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ROTARY FORMS PRESS INC VOLUNTARY EMPLOYEE BENEFIT PLAN 401k Plan overview

Plan NameROTARY FORMS PRESS INC VOLUNTARY EMPLOYEE BENEFIT PLAN
Plan identification number 501

ROTARY FORMS PRESS INC VOLUNTARY EMPLOYEE BENEFIT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Long-term disability cover

401k Sponsoring company profile

ROTARY FORMS PRESS, INC. has sponsored the creation of one or more 401k plans.

Company Name:ROTARY FORMS PRESS, INC.
Employer identification number (EIN):310600973
NAIC Classification:323100

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ROTARY FORMS PRESS INC VOLUNTARY EMPLOYEE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012020-04-01
5012019-04-01
5012018-04-01
5012017-04-01BRIAN CASSNER
5012016-04-01BRIAN CASSNER
5012015-04-01BRIAN CASSNER
5012014-04-01BRIAN CASSNER
5012013-04-01BRIAN CASSNER
5012012-04-01BRIAN CASSNER
5012010-04-01BRIAN CASSNER
5012009-04-01BRIAN CASSNER

Plan Statistics for ROTARY FORMS PRESS INC VOLUNTARY EMPLOYEE BENEFIT PLAN

401k plan membership statisitcs for ROTARY FORMS PRESS INC VOLUNTARY EMPLOYEE BENEFIT PLAN

Measure Date Value
2020: ROTARY FORMS PRESS INC VOLUNTARY EMPLOYEE BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year2020-04-0125
Total number of active participants reported on line 7a of the Form 55002020-04-0125
Total of all active and inactive participants2020-04-0125
Total participants2020-04-0125
2019: ROTARY FORMS PRESS INC VOLUNTARY EMPLOYEE BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year2019-04-0126
Total number of active participants reported on line 7a of the Form 55002019-04-0125
Total of all active and inactive participants2019-04-0125
Total participants2019-04-0125
2018: ROTARY FORMS PRESS INC VOLUNTARY EMPLOYEE BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year2018-04-0130
Total number of active participants reported on line 7a of the Form 55002018-04-0126
Total of all active and inactive participants2018-04-0126
Total participants2018-04-0126
2017: ROTARY FORMS PRESS INC VOLUNTARY EMPLOYEE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year2017-04-0131
Total number of active participants reported on line 7a of the Form 55002017-04-0130
Total of all active and inactive participants2017-04-0130
Total participants2017-04-0130
2016: ROTARY FORMS PRESS INC VOLUNTARY EMPLOYEE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year2016-04-0133
Total number of active participants reported on line 7a of the Form 55002016-04-0131
Total of all active and inactive participants2016-04-0131
Total participants2016-04-0131
2015: ROTARY FORMS PRESS INC VOLUNTARY EMPLOYEE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year2015-04-0134
Total number of active participants reported on line 7a of the Form 55002015-04-0133
Total of all active and inactive participants2015-04-0133
Total participants2015-04-010
2014: ROTARY FORMS PRESS INC VOLUNTARY EMPLOYEE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year2014-04-0138
Total number of active participants reported on line 7a of the Form 55002014-04-0134
Total of all active and inactive participants2014-04-0134
Total participants2014-04-010
2013: ROTARY FORMS PRESS INC VOLUNTARY EMPLOYEE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year2013-04-0138
Total number of active participants reported on line 7a of the Form 55002013-04-0138
Total of all active and inactive participants2013-04-0138
Total participants2013-04-010
2012: ROTARY FORMS PRESS INC VOLUNTARY EMPLOYEE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year2012-04-0148
Total number of active participants reported on line 7a of the Form 55002012-04-0138
Total of all active and inactive participants2012-04-0138
Total participants2012-04-010
2010: ROTARY FORMS PRESS INC VOLUNTARY EMPLOYEE BENEFIT PLAN 2010 401k membership
Total participants, beginning-of-year2010-04-0152
Total number of active participants reported on line 7a of the Form 55002010-04-0149
Total of all active and inactive participants2010-04-0149
Total participants2010-04-0149
2009: ROTARY FORMS PRESS INC VOLUNTARY EMPLOYEE BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year2009-04-0161
Total number of active participants reported on line 7a of the Form 55002009-04-0152
Total of all active and inactive participants2009-04-0152
Total participants2009-04-0152

