BALDWIN WALLACE UNIVERSITY has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan GROUP TOTAL DISABILITY BENEFITS LIFE AND AD & D INSURANCE PLANS OF BW - PRUDENTIAL
401k plan membership statisitcs for GROUP TOTAL DISABILITY BENEFITS LIFE AND AD & D INSURANCE PLANS OF BW - PRUDENTIAL
| Measure | Date | Value |
|---|
| 2019: GROUP TOTAL DISABILITY BENEFITS LIFE AND AD & D INSURANCE PLANS OF BW - PRUDENTIAL 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-01-01 | 628 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 627 |
| Total of all active and inactive participants | 2019-01-01 | 627 |
| Total participants | 2019-01-01 | 627 |
| 2018: GROUP TOTAL DISABILITY BENEFITS LIFE AND AD & D INSURANCE PLANS OF BW - PRUDENTIAL 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-01-01 | 634 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 628 |
| Total of all active and inactive participants | 2018-01-01 | 628 |
| Total participants | 2018-01-01 | 628 |
| 2017: GROUP TOTAL DISABILITY BENEFITS LIFE AND AD & D INSURANCE PLANS OF BW - PRUDENTIAL 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-01-01 | 611 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 634 |
| Total of all active and inactive participants | 2017-01-01 | 634 |
| Total participants | 2017-01-01 | 634 |
| 2016: GROUP TOTAL DISABILITY BENEFITS LIFE AND AD & D INSURANCE PLANS OF BW - PRUDENTIAL 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-01-01 | 592 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 611 |
| Total of all active and inactive participants | 2016-01-01 | 611 |
| Total participants | 2016-01-01 | 611 |
| 2015: GROUP TOTAL DISABILITY BENEFITS LIFE AND AD & D INSURANCE PLANS OF BW - PRUDENTIAL 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-01-01 | 571 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 592 |
| Total of all active and inactive participants | 2015-01-01 | 592 |
| Total participants | 2015-01-01 | 592 |
| 2014: GROUP TOTAL DISABILITY BENEFITS LIFE AND AD & D INSURANCE PLANS OF BW - PRUDENTIAL 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-01-01 | 569 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 571 |
| Total of all active and inactive participants | 2014-01-01 | 571 |
| Total participants | 2014-01-01 | 571 |
| 2013: GROUP TOTAL DISABILITY BENEFITS LIFE AND AD & D INSURANCE PLANS OF BW - PRUDENTIAL 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-01-01 | 556 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 569 |
| Number of retired or separated participants receiving benefits | 2013-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2013-01-01 | 0 |
| Total of all active and inactive participants | 2013-01-01 | 569 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2013-01-01 | 0 |
| Total participants | 2013-01-01 | 569 |
| Number of participants with account balances | 2013-01-01 | 0 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2013-01-01 | 0 |
| 2012: GROUP TOTAL DISABILITY BENEFITS LIFE AND AD & D INSURANCE PLANS OF BW - PRUDENTIAL 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-01-01 | 546 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 556 |
| Total of all active and inactive participants | 2012-01-01 | 556 |
| Total participants | 2012-01-01 | 556 |
| 2011: GROUP TOTAL DISABILITY BENEFITS LIFE AND AD & D INSURANCE PLANS OF BW - PRUDENTIAL 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-01-01 | 549 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 546 |
| Total of all active and inactive participants | 2011-01-01 | 546 |
| Total participants | 2011-01-01 | 546 |
| 2009: GROUP TOTAL DISABILITY BENEFITS LIFE AND AD & D INSURANCE PLANS OF BW - PRUDENTIAL 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-01-01 | 626 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 625 |
| Number of retired or separated participants receiving benefits | 2009-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2009-01-01 | 0 |
| Total of all active and inactive participants | 2009-01-01 | 625 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2009-01-01 | 0 |
| Total participants | 2009-01-01 | 625 |
| 2019: GROUP TOTAL DISABILITY BENEFITS LIFE AND AD & D INSURANCE PLANS OF BW - PRUDENTIAL 2019 form 5500 responses |
|---|
| 2019-01-01 | Type of plan entity | Single employer plan |
| 2019-01-01 | Submission has been amended | No |
| 2019-01-01 | This submission is the final filing | No |
| 2019-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2019-01-01 | Plan is a collectively bargained plan | No |
| 2019-01-01 | Plan funding arrangement – Insurance | Yes |
| 2019-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: GROUP TOTAL DISABILITY BENEFITS LIFE AND AD & D INSURANCE PLANS OF BW - PRUDENTIAL 2018 form 5500 responses |
|---|
| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | Submission has been amended | No |
| 2018-01-01 | This submission is the final filing | No |
| 2018-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2018-01-01 | Plan is a collectively bargained plan | No |
| 2018-01-01 | Plan funding arrangement – Insurance | Yes |
| 2018-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: GROUP TOTAL DISABILITY BENEFITS LIFE AND AD & D INSURANCE PLANS OF BW - PRUDENTIAL 2017 form 5500 responses |
