 | Number of Individuals Covered | 34 | Insurance policy start date | 2018-12-01 | Insurance policy end date | 2019-11-30 | Total amount of commissions paid to insurance broker | USD $1,244 | Total amount of fees paid to insurance company | USD $0 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $4,609 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,244 | Amount paid for insurance broker fees | 0 | Additional information about fees paid to insurance broker | NONE | Insurance broker organization code? | 3 |
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EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | PCI |
Policy instance | 1 |
Insurance contract or identification number | PCI | Number of Individuals Covered | 33 | Insurance policy start date | 2018-12-01 | Insurance policy end date | 2019-11-30 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $105,864 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) |
Policy contract number | PCI |
Policy instance | 1 |
Insurance contract or identification number | PCI | Number of Individuals Covered | 31 | Insurance policy start date | 2017-12-01 | Insurance policy end date | 2018-11-30 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $94,243 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62294 ) |
Policy contract number | 9809 |
Policy instance | 3 |
Insurance contract or identification number | 9809 | Number of Individuals Covered | 22 | Insurance policy start date | 2017-12-01 | Insurance policy end date | 2018-11-30 | Total amount of commissions paid to insurance broker | USD $845 | Total amount of fees paid to insurance company | USD $0 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $9,961 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
Policy contract number | F021882 |
Policy instance | 4 |
Insurance contract or identification number | F021882 | Number of Individuals Covered | 36 | Insurance policy start date | 2017-12-01 | Insurance policy end date | 2018-11-30 | Total amount of commissions paid to insurance broker | USD $522 | Total amount of fees paid to insurance company | USD $0 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | AD&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 Carrier | USD $1,933 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
Policy contract number | F021882 |
Policy instance | 5 |
Insurance contract or identification number | F021882 | Number of Individuals Covered | 0 | Insurance policy start date | 2017-12-01 | Insurance policy end date | 2018-11-30 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $0 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
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NVA VISION (National Association of Insurance Commissioners NAIC id number: 11686 ) |
Policy contract number | 8382086194 |
Policy instance | 2 |
Insurance contract or identification number | 8382086194 | Number of Individuals Covered | 42 | Insurance policy start date | 2017-12-01 | Insurance policy end date | 2018-11-30 | 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 plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $1,535 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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