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SECO WARWICK LIFE ADD AND WEEKLY INDEMITY INSURANCE PLAN 401k Plan overview

Plan NameSECO WARWICK LIFE ADD AND WEEKLY INDEMITY INSURANCE PLAN
Plan identification number 502

SECO WARWICK LIFE ADD AND WEEKLY INDEMITY INSURANCE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Temporary disability (accident and sickness)
  • Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

SECO/WARWICK CORPORATION has sponsored the creation of one or more 401k plans.

Company Name:SECO/WARWICK CORPORATION
Employer identification number (EIN):251476191
NAIC Classification:333200

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SECO WARWICK LIFE ADD AND WEEKLY INDEMITY INSURANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022017-05-01
5022016-05-01 JOHN ANTHONY2019-06-21
5022015-05-01JASON ACKERMAN
5022014-05-01SHARON DUNN SHARON DUNN2015-11-24
5022013-05-01SHARON DUNN SHARON DUNN2014-11-14
5022012-05-01SHARON DUNN SHARON DUNN2013-07-31
5022011-05-01ARTHUR RUSSO
5022010-05-01ARTHUR RUSSO
5022009-05-01ARTHUR RUSSO

Plan Statistics for SECO WARWICK LIFE ADD AND WEEKLY INDEMITY INSURANCE PLAN

401k plan membership statisitcs for SECO WARWICK LIFE ADD AND WEEKLY INDEMITY INSURANCE PLAN

Measure Date Value
2017: SECO WARWICK LIFE ADD AND WEEKLY INDEMITY INSURANCE PLAN 2017 401k membership
Total participants, beginning-of-year2017-05-01138
Total number of active participants reported on line 7a of the Form 55002017-05-0168
Number of retired or separated participants receiving benefits2017-05-0166
Total of all active and inactive participants2017-05-01134
Total participants2017-05-01134
2016: SECO WARWICK LIFE ADD AND WEEKLY INDEMITY INSURANCE PLAN 2016 401k membership
Total participants, beginning-of-year2016-05-01144
Total number of active participants reported on line 7a of the Form 55002016-05-0174
Number of retired or separated participants receiving benefits2016-05-0164
Total of all active and inactive participants2016-05-01138
Total participants2016-05-01138
2015: SECO WARWICK LIFE ADD AND WEEKLY INDEMITY INSURANCE PLAN 2015 401k membership
Total participants, beginning-of-year2015-05-01157
Total number of active participants reported on line 7a of the Form 55002015-05-0186
Number of retired or separated participants receiving benefits2015-05-0158
Total of all active and inactive participants2015-05-01144
Total participants2015-05-01144
2014: SECO WARWICK LIFE ADD AND WEEKLY INDEMITY INSURANCE PLAN 2014 401k membership
Total participants, beginning-of-year2014-05-01158
Total number of active participants reported on line 7a of the Form 55002014-05-0197
Number of retired or separated participants receiving benefits2014-05-0160
Total of all active and inactive participants2014-05-01157
Total participants2014-05-01157
2013: SECO WARWICK LIFE ADD AND WEEKLY INDEMITY INSURANCE PLAN 2013 401k membership
Total participants, beginning-of-year2013-05-01153
Total number of active participants reported on line 7a of the Form 55002013-05-01102
Number of retired or separated participants receiving benefits2013-05-0156
Total of all active and inactive participants2013-05-01158
Total participants2013-05-01158
2012: SECO WARWICK LIFE ADD AND WEEKLY INDEMITY INSURANCE PLAN 2012 401k membership
Total participants, beginning-of-year2012-05-01142
Total number of active participants reported on line 7a of the Form 55002012-05-0194
Number of retired or separated participants receiving benefits2012-05-0156
Total of all active and inactive participants2012-05-01150
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-05-013
Total participants2012-05-01153
2011: SECO WARWICK LIFE ADD AND WEEKLY INDEMITY INSURANCE PLAN 2011 401k membership
Total participants, beginning-of-year2011-05-01130
Total number of active participants reported on line 7a of the Form 55002011-05-0184
Number of retired or separated participants receiving benefits2011-05-0157
Total of all active and inactive participants2011-05-01141
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-05-011
Total participants2011-05-01142
2010: SECO WARWICK LIFE ADD AND WEEKLY INDEMITY INSURANCE PLAN 2010 401k membership
Total participants, beginning-of-year2010-05-01122
Total number of active participants reported on line 7a of the Form 55002010-05-0172
Number of retired or separated participants receiving benefits2010-05-0158
Number of other retired or separated participants entitled to future benefits2010-05-010
Total of all active and inactive participants2010-05-01130
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-05-010
Total participants2010-05-01130
Number of participants with account balances2010-05-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-05-010
Number of employers contributing to the scheme2010-05-010
2009: SECO WARWICK LIFE ADD AND WEEKLY INDEMITY INSURANCE PLAN 2009 401k membership
Total participants, beginning-of-year2009-05-01121
Total number of active participants reported on line 7a of the Form 55002009-05-0164
Number of retired or separated participants receiving benefits2009-05-0158
Number of other retired or separated participants entitled to future benefits2009-05-010
Total of all active and inactive participants2009-05-01122
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-05-010
Total participants2009-05-01122
Number of participants with account balances2009-05-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-05-010