Financial Data on ROTARY FORMS PRESS INC VOLUNTARY EMPLOYEE BENEFIT PLAN

Measure Date Value
2021 : ROTARY FORMS PRESS INC VOLUNTARY EMPLOYEE BENEFIT PLAN 2021 401k financial data
Total plan liabilities at end of year2021-03-31$8,896
Total plan liabilities at beginning of year2021-03-31$5,148
Total income from all sources2021-03-31$223,274
Expenses. Total of all expenses incurred2021-03-31$227,022
Benefits paid (including direct rollovers)2021-03-31$201,557
Total contributions received or receivable from participants2021-03-31$41,616
Net income (gross income less expenses)2021-03-31$-3,748
Net plan assets at end of year (total assets less liabilities)2021-03-31$-8,896
Net plan assets at beginning of year (total assets less liabilities)2021-03-31$-5,148
Total contributions received or receivable from employer(s)2021-03-31$181,658
Expenses. Administrative service providers (salaries,fees and commissions)2021-03-31$25,465
2020 : ROTARY FORMS PRESS INC VOLUNTARY EMPLOYEE BENEFIT PLAN 2020 401k financial data
Total plan liabilities at end of year2020-03-31$5,148
Total plan liabilities at beginning of year2020-03-31$16,478
Total income from all sources2020-03-31$163,990
Expenses. Total of all expenses incurred2020-03-31$152,660
Benefits paid (including direct rollovers)2020-03-31$135,307
Total contributions received or receivable from participants2020-03-31$43,442
Net income (gross income less expenses)2020-03-31$11,330
Net plan assets at end of year (total assets less liabilities)2020-03-31$-5,148
Net plan assets at beginning of year (total assets less liabilities)2020-03-31$-16,478
Total contributions received or receivable from employer(s)2020-03-31$120,548
Expenses. Administrative service providers (salaries,fees and commissions)2020-03-31$17,353
2018 : ROTARY FORMS PRESS INC VOLUNTARY EMPLOYEE BENEFIT PLAN 2018 401k financial data
Total plan liabilities at end of year2018-03-31$17,529
Total plan liabilities at beginning of year2018-03-31$25,281
Total income from all sources2018-03-31$320,094
Expenses. Total of all expenses incurred2018-03-31$312,342
Benefits paid (including direct rollovers)2018-03-31$295,409
Total contributions received or receivable from participants2018-03-31$93,069
Expenses. Other expenses not covered elsewhere2018-03-31$16,933
Net income (gross income less expenses)2018-03-31$7,752
Net plan assets at end of year (total assets less liabilities)2018-03-31$-17,529
Net plan assets at beginning of year (total assets less liabilities)2018-03-31$-25,281
Total contributions received or receivable from employer(s)2018-03-31$227,025
2017 : ROTARY FORMS PRESS INC VOLUNTARY EMPLOYEE BENEFIT PLAN 2017 401k financial data
Total plan liabilities at end of year2017-03-31$25,281
Total plan liabilities at beginning of year2017-03-31$23,185
Total income from all sources2017-03-31$373,373
Expenses. Total of all expenses incurred2017-03-31$375,469
Benefits paid (including direct rollovers)2017-03-31$358,600
Total contributions received or receivable from participants2017-03-31$84,466
Expenses. Other expenses not covered elsewhere2017-03-31$16,869
Net income (gross income less expenses)2017-03-31$-2,096
Net plan assets at end of year (total assets less liabilities)2017-03-31$-25,281
Net plan assets at beginning of year (total assets less liabilities)2017-03-31$-23,185
Total contributions received or receivable from employer(s)2017-03-31$288,907
2016 : ROTARY FORMS PRESS INC VOLUNTARY EMPLOYEE BENEFIT PLAN 2016 401k financial data
Total plan liabilities at end of year2016-03-31$23,185
Total plan liabilities at beginning of year2016-03-31$38,619
Total income from all sources2016-03-31$385,724
Expenses. Total of all expenses incurred2016-03-31$370,290
Benefits paid (including direct rollovers)2016-03-31$354,590
Total contributions received or receivable from participants2016-03-31$67,874
Expenses. Other expenses not covered elsewhere2016-03-31$15,700
