JFW INDUSTRIES, INC. has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan JFW INDUSTRIES, INC. DISABILITY INSURANCE PLAN
401k plan membership statisitcs for JFW INDUSTRIES, INC. DISABILITY INSURANCE PLAN
| Measure | Date | Value |
|---|
| 2019: JFW INDUSTRIES, INC. DISABILITY INSURANCE PLAN 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-01-01 | 77 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 68 |
| Total of all active and inactive participants | 2019-01-01 | 68 |
| 2018: JFW INDUSTRIES, INC. DISABILITY INSURANCE PLAN 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-01-01 | 80 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 77 |
| Total of all active and inactive participants | 2018-01-01 | 77 |
| 2017: JFW INDUSTRIES, INC. DISABILITY INSURANCE PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-01-01 | 91 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 80 |
| Total of all active and inactive participants | 2017-01-01 | 80 |
| 2016: JFW INDUSTRIES, INC. DISABILITY INSURANCE PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-01-01 | 97 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 91 |
| Total of all active and inactive participants | 2016-01-01 | 91 |
| 2015: JFW INDUSTRIES, INC. DISABILITY INSURANCE PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-01-01 | 99 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 97 |
| Total of all active and inactive participants | 2015-01-01 | 97 |
| 2014: JFW INDUSTRIES, INC. DISABILITY INSURANCE PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-01-01 | 99 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 99 |
| Total of all active and inactive participants | 2014-01-01 | 99 |
| 2013: JFW INDUSTRIES, INC. DISABILITY INSURANCE PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-01-01 | 97 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 99 |
| Total of all active and inactive participants | 2013-01-01 | 99 |
| 2012: JFW INDUSTRIES, INC. DISABILITY INSURANCE PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-01-01 | 97 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 97 |
| Total of all active and inactive participants | 2012-01-01 | 97 |
| 2011: JFW INDUSTRIES, INC. DISABILITY INSURANCE PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-01-01 | 97 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 97 |
| Total of all active and inactive participants | 2011-01-01 | 97 |
| 2010: JFW INDUSTRIES, INC. DISABILITY INSURANCE PLAN 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-01-01 | 101 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-01-01 | 97 |
| Total of all active and inactive participants | 2010-01-01 | 97 |
| 2009: JFW INDUSTRIES, INC. DISABILITY INSURANCE PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-01-01 | 106 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 101 |
| Total of all active and inactive participants | 2009-01-01 | 101 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 10202528 00000 |
| Policy instance | 3 |
| Insurance contract or identification number | 10202528 00000 | | Number of Individuals Covered | 68 | | Insurance policy start date | 2018-03-01 | | Insurance policy end date | 2019-02-28 | | Total amount of commissions paid to insurance broker | USD $1,668 | | Total amount of fees paid to insurance company | USD $672 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $11,119 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,668 | | Amount paid for insurance broker fees | 556 | | Additional information about fees paid to insurance broker | FEES | | Insurance broker organization code? | 3 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 10202529 00000 |
| Policy instance | 2 |
| Insurance contract or identification number | 10202529 00000 | | Number of Individuals Covered | 43 | | Insurance policy start date | 2018-03-01 | | Insurance policy end date | 2019-02-28 | | Total amount of commissions paid to insurance broker | USD $2,339 | | Total amount of fees paid to insurance company | USD $941 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $15,594 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,339 | | Amount paid for insurance broker fees | 780 | | Additional information about fees paid to insurance broker | FEES | | Insurance broker organization code? | 3 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 40000100019556 |
| Policy instance | 1 |
| Insurance contract or identification number | 40000100019556 | | Number of Individuals Covered | 41 | | Insurance policy start date | 2018-03-01 | | Insurance policy end date | 2019-02-28 | | Total amount of commissions paid to insurance broker | USD $3,803 | | Total amount of fees paid to insurance company | USD $1,523 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $25,355 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,803 | | Amount paid for insurance broker fees | 1268 | | Additional information about fees paid to insurance broker | FEES | | Insurance broker organization code? | 3 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 40000100019556 |
| Policy instance | 1 |
