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GLANTZ DENTAL AND LIFE INSURANCE BENEFITS PLAN 401k Plan overview

Plan NameGLANTZ DENTAL AND LIFE INSURANCE BENEFITS PLAN
Plan identification number 501

GLANTZ DENTAL AND LIFE INSURANCE BENEFITS PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Dental
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover

401k Sponsoring company profile

NGS HOLDINGS, INC. has sponsored the creation of one or more 401k plans.

Company Name:NGS HOLDINGS, INC.
Employer identification number (EIN):262322592
NAIC Classification:541600

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GLANTZ DENTAL AND LIFE INSURANCE BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012018-01-01GREG MAUDLIN
5012017-01-01GREG MAUDLIN
5012016-01-01GREG MAUDLIN
5012015-01-01GREG MAUDLIN
5012015-01-01GREG MAUDLIN
5012014-01-01GREG MAUDLIN
5012013-01-01GREG MAUDLIN
5012012-01-01MICHAEL KELLEY
5012011-01-01MICHAEL KELLEY
5012010-01-01MICHAEL KELLEY
5012009-03-01 MICHAEL KELLEY2010-09-01
5012009-03-01MICHAEL KELLEY

Plan Statistics for GLANTZ DENTAL AND LIFE INSURANCE BENEFITS PLAN

401k plan membership statisitcs for GLANTZ DENTAL AND LIFE INSURANCE BENEFITS PLAN

Measure Date Value
2018: GLANTZ DENTAL AND LIFE INSURANCE BENEFITS PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-010
Total number of active participants reported on line 7a of the Form 55002018-01-010
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 participants2018-01-010
2017: GLANTZ DENTAL AND LIFE INSURANCE BENEFITS PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01290
Total number of active participants reported on line 7a of the Form 55002017-01-01288
Number of retired or separated participants receiving benefits2017-01-012
Total of all active and inactive participants2017-01-01290
2016: GLANTZ DENTAL AND LIFE INSURANCE BENEFITS PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01284
Total number of active participants reported on line 7a of the Form 55002016-01-01282
Total of all active and inactive participants2016-01-01282
2015: GLANTZ DENTAL AND LIFE INSURANCE BENEFITS PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01278
Total number of active participants reported on line 7a of the Form 55002015-01-01280
Number of retired or separated participants receiving benefits2015-01-014
Total of all active and inactive participants2015-01-01284
2014: GLANTZ DENTAL AND LIFE INSURANCE BENEFITS PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01278
Total number of active participants reported on line 7a of the Form 55002014-01-01280
Number of retired or separated participants receiving benefits2014-01-014
Total of all active and inactive participants2014-01-01284
2013: GLANTZ DENTAL AND LIFE INSURANCE BENEFITS PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01261
Total number of active participants reported on line 7a of the Form 55002013-01-01282
Number of retired or separated participants receiving benefits2013-01-010
Total of all active and inactive participants2013-01-01282
2012: GLANTZ DENTAL AND LIFE INSURANCE BENEFITS PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01275
Total number of active participants reported on line 7a of the Form 55002012-01-01286
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 participants2012-01-01286
2011: GLANTZ DENTAL AND LIFE INSURANCE BENEFITS PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01192
Total number of active participants reported on line 7a of the Form 55002011-01-01213
Number of retired or separated participants receiving benefits2011-01-011
Number of other retired or separated participants entitled to future benefits2011-01-010
Total of all active and inactive participants2011-01-01214
2010: GLANTZ DENTAL AND LIFE INSURANCE BENEFITS PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-01187
Total number of active participants reported on line 7a of the Form 55002010-01-01189
Number of retired or separated participants receiving benefits2010-01-013
Number of other retired or separated participants entitled to future benefits2010-01-010
Total of all active and inactive participants2010-01-01192
2009: GLANTZ DENTAL AND LIFE INSURANCE BENEFITS PLAN 2009 401k membership
Total participants, beginning-of-year2009-03-01180
Total number of active participants reported on line 7a of the Form 55002009-03-01186
Number of retired or separated participants receiving benefits2009-03-012
Number of other retired or separated participants entitled to future benefits2009-03-010
Total of all active and inactive participants2009-03-01188
Total participants2009-03-010