|---|
| 2017-01-01 | Type of plan entity | Single employer plan |
| 2017-01-01 | Submission has been amended | No |
| 2017-01-01 | This submission is the final filing | No |
| 2017-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2017-01-01 | Plan is a collectively bargained plan | No |
| 2017-01-01 | Plan funding arrangement – Insurance | Yes |
| 2017-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: GROUP TOTAL DISABILITY BENEFITS LIFE AND AD & D INSURANCE PLANS OF BW - PRUDENTIAL 2016 form 5500 responses |
|---|
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | Submission has been amended | No |
| 2016-01-01 | This submission is the final filing | No |
| 2016-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-01-01 | Plan is a collectively bargained plan | No |
| 2016-01-01 | Plan funding arrangement – Insurance | Yes |
| 2016-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: GROUP TOTAL DISABILITY BENEFITS LIFE AND AD & D INSURANCE PLANS OF BW - PRUDENTIAL 2015 form 5500 responses |
|---|
| 2015-01-01 | Type of plan entity | Single employer plan |
| 2015-01-01 | Submission has been amended | No |
| 2015-01-01 | This submission is the final filing | No |
| 2015-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-01-01 | Plan is a collectively bargained plan | No |
| 2015-01-01 | Plan funding arrangement – Insurance | Yes |
| 2015-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: GROUP TOTAL DISABILITY BENEFITS LIFE AND AD & D INSURANCE PLANS OF BW - PRUDENTIAL 2014 form 5500 responses |
|---|
| 2014-01-01 | Type of plan entity | Single employer plan |
| 2014-01-01 | Submission has been amended | No |
| 2014-01-01 | This submission is the final filing | No |
| 2014-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2014-01-01 | Plan is a collectively bargained plan | No |
| 2014-01-01 | Plan funding arrangement – Insurance | Yes |
| 2014-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: GROUP TOTAL DISABILITY BENEFITS LIFE AND AD & D INSURANCE PLANS OF BW - PRUDENTIAL 2013 form 5500 responses |
|---|
| 2013-01-01 | Type of plan entity | Single employer plan |
| 2013-01-01 | Submission has been amended | No |
| 2013-01-01 | This submission is the final filing | No |
| 2013-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2013-01-01 | Plan is a collectively bargained plan | No |
| 2013-01-01 | Plan funding arrangement – Insurance | Yes |
| 2013-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: GROUP TOTAL DISABILITY BENEFITS LIFE AND AD & D INSURANCE PLANS OF BW - PRUDENTIAL 2012 form 5500 responses |
|---|
| 2012-01-01 | Type of plan entity | Single employer plan |
| 2012-01-01 | Submission has been amended | No |
| 2012-01-01 | This submission is the final filing | No |
| 2012-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2012-01-01 | Plan is a collectively bargained plan | No |
| 2012-01-01 | Plan funding arrangement – Insurance | Yes |
| 2012-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: GROUP TOTAL DISABILITY BENEFITS LIFE AND AD & D INSURANCE PLANS OF BW - PRUDENTIAL 2011 form 5500 responses |
|---|
| 2011-01-01 | Type of plan entity | Single employer plan |
| 2011-01-01 | Submission has been amended | No |
| 2011-01-01 | This submission is the final filing | No |
| 2011-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2011-01-01 | Plan is a collectively bargained plan | No |
| 2011-01-01 | Plan funding arrangement – Insurance | Yes |
| 2011-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: GROUP TOTAL DISABILITY BENEFITS LIFE AND AD & D INSURANCE PLANS OF BW - PRUDENTIAL 2009 form 5500 responses |
|---|
| 2009-01-01 | Type of plan entity | Single employer plan |
| 2009-01-01 | Submission has been amended | No |
| 2009-01-01 | This submission is the final filing | No |
| 2009-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2009-01-01 | Plan is a collectively bargained plan | No |
| 2009-01-01 | Plan funding arrangement – Insurance | Yes |
| 2009-01-01 | Plan benefit arrangement – Insurance | Yes |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 11177 |
| Policy instance | 1 |
| Insurance contract or identification number | 11177 | | Number of Individuals Covered | 627 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $28,636 | | Total amount of fees paid to insurance company | USD $227 | | 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 | Yes | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | AD AND 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 $145,619 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 227 | | Insurance broker organization code? | 5 | | Commission paid to Insurance Broker | USD $15,365 |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 11177 |
| Policy instance | 1 |
| Insurance contract or identification number | 11177 | | Number of Individuals Covered | 628 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $28,520 | | Total amount of fees paid to insurance company | USD $227 | | 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 | Yes | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | AD AND 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 $145,627 | | Commission paid to Insurance Broker | USD $28,520 | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 227 |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 11177 |