| Insurance contract or identification number | 40000100019556 | | Number of Individuals Covered | 46 | | Insurance policy start date | 2017-03-01 | | Insurance policy end date | 2018-02-28 | | Total amount of commissions paid to insurance broker | USD $3,451 | | Total amount of fees paid to insurance company | USD $1,151 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $23,006 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,573 | | Amount paid for insurance broker fees | 858 | | Additional information about fees paid to insurance broker | FEES | | Insurance broker organization code? | 3 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 10202529 00000 |
| Policy instance | 2 |
| Insurance contract or identification number | 10202529 00000 | | Number of Individuals Covered | 48 | | Insurance policy start date | 2017-03-01 | | Insurance policy end date | 2018-02-28 | | Total amount of commissions paid to insurance broker | USD $2,342 | | Total amount of fees paid to insurance company | USD $780 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $15,614 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,780 | | Amount paid for insurance broker fees | 593 | | Additional information about fees paid to insurance broker | FEES | | Insurance broker organization code? | 3 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 10202528 00000 |
| Policy instance | 3 |
| Insurance contract or identification number | 10202528 00000 | | Number of Individuals Covered | 77 | | Insurance policy start date | 2017-03-01 | | Insurance policy end date | 2018-02-28 | | Total amount of commissions paid to insurance broker | USD $1,602 | | Total amount of fees paid to insurance company | USD $534 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $10,681 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,205 | | Amount paid for insurance broker fees | 402 | | Additional information about fees paid to insurance broker | FEES | | Insurance broker organization code? | 3 |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 10202529 00000 |
| Policy instance | 2 |
| Insurance contract or identification number | 10202529 00000 | | Number of Individuals Covered | 51 | | Insurance policy start date | 2016-03-01 | | Insurance policy end date | 2017-02-28 | | Total amount of commissions paid to insurance broker | USD $2,312 | | Total amount of fees paid to insurance company | USD $1,504 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $15,416 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,312 | | Amount paid for insurance broker fees | 770 | | Additional information about fees paid to insurance broker | FEES | | Insurance broker organization code? | 3 | | Insurance broker name | |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 10202528 00000 |
| Policy instance | 3 |
| Insurance contract or identification number | 10202528 00000 | | Number of Individuals Covered | 80 | | Insurance policy start date | 2016-03-01 | | Insurance policy end date | 2017-02-28 | | Total amount of commissions paid to insurance broker | USD $1,584 | | Total amount of fees paid to insurance company | USD $1,010 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $10,559 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,584 | | Amount paid for insurance broker fees | 528 | | Additional information about fees paid to insurance broker | FEES | | Insurance broker organization code? | 3 | | Insurance broker name | |
|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
| Policy contract number | 40000100019556 |
| Policy instance | 1 |
| Insurance contract or identification number | 40000100019556 | | Number of Individuals Covered | 50 | | Insurance policy start date | 2016-03-01 | | Insurance policy end date | 2017-02-28 | | Total amount of commissions paid to insurance broker | USD $3,847 | | Total amount of fees paid to insurance company | USD $2,319 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $25,646 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,847 | | Amount paid for insurance broker fees | 1282 | | Additional information about fees paid to insurance broker | FEES | | Insurance broker organization code? | 3 | | Insurance broker name | |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000992E GVTL |
| Policy instance | 1 |
| Insurance contract or identification number | G000992E GVTL | | Number of Individuals Covered | 54 | | Insurance policy start date | 2014-05-01 | | Insurance policy end date | 2015-03-01 | | Total amount of commissions paid to insurance broker | USD $2,985 | | Total amount of fees paid to insurance company | USD $1,194 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $19,898 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,985 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | AGENT OR BROKER OF RECORD | | Insurance broker organization code? | 3 | | Insurance broker name | NFP-NATIONAL SERVICES INC. |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000992E GUC |
| Policy instance | 2 |
| Insurance contract or identification number | G000992E GUC | | Number of Individuals Covered | 55 | | Insurance policy start date | 2014-05-01 | | Insurance policy end date | 2015-03-01 | | Total amount of commissions paid to insurance broker | USD $2,563 | | Total amount of fees paid to insurance company | USD $1,025 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $17,085 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,563 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | AGENT OR BROKER OF RECORDAGENT OR BROKER OF RECORD | | Insurance broker organization code? | 3 | | Insurance broker name | NFP-NATIONAL SERVICES INC. |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000992E GLTD |