Form 5500 Responses for SECO WARWICK LIFE ADD AND WEEKLY INDEMITY INSURANCE PLAN

2017: SECO WARWICK LIFE ADD AND WEEKLY INDEMITY INSURANCE PLAN 2017 form 5500 responses
2017-05-01Type of plan entitySingle employer plan
2017-05-01Submission has been amendedNo
2017-05-01This submission is the final filingNo
2017-05-01This return/report is a short plan year return/report (less than 12 months)No
2017-05-01Plan is a collectively bargained planNo
2017-05-01Plan funding arrangement – InsuranceYes
2017-05-01Plan benefit arrangement – InsuranceYes
2016: SECO WARWICK LIFE ADD AND WEEKLY INDEMITY INSURANCE PLAN 2016 form 5500 responses
2016-05-01Type of plan entitySingle employer plan
2016-05-01Submission has been amendedNo
2016-05-01This submission is the final filingNo
2016-05-01This return/report is a short plan year return/report (less than 12 months)No
2016-05-01Plan is a collectively bargained planNo
2016-05-01Plan funding arrangement – InsuranceYes
2016-05-01Plan benefit arrangement – InsuranceYes
2015: SECO WARWICK LIFE ADD AND WEEKLY INDEMITY INSURANCE PLAN 2015 form 5500 responses
2015-05-01Type of plan entitySingle employer plan
2015-05-01Submission has been amendedNo
2015-05-01This submission is the final filingNo
2015-05-01This return/report is a short plan year return/report (less than 12 months)No
2015-05-01Plan is a collectively bargained planNo
2015-05-01Plan funding arrangement – InsuranceYes
2015-05-01Plan benefit arrangement – InsuranceYes
2014: SECO WARWICK LIFE ADD AND WEEKLY INDEMITY INSURANCE PLAN 2014 form 5500 responses
2014-05-01Type of plan entitySingle employer plan
2014-05-01Submission has been amendedNo
2014-05-01This submission is the final filingNo
2014-05-01This return/report is a short plan year return/report (less than 12 months)No
2014-05-01Plan is a collectively bargained planNo
2014-05-01Plan funding arrangement – InsuranceYes
2014-05-01Plan benefit arrangement – InsuranceYes
2013: SECO WARWICK LIFE ADD AND WEEKLY INDEMITY INSURANCE PLAN 2013 form 5500 responses
2013-05-01Type of plan entitySingle employer plan
2013-05-01Submission has been amendedNo
2013-05-01This submission is the final filingNo
2013-05-01This return/report is a short plan year return/report (less than 12 months)No
2013-05-01Plan is a collectively bargained planNo
2013-05-01Plan funding arrangement – InsuranceYes
2013-05-01Plan benefit arrangement – InsuranceYes
2012: SECO WARWICK LIFE ADD AND WEEKLY INDEMITY INSURANCE PLAN 2012 form 5500 responses
2012-05-01Type of plan entitySingle employer plan
2012-05-01Submission has been amendedNo
2012-05-01This submission is the final filingNo
2012-05-01This return/report is a short plan year return/report (less than 12 months)No
2012-05-01Plan is a collectively bargained planNo
2012-05-01Plan funding arrangement – InsuranceYes
2012-05-01Plan benefit arrangement – InsuranceYes
2011: SECO WARWICK LIFE ADD AND WEEKLY INDEMITY INSURANCE PLAN 2011 form 5500 responses
2011-05-01Type of plan entitySingle employer plan
2011-05-01Submission has been amendedNo
2011-05-01This submission is the final filingNo
2011-05-01This return/report is a short plan year return/report (less than 12 months)No
2011-05-01Plan is a collectively bargained planNo
2011-05-01Plan funding arrangement – InsuranceYes
2011-05-01Plan benefit arrangement – InsuranceYes
2010: SECO WARWICK LIFE ADD AND WEEKLY INDEMITY INSURANCE PLAN 2010 form 5500 responses
2010-05-01Type of plan entitySingle employer plan
2010-05-01Submission has been amendedNo
2010-05-01This submission is the final filingNo
2010-05-01This return/report is a short plan year return/report (less than 12 months)No
2010-05-01Plan is a collectively bargained planNo
2010-05-01Plan funding arrangement – InsuranceYes
2010-05-01Plan benefit arrangement – InsuranceYes
2009: SECO WARWICK LIFE ADD AND WEEKLY INDEMITY INSURANCE PLAN 2009 form 5500 responses
2009-05-01Type of plan entitySingle employer plan
2009-05-01Submission has been amendedNo
2009-05-01This submission is the final filingNo
2009-05-01This return/report is a short plan year return/report (less than 12 months)No
2009-05-01Plan is a collectively bargained planNo
2009-05-01Plan funding arrangement – InsuranceYes
2009-05-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010200683
Policy instance 2
Insurance contract or identification number000010200683
Number of Individuals Covered42
Insurance policy start date2017-05-01
Insurance policy end date2018-04-30
Total amount of commissions paid to insurance brokerUSD $1,288
Total amount of fees paid to insurance companyUSD $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 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 BenefitNo
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 $11,016
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010200681
Policy instance 1
Insurance contract or identification number000010200681