| Policy instance | 1 |
| Insurance contract or identification number | 11177 | | Number of Individuals Covered | 634 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $27,592 | | Total amount of fees paid to insurance company | USD $222 | | 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 | Yes | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | AD AND 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 $143,072 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 11177 |
| Policy instance | 1 |
| Insurance contract or identification number | 11177 | | Number of Individuals Covered | 592 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $14,784 | | Total amount of fees paid to insurance company | USD $207 | | 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 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 | Yes | | Unemployment Insurance Welfare Benefit | No | | Other welfare benefits provided | AD AND 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 $133,933 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 207 | | Additional information about fees paid to insurance broker | THIRD PARTY ADMINISTRATION FEES | | Insurance broker organization code? | 5 | | Commission paid to Insurance Broker | USD $14,784 | | Insurance broker name | ASSURED PARTNERS OF OHIO LLC |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 11177 |
| Policy instance | 1 |
| Insurance contract or identification number | 11177 | | Number of Individuals Covered | 571 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $13,872 | | Total amount of fees paid to insurance company | USD $219 | | 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 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 | Yes | | 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 $123,606 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $13,872 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | SALES AND SERVICE | | Insurance broker organization code? | 3 | | Insurance broker name | AXA ASSISTANCE USA |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 11177 |
| Policy instance | 1 |
| Insurance contract or identification number | 11177 | | Number of Individuals Covered | 569 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $17,267 | | Total amount of fees paid to insurance company | USD $200 | | 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 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 | Yes | | 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 $118,232 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $0 | | Amount paid for insurance broker fees | 200 | | Additional information about fees paid to insurance broker | TPA FEE | | Insurance broker organization code? | 5 | | Insurance broker name | ASSURED PARTNERS OF OHIO LLC |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 11177 |
| Policy instance | 1 |
| Insurance contract or identification number | 11177 | | Number of Individuals Covered | 556 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $15,362 | | Total amount of fees paid to insurance company | USD $197 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD & D | | Welfare Benefit Premiums Paid to Carrier | USD $116,499 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $15,362 | | Additional information about fees paid to insurance broker | SALES AND SERVICE | | Insurance broker organization code? | 3 | | Amount paid for insurance broker fees | 197 | | Insurance broker name | AXA ASSISTANCE USA |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 11177 |
| Policy instance | 2 |
| Insurance contract or identification number | 11177 | | Number of Individuals Covered | 546 | | Insurance policy start date | 2011-07-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $3,430 | | Total amount of fees paid to insurance company | USD $67 | | Welfare Benefit Premiums Paid to Carrier | USD $98,012 | | 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 number | 674765G |
| Policy instance | 1 |
| Insurance contract or identification number | 674765G | | Number of Individuals Covered | 543 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-06-30 | | Total amount of commissions paid to insurance broker | USD $10,226 | | Total amount of fees paid to insurance company | USD $2,155 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | A D & D | | Welfare Benefit Premiums Paid to Carrier | USD $146,526 | | 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 number | 674765G |
| Policy instance | 1 |
| Insurance contract or identification number | 674765G | | Number of Individuals Covered | 549 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $11,656 | | Total amount of fees paid to insurance company | USD $2,199 | | Life Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | A D & D | | Welfare Benefit Premiums Paid to Carrier | USD $168,727 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $11,656 | | Amount paid for insurance broker fees | 2199 | | Additional information about fees paid to insurance broker | BONUS | | Insurance broker organization code? | 3 | | Insurance broker name | GROUP BENEFITS AGENCY INC |
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