| Policy instance | 3 |
| Insurance contract or identification number | G000992E GLTD | | Number of Individuals Covered | 97 | | Insurance policy start date | 2014-05-01 | | Insurance policy end date | 2015-03-01 | | Total amount of commissions paid to insurance broker | USD $1,482 | | Total amount of fees paid to insurance company | USD $593 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $9,877 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,482 | | Amount paid for insurance broker fees | 0 | | Additional information about fees paid to insurance broker | AGENT OR BROKER OF RECORD | | Insurance broker organization code? | 3 | | Insurance broker name | NFP-NATIONAL SERVICES INC. |
|
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
| Policy contract number | E4105045 |
| Policy instance | 4 |
| Insurance contract or identification number | E4105045 | | Number of Individuals Covered | 28 | | Insurance policy start date | 2014-03-01 | | Insurance policy end date | 2015-02-28 | | Total amount of commissions paid to insurance broker | USD $1,633 | | Total amount of fees paid to insurance company | USD $580 | | Welfare Benefit Premiums Paid to Carrier | USD $15,725 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $905 | | Amount paid for insurance broker fees | 568 | | Insurance broker organization code? | 3 | | Insurance broker name | JOHN GREGORY GOFF |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000992E GVTL |
| Policy instance | 1 |
| Insurance contract or identification number | G000992E GVTL | | Number of Individuals Covered | 59 | | Insurance policy start date | 2013-05-01 | | Insurance policy end date | 2014-05-01 | | Total amount of commissions paid to insurance broker | USD $3,548 | | Total amount of fees paid to insurance company | USD $2,174 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $23,654 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,548 | | Amount paid for insurance broker fees | 755 | | Additional information about fees paid to insurance broker | OTHER COMPENSATION | | Insurance broker organization code? | 3 | | Insurance broker name | NFP-NATIONAL SERVICES INC. |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000992E GUC |
| Policy instance | 2 |
| Insurance contract or identification number | G000992E GUC | | Number of Individuals Covered | 57 | | Insurance policy start date | 2013-05-01 | | Insurance policy end date | 2014-05-01 | | Total amount of commissions paid to insurance broker | USD $3,132 | | Total amount of fees paid to insurance company | USD $1,934 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $20,883 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,132 | | Amount paid for insurance broker fees | 681 | | Additional information about fees paid to insurance broker | OTHER COMPENSATION | | Insurance broker organization code? | 3 | | Insurance broker name | NFP-NATIONAL SERVICES INC. |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000992E GLTD |
| Policy instance | 3 |
| Insurance contract or identification number | G000992E GLTD | | Number of Individuals Covered | 99 | | Insurance policy start date | 2013-05-01 | | Insurance policy end date | 2014-05-01 | | Total amount of commissions paid to insurance broker | USD $1,790 | | Total amount of fees paid to insurance company | USD $1,099 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $11,934 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,790 | | Amount paid for insurance broker fees | 383 | | Additional information about fees paid to insurance broker | OTHER COMPENSATION | | Insurance broker organization code? | 3 | | Insurance broker name | NFP-NATIONAL SERVICES INC. |
|
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) |
| Policy contract number | E4105045 |
| Policy instance | 4 |
| Insurance contract or identification number | E4105045 | | Number of Individuals Covered | 34 | | Insurance policy start date | 2013-03-01 | | Insurance policy end date | 2014-02-28 | | Total amount of commissions paid to insurance broker | USD $8,510 | | Total amount of fees paid to insurance company | USD $4,865 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Welfare Benefit Premiums Paid to Carrier | USD $17,230 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,617 | | Amount paid for insurance broker fees | 3633 | | Insurance broker organization code? | 3 | | Insurance broker name | DENNIS W BYERS |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000992E GLTD |
| Policy instance | 3 |
| Insurance contract or identification number | G000992E GLTD | | Number of Individuals Covered | 99 | | Insurance policy start date | 2012-05-01 | | Insurance policy end date | 2013-05-01 | | Total amount of commissions paid to insurance broker | USD $1,755 | | Total amount of fees paid to insurance company | USD $1,021 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $11,701 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,755 | | Amount paid for insurance broker fees | 436 | | Additional information about fees paid to insurance broker | OTHER COMPENSATION | | Insurance broker organization code? | 3 | | Insurance broker name | NFP-NATIONAL SERVICES INC. |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000992E GUC |