Net income (gross income less expenses)2016-03-31$15,434
Net plan assets at end of year (total assets less liabilities)2016-03-31$-23,185
Net plan assets at beginning of year (total assets less liabilities)2016-03-31$-38,619
Total contributions received or receivable from employer(s)2016-03-31$317,850
2015 : ROTARY FORMS PRESS INC VOLUNTARY EMPLOYEE BENEFIT PLAN 2015 401k financial data
Total plan liabilities at end of year2015-03-31$38,619
Total plan liabilities at beginning of year2015-03-31$15,408
Total income from all sources2015-03-31$388,750
Expenses. Total of all expenses incurred2015-03-31$411,961
Benefits paid (including direct rollovers)2015-03-31$395,738
Total contributions received or receivable from participants2015-03-31$71,781
Expenses. Other expenses not covered elsewhere2015-03-31$16,223
Net income (gross income less expenses)2015-03-31$-23,211
Net plan assets at end of year (total assets less liabilities)2015-03-31$-38,619
Net plan assets at beginning of year (total assets less liabilities)2015-03-31$-15,408
Total contributions received or receivable from employer(s)2015-03-31$316,969
2014 : ROTARY FORMS PRESS INC VOLUNTARY EMPLOYEE BENEFIT PLAN 2014 401k financial data
Total plan liabilities at end of year2014-03-31$15,408
Total plan liabilities at beginning of year2014-03-31$19,318
Total income from all sources2014-03-31$295,664
Expenses. Total of all expenses incurred2014-03-31$295,718
Benefits paid (including direct rollovers)2014-03-31$279,611
Total plan assets at end of year2014-03-31$0
Total plan assets at beginning of year2014-03-31$3,964
Total contributions received or receivable from participants2014-03-31$79,650
Expenses. Other expenses not covered elsewhere2014-03-31$16,107
Net income (gross income less expenses)2014-03-31$-54
Net plan assets at end of year (total assets less liabilities)2014-03-31$-15,408
Net plan assets at beginning of year (total assets less liabilities)2014-03-31$-15,354
Total contributions received or receivable from employer(s)2014-03-31$216,014
2013 : ROTARY FORMS PRESS INC VOLUNTARY EMPLOYEE BENEFIT PLAN 2013 401k financial data
Total plan liabilities at end of year2013-03-31$19,318
Total plan liabilities at beginning of year2013-03-31$20,421
Total income from all sources2013-03-31$287,337
Expenses. Total of all expenses incurred2013-03-31$286,078
Benefits paid (including direct rollovers)2013-03-31$268,765
Total plan assets at end of year2013-03-31$3,964
Total plan assets at beginning of year2013-03-31$3,808
Total contributions received or receivable from participants2013-03-31$89,969
Expenses. Other expenses not covered elsewhere2013-03-31$17,313
Net income (gross income less expenses)2013-03-31$1,259
Net plan assets at end of year (total assets less liabilities)2013-03-31$-15,354
Net plan assets at beginning of year (total assets less liabilities)2013-03-31$-16,613
Total contributions received or receivable from employer(s)2013-03-31$197,368
2011 : ROTARY FORMS PRESS INC VOLUNTARY EMPLOYEE BENEFIT PLAN 2011 401k financial data
Total plan liabilities at end of year2011-03-31$34,525
Total plan liabilities at beginning of year2011-03-31$63,137
Total income from all sources2011-03-31$323,888
Expenses. Total of all expenses incurred2011-03-31$361,947
Benefits paid (including direct rollovers)2011-03-31$343,548
Total plan assets at end of year2011-03-31$88,603
Total plan assets at beginning of year2011-03-31$155,274
Total contributions received or receivable from participants2011-03-31$11,220
Expenses. Other expenses not covered elsewhere2011-03-31$18,399
Net income (gross income less expenses)2011-03-31$-38,059
Net plan assets at end of year (total assets less liabilities)2011-03-31$54,078
Net plan assets at beginning of year (total assets less liabilities)2011-03-31$92,137
Total contributions received or receivable from employer(s)2011-03-31$312,668