Form 5500 Responses for GLANTZ DENTAL AND LIFE INSURANCE BENEFITS PLAN

2018: GLANTZ DENTAL AND LIFE INSURANCE BENEFITS PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingYes
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: GLANTZ DENTAL AND LIFE INSURANCE BENEFITS PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: GLANTZ DENTAL AND LIFE INSURANCE BENEFITS PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: GLANTZ DENTAL AND LIFE INSURANCE BENEFITS PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: GLANTZ DENTAL AND LIFE INSURANCE BENEFITS PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: GLANTZ DENTAL AND LIFE INSURANCE BENEFITS PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: GLANTZ DENTAL AND LIFE INSURANCE BENEFITS PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: GLANTZ DENTAL AND LIFE INSURANCE BENEFITS PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2010: GLANTZ DENTAL AND LIFE INSURANCE BENEFITS PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedYes
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – InsuranceYes
2009: GLANTZ DENTAL AND LIFE INSURANCE BENEFITS PLAN 2009 form 5500 responses
2009-03-01Type of plan entitySingle employer plan
2009-03-01Submission has been amendedNo
2009-03-01This submission is the final filingNo
2009-03-01This return/report is a short plan year return/report (less than 12 months)Yes
2009-03-01Plan is a collectively bargained planNo
2009-03-01Plan funding arrangement – InsuranceYes
2009-03-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number233440
Policy instance 3
Insurance contract or identification number233440
Number of Individuals Covered304
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $33,521
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D, CRITICAL ILLNESS, SPOUSE & DEPENDENT CRITICAL ILLNESS & LIFE
Welfare Benefit Premiums Paid to CarrierUSD $220,698
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $28,038
Insurance broker organization code?3
Insurance broker nameEPIC INSURANCE SOLUTIONS AGENCY LLC
ANTHEM HEALTH PLAN OF KENTUCKY D.B.A. ANTHEM BLUECROSS BLUESHIELD (National Association of Insurance Commissioners NAIC id number: 95120 )
Policy contract number797298
Policy instance 2
Insurance contract or identification number797298
Number of Individuals Covered238
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $13,460
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $134,597
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,146
Insurance broker organization code?3
Insurance broker nameEPIC INSURANCE SOLUTIONS AGENCY LLC
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract number823292
Policy instance 1
Insurance contract or identification number823292
Number of Individuals Covered10
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedDISABILITY BENEFITS LAW
Welfare Benefit Premiums Paid to CarrierUSD $405
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COMPBENEFITS (National Association of Insurance Commissioners NAIC id number: 54739 )
Policy contract number635463
Policy instance 3
Insurance contract or identification number635463
Number of Individuals Covered203
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $465
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $111,097
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number233440
Policy instance 2
Insurance contract or identification number233440
Number of Individuals Covered275
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $27,964
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $186,559
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract number823292
Policy instance 1
Insurance contract or identification number823292
Number of Individuals Covered10
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $38
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedDISABILITY BENEFITS LAW
Welfare Benefit Premiums Paid to CarrierUSD $392
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 number871973G
Policy instance 3
Insurance contract or identification number871973G
Number of Individuals Covered280
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $-5
Total amount of fees paid to insurance companyUSD $1,877
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $-91
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees1877
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
Commission paid to Insurance BrokerUSD $-1
Insurance broker nameEPIC INSURANCE SOLUTIONS LLC
COMPBENEFITS (National Association of Insurance Commissioners NAIC id number: 54739 )
Policy contract number635463
Policy instance 4
Insurance contract or identification number635463
Number of Individuals Covered203
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $465
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $111,097
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $465
Insurance broker organization code?3
Insurance broker nameEPIC INSURANCE SOLUTIONS LLC
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number233440
Policy instance 2
Insurance contract or identification number233440
Number of Individuals Covered275
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $27,964
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $186,559
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $27,964
Insurance broker organization code?3
Insurance broker nameEPIC INSURANCE SOLUTIONS LLC
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract number823292
Policy instance 1
Insurance contract or identification number823292
Number of Individuals Covered10
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $38
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedDISABILITY BENEFITS LAW
Welfare Benefit Premiums Paid to CarrierUSD $392
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $38
Insurance broker organization code?3
Insurance broker nameSUNLIFE AGENT
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number871973G
Policy instance 2
Insurance contract or identification number871973G
Number of Individuals Covered282
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $15,676
Total amount of fees paid to insurance companyUSD $1,135
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $148,962
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees1135
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
Commission paid to Insurance BrokerUSD $10,411
Insurance broker nameEPIC INSURANCE SOLUTIONS LLC
COMPBENEFITS (National Association of Insurance Commissioners NAIC id number: 54739 )
Policy contract number635463
Policy instance 1
Insurance contract or identification number635463
Number of Individuals Covered210
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $5,999
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $114,532
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,267
Insurance broker organization code?3
Insurance broker nameEPIC INSURANCE SOLUTIONS
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number871973G
Policy instance 2
Insurance contract or identification number871973G
Number of Individuals Covered284
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $17,785
Total amount of fees paid to insurance companyUSD $3,150
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $142,821
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees3150
Additional information about fees paid to insurance brokerBONUS PAID BY THE HARTFORD
Insurance broker organization code?3
Insurance broker nameNATIONAL CITY INS GRP INC
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00435572
Policy instance 1
Insurance contract or identification number00435572
Number of Individuals Covered198
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $4,053
Total amount of fees paid to insurance companyUSD $7,000
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $118,476
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,053
Amount paid for insurance broker fees7000
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
Insurance broker nameUSI MIDWEST INC.
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00435572
Policy instance 1
Insurance contract or identification number00435572
Number of Individuals Covered207
Insurance policy start date2010-09-01
Insurance policy end date2011-08-31
Total amount of commissions paid to insurance brokerUSD $7,452
Total amount of fees paid to insurance companyUSD $6,351
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $138,335
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00435572
Policy instance 2
Insurance contract or identification number00435572
Number of Individuals Covered206
Insurance policy start date2011-09-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $1,393
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $33,387
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 numberF017338
Policy instance 3
Insurance contract or identification numberF017338
Number of Individuals Covered265
Insurance policy start date2010-09-01
Insurance policy end date2011-08-31
Total amount of commissions paid to insurance brokerUSD $12,561
Total amount of fees paid to insurance companyUSD $192
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD & D
Welfare Benefit Premiums Paid to CarrierUSD $100,974
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 numberF017338
Policy instance 1
Insurance contract or identification numberF017338
Number of Individuals Covered258
Insurance policy start date2009-09-01
Insurance policy end date2010-08-31
Total amount of commissions paid to insurance brokerUSD $11,610
Total amount of fees paid to insurance companyUSD $5,202
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD & D
Welfare Benefit Premiums Paid to CarrierUSD $97,510
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00435572
Policy instance 2
Insurance contract or identification number00435572
Number of Individuals Covered215
Insurance policy start date2009-09-01
Insurance policy end date2010-08-31
Total amount of commissions paid to insurance brokerUSD $7,311
Total amount of fees paid to insurance companyUSD $6,206
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $137,148
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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