Number of Individuals Covered134
Insurance policy start date2017-05-01
Insurance policy end date2018-04-30
Total amount of commissions paid to insurance brokerUSD $3,052
Total amount of fees paid to insurance companyUSD $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 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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 $41,288
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010200683
Policy instance 2
Insurance contract or identification number000010200683
Number of Individuals Covered56
Insurance policy start date2015-05-01
Insurance policy end date2016-04-30
Total amount of commissions paid to insurance brokerUSD $1,617
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 BenefitNo
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 $15,287
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,617
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameLOESEL SCHAAF INSURANCE AGENCY INC
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010200681
Policy instance 1
Insurance contract or identification number000010200681
Number of Individuals Covered144
Insurance policy start date2015-05-01
Insurance policy end date2016-04-30
Total amount of commissions paid to insurance brokerUSD $2,675
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 $41,091
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,675
Insurance broker organization code?3
Insurance broker nameLOESEL-SCHAAF INSURANCE AGENCY INC
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010200683
Policy instance 3
Insurance contract or identification number000010200683
Number of Individuals Covered63
Insurance policy start date2015-01-01
Insurance policy end date2015-04-30
Total amount of commissions paid to insurance brokerUSD $673
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 BenefitNo
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 $5,116
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $673
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameLOESEL SCHAAF INSURANCE AGENCY INC
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010200681
Policy instance 2
Insurance contract or identification number000010200681
Number of Individuals Covered157
Insurance policy start date2015-01-01
Insurance policy end date2015-04-30
Total amount of commissions paid to insurance brokerUSD $1,524
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 $13,927
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,524
Insurance broker organization code?3
Insurance broker nameLOESEL SCHAFF INSURANCE AGENCY INC
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberFHM3903PA
Policy instance 1
Insurance contract or identification numberFHM3903PA
Number of Individuals Covered157
Insurance policy start date2014-05-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $1,311
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 $43,687
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,311
Insurance broker organization code?3
Insurance broker nameLOESEL SCHAAF INSURANCE AGENCY INC
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberFHM3903PA
Policy instance 1
Insurance contract or identification numberFHM3903PA
Number of Individuals Covered158
Insurance policy start date2013-05-01
Insurance policy end date2014-04-30
Total amount of commissions paid to insurance brokerUSD $2,863
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,863
Insurance broker organization code?3
Insurance broker nameLOESEL SCHAAF INSURANCE AGENCY INC
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberFHM3903PA
Policy instance 1
Insurance contract or identification numberFHM3903PA
Number of Individuals Covered153
Insurance policy start date2012-05-01
Insurance policy end date2013-04-30
Total amount of commissions paid to insurance brokerUSD $2,715
Health Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Amount paid for insurance broker fees2715
Insurance broker organization code?3
Insurance broker nameLOESEL-SCHAAF INSURANCE AGENY INC
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberFHM3903PA
Policy instance 1
Insurance contract or identification numberFHM3903PA
Number of Individuals Covered142
Insurance policy start date2011-05-01
Insurance policy end date2012-04-30
Total amount of commissions paid to insurance brokerUSD $2,558
Health Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitNo
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberFHM3903PA
Policy instance 1
Insurance contract or identification numberFHM3903PA
Number of Individuals Covered130
Insurance policy start date2010-05-01
Insurance policy end date2011-04-30
Total amount of commissions paid to insurance brokerUSD $2,430
Health Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,430
Insurance broker organization code?3
Insurance broker nameLOESEL SCHAAF INSURANCE AGENCY INC

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