Form 5500 Responses for ROTARY FORMS PRESS INC VOLUNTARY EMPLOYEE BENEFIT PLAN

2020: ROTARY FORMS PRESS INC VOLUNTARY EMPLOYEE BENEFIT PLAN 2020 form 5500 responses
2020-04-01Type of plan entitySingle employer plan
2020-04-01Plan funding arrangement – InsuranceYes
2020-04-01Plan funding arrangement – TrustYes
2020-04-01Plan funding arrangement – General assets of the sponsorYes
2020-04-01Plan benefit arrangement – InsuranceYes
2020-04-01Plan benefit arrangement - TrustYes
2019: ROTARY FORMS PRESS INC VOLUNTARY EMPLOYEE BENEFIT PLAN 2019 form 5500 responses
2019-04-01Type of plan entitySingle employer plan
2019-04-01Plan funding arrangement – InsuranceYes
2019-04-01Plan funding arrangement – TrustYes
2019-04-01Plan funding arrangement – General assets of the sponsorYes
2019-04-01Plan benefit arrangement – InsuranceYes
2019-04-01Plan benefit arrangement - TrustYes
2018: ROTARY FORMS PRESS INC VOLUNTARY EMPLOYEE BENEFIT PLAN 2018 form 5500 responses
2018-04-01Type of plan entitySingle employer plan
2018-04-01Plan funding arrangement – InsuranceYes
2018-04-01Plan funding arrangement – TrustYes
2018-04-01Plan funding arrangement – General assets of the sponsorYes
2018-04-01Plan benefit arrangement – InsuranceYes
2018-04-01Plan benefit arrangement - TrustYes
2017: ROTARY FORMS PRESS INC VOLUNTARY EMPLOYEE BENEFIT PLAN 2017 form 5500 responses
2017-04-01Type of plan entitySingle employer plan
2017-04-01Plan funding arrangement – InsuranceYes
2017-04-01Plan funding arrangement – TrustYes
2017-04-01Plan funding arrangement – General assets of the sponsorYes
2017-04-01Plan benefit arrangement – InsuranceYes
2017-04-01Plan benefit arrangement - TrustYes
2016: ROTARY FORMS PRESS INC VOLUNTARY EMPLOYEE BENEFIT PLAN 2016 form 5500 responses
2016-04-01Type of plan entitySingle employer plan
2016-04-01Plan funding arrangement – InsuranceYes
2016-04-01Plan funding arrangement – TrustYes
2016-04-01Plan funding arrangement – General assets of the sponsorYes
2016-04-01Plan benefit arrangement – InsuranceYes
2016-04-01Plan benefit arrangement - TrustYes
2015: ROTARY FORMS PRESS INC VOLUNTARY EMPLOYEE BENEFIT PLAN 2015 form 5500 responses
2015-04-01Type of plan entitySingle employer plan
2015-04-01Plan funding arrangement – InsuranceYes
2015-04-01Plan funding arrangement – TrustYes
2015-04-01Plan funding arrangement – General assets of the sponsorYes
2015-04-01Plan benefit arrangement – InsuranceYes
2015-04-01Plan benefit arrangement - TrustYes
2014: ROTARY FORMS PRESS INC VOLUNTARY EMPLOYEE BENEFIT PLAN 2014 form 5500 responses
2014-04-01Type of plan entitySingle employer plan
2014-04-01Plan funding arrangement – InsuranceYes
2014-04-01Plan funding arrangement – TrustYes
2014-04-01Plan funding arrangement – General assets of the sponsorYes
2014-04-01Plan benefit arrangement – InsuranceYes
2014-04-01Plan benefit arrangement - TrustYes
2013: ROTARY FORMS PRESS INC VOLUNTARY EMPLOYEE BENEFIT PLAN 2013 form 5500 responses
2013-04-01Type of plan entitySingle employer plan
2013-04-01Plan funding arrangement – InsuranceYes
2013-04-01Plan funding arrangement – TrustYes
2013-04-01Plan funding arrangement – General assets of the sponsorYes
2013-04-01Plan benefit arrangement – InsuranceYes
2013-04-01Plan benefit arrangement - TrustYes
2012: ROTARY FORMS PRESS INC VOLUNTARY EMPLOYEE BENEFIT PLAN 2012 form 5500 responses
2012-04-01Type of plan entitySingle employer plan
2012-04-01Plan funding arrangement – InsuranceYes
2012-04-01Plan funding arrangement – TrustYes
2012-04-01Plan funding arrangement – General assets of the sponsorYes
2012-04-01Plan benefit arrangement – InsuranceYes
2012-04-01Plan benefit arrangement - TrustYes
2010: ROTARY FORMS PRESS INC VOLUNTARY EMPLOYEE BENEFIT PLAN 2010 form 5500 responses
2010-04-01Type of plan entitySingle employer plan
2010-04-01Plan funding arrangement – InsuranceYes
2010-04-01Plan funding arrangement – TrustYes
2010-04-01Plan funding arrangement – General assets of the sponsorYes
2010-04-01Plan benefit arrangement – InsuranceYes
2010-04-01Plan benefit arrangement - TrustYes
2009: ROTARY FORMS PRESS INC VOLUNTARY EMPLOYEE BENEFIT PLAN 2009 form 5500 responses
2009-04-01Type of plan entitySingle employer plan
2009-04-01Plan funding arrangement – InsuranceYes
2009-04-01Plan funding arrangement – TrustYes
2009-04-01Plan funding arrangement – General assets of the sponsorYes
2009-04-01Plan benefit arrangement – InsuranceYes
2009-04-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 )
Policy contract number98-47-962
Policy instance 2
Insurance contract or identification number98-47-962
Number of Individuals Covered25
Insurance policy start date2020-04-01
Insurance policy end date2021-03-31
Total amount of fees paid to insurance companyUSD $84,674
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees84674
Additional information about fees paid to insurance brokerMEDICAL PREMIUMS
Insurance broker organization code?3
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract numberHCL12727
Policy instance 1
Insurance contract or identification numberHCL12727
Number of Individuals Covered25
Insurance policy start date2020-04-01
Insurance policy end date2021-03-31
Total amount of commissions paid to insurance brokerUSD $9,758
Total amount of fees paid to insurance companyUSD $9,758
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,758
Amount paid for insurance broker fees9758
Additional information about fees paid to insurance brokerMEDICAL PREMIUMS
Insurance broker organization code?3
ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 )
Policy contract number98-47-962
Policy instance 2
Insurance contract or identification number98-47-962
Number of Individuals Covered25
Insurance policy start date2019-04-01
Insurance policy end date2020-03-31
Total amount of fees paid to insurance companyUSD $82,766
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees82766
Additional information about fees paid to insurance brokerMEDICAL PREMIUMS
Insurance broker organization code?3
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract numberHCL12727
Policy instance 1
Insurance contract or identification numberHCL12727
Number of Individuals Covered25
Insurance policy start date2019-04-01
Insurance policy end date2020-03-30
Total amount of commissions paid to insurance brokerUSD $6,670
Total amount of fees paid to insurance companyUSD $6,670
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,670
Amount paid for insurance broker fees6670
Additional information about fees paid to insurance brokerMEDICAL PREMIUMS
Insurance broker organization code?3
ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 )
Policy contract number98-47-962
Policy instance 2
Insurance contract or identification number98-47-962
Number of Individuals Covered26
Insurance policy start date2018-04-01
Insurance policy end date2019-03-31
Total amount of fees paid to insurance companyUSD $78,041
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees78041
Additional information about fees paid to insurance brokerMEDICAL PREMIUMS
Insurance broker organization code?3
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract numberHCL12727
Policy instance 1
Insurance contract or identification numberHCL12727
Number of Individuals Covered26
Insurance policy start date2018-04-01
Insurance policy end date2019-03-31
Total amount of commissions paid to insurance brokerUSD $8,206
Total amount of fees paid to insurance companyUSD $8,206
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,206
Amount paid for insurance broker fees8206
Additional information about fees paid to insurance brokerMEDICAL PREMIUMS
Insurance broker organization code?3
ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 )
Policy contract number98-47-962
Policy instance 2
Insurance contract or identification number98-47-962
Number of Individuals Covered30
Insurance policy start date2017-04-01
Insurance policy end date2018-03-31
Total amount of fees paid to insurance companyUSD $80,738
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees80738
Additional information about fees paid to insurance brokerMEDICAL PREMIUMS
Insurance broker organization code?3
Insurance broker nameSPECTRUM UNDERWRITING MANAGERS
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract numberHCL12727
Policy instance 1
Insurance contract or identification numberHCL12727
Number of Individuals Covered30
Insurance policy start date2017-04-01
Insurance policy end date2018-03-31
Total amount of commissions paid to insurance brokerUSD $8,971
Total amount of fees paid to insurance companyUSD $8,971
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,971
Amount paid for insurance broker fees8971
Additional information about fees paid to insurance brokerMEDICAL PREMIUMS
Insurance broker organization code?3
Insurance broker nameWELLS FARGO INSURANCE SERVICES
ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 )
Policy contract number98-47-962
Policy instance 2
Insurance contract or identification number98-47-962
Number of Individuals Covered33
Insurance policy start date2015-04-01
Insurance policy end date2016-03-31
Total amount of fees paid to insurance companyUSD $83,657
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees83657
Additional information about fees paid to insurance brokerMEDICAL PREMIUMS
Insurance broker organization code?3
Insurance broker nameSPECTRUM UNDERWRITING MANAGERS
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract numberHCL12727
Policy instance 1
Insurance contract or identification numberHCL12727
Number of Individuals Covered33
Insurance policy start date2015-04-01
Insurance policy end date2016-03-31
Total amount of commissions paid to insurance brokerUSD $9,296
Total amount of fees paid to insurance companyUSD $9,296
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,296
Amount paid for insurance broker fees9296
Additional information about fees paid to insurance brokerMEDICAL PREMIUMS
Insurance broker organization code?3
Insurance broker nameWELLS FARGO INSURANCE SERVICES
ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 )
Policy contract number98-47-962
Policy instance 2
Insurance contract or identification number98-47-962
Number of Individuals Covered34
Insurance policy start date2014-04-01
Insurance policy end date2015-03-31
Total amount of fees paid to insurance companyUSD $20,571
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees20571
Additional information about fees paid to insurance brokerMEDICAL PREMIUMS
Insurance broker organization code?3
Insurance broker nameSPECTRUM UNDERWRITING MANAGERS
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract numberHCL12727
Policy instance 1
Insurance contract or identification numberHCL12727
Number of Individuals Covered34
Insurance policy start date2014-04-01
Insurance policy end date2015-03-31
Total amount of commissions paid to insurance brokerUSD $9,571
Total amount of fees paid to insurance companyUSD $75,134
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,571
Amount paid for insurance broker fees75134
Additional information about fees paid to insurance brokerMEDICAL PREMIUMS
Insurance broker organization code?3
Insurance broker nameWELLS FARGO INSURANCE SERVICES
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract numberHCL12727
Policy instance 1
Insurance contract or identification numberHCL12727
Number of Individuals Covered38
Insurance policy start date2013-04-01
Insurance policy end date2014-03-31
Total amount of commissions paid to insurance brokerUSD $9,809
Total amount of fees paid to insurance companyUSD $98,103
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,809
Amount paid for insurance broker fees98103
Additional information about fees paid to insurance brokerMEDICAL PREMIUMS
Insurance broker organization code?3
Insurance broker nameWELLS FARGO INSURANCE SERVICES
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract numberHCL12727
Policy instance 1
Insurance contract or identification numberHCL12727
Number of Individuals Covered38
Insurance policy start date2012-04-01
Insurance policy end date2013-03-31
Total amount of commissions paid to insurance brokerUSD $9,877
Total amount of fees paid to insurance companyUSD $98,773
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,877
Amount paid for insurance broker fees98773
Additional information about fees paid to insurance brokerMEDICAL PREMIUMS
Insurance broker organization code?3
Insurance broker nameWELLS FARGO INSURANCE SERVICES
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract numberHCL12727
Policy instance 1
Insurance contract or identification numberHCL12727
Number of Individuals Covered49
Insurance policy start date2010-04-01
Insurance policy end date2011-03-31
Total amount of commissions paid to insurance brokerUSD $9,866
Total amount of fees paid to insurance companyUSD $98,651
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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