| Policy instance | 2 |
| Insurance contract or identification number | G000992E GUC | | Number of Individuals Covered | 60 | | Insurance policy start date | 2012-05-01 | | Insurance policy end date | 2013-05-01 | | Total amount of commissions paid to insurance broker | USD $3,250 | | Total amount of fees paid to insurance company | USD $1,896 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $21,667 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,250 | | Amount paid for insurance broker fees | 813 | | Additional information about fees paid to insurance broker | OTHER COMPENSATION | | Insurance broker organization code? | 3 | | Insurance broker name | NFP-NATIONAL SERVICES INC. |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000992E GVTL |
| Policy instance | 1 |
| Insurance contract or identification number | G000992E GVTL | | Number of Individuals Covered | 60 | | Insurance policy start date | 2012-05-01 | | Insurance policy end date | 2013-05-01 | | Total amount of commissions paid to insurance broker | USD $3,169 | | Total amount of fees paid to insurance company | USD $1,819 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $21,127 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,169 | | Amount paid for insurance broker fees | 763 | | Additional information about fees paid to insurance broker | OTHER COMPENSATION | | Insurance broker organization code? | 3 | | Insurance broker name | NFP-NATIONAL SERVICES INC. |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000992E GVTL |
| Policy instance | 1 |
| Insurance contract or identification number | G000992E GVTL | | Number of Individuals Covered | 55 | | Insurance policy start date | 2011-05-01 | | Insurance policy end date | 2012-05-01 | | Total amount of commissions paid to insurance broker | USD $3,381 | | Total amount of fees paid to insurance company | USD $928 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $18,551 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,381 | | Amount paid for insurance broker fees | 928 | | Additional information about fees paid to insurance broker | AGENT OR BROKER OF RECORD OTHER COMPENSATION | | Insurance broker organization code? | 3 | | Insurance broker name | JOE HALEY/BENEFIT DECISIONS, INC. |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000992E GLTD |
| Policy instance | 3 |
| Insurance contract or identification number | G000992E GLTD | | Number of Individuals Covered | 97 | | Insurance policy start date | 2011-05-01 | | Insurance policy end date | 2012-05-01 | | Total amount of commissions paid to insurance broker | USD $1,947 | | Total amount of fees paid to insurance company | USD $536 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $10,713 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,947 | | Amount paid for insurance broker fees | 536 | | Additional information about fees paid to insurance broker | AGENT OR BROKER OF RECORD OTHER COMPENSATION | | Insurance broker organization code? | 3 | | Insurance broker name | JOE HALEY/BENEFIT DECISIONS, INC. |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000992E GUC |
| Policy instance | 2 |
| Insurance contract or identification number | G000992E GUC | | Number of Individuals Covered | 59 | | Insurance policy start date | 2011-05-01 | | Insurance policy end date | 2012-05-01 | | Total amount of commissions paid to insurance broker | USD $3,668 | | Total amount of fees paid to insurance company | USD $1,007 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $20,146 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,668 | | Amount paid for insurance broker fees | 1007 | | Additional information about fees paid to insurance broker | AGENT OR BROKER OF RECORD OTHER COMPENSATION | | Insurance broker organization code? | 3 | | Insurance broker name | JOE HALEY/BENEFIT DECISIONS, INC. |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000992E GLTD |
| Policy instance | 3 |
| Insurance contract or identification number | G000992E GLTD | | Number of Individuals Covered | 97 | | Insurance policy start date | 2010-05-01 | | Insurance policy end date | 2011-05-01 | | Total amount of commissions paid to insurance broker | USD $2,016 | | Total amount of fees paid to insurance company | USD $537 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $10,733 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000992E GUC |
| Policy instance | 2 |
| Insurance contract or identification number | G000992E GUC | | Number of Individuals Covered | 61 | | Insurance policy start date | 2010-05-01 | | Insurance policy end date | 2011-05-01 | | Total amount of commissions paid to insurance broker | USD $3,156 | | Total amount of fees paid to insurance company | USD $1,052 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $21,042 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000992E GVTL |
| Policy instance | 1 |
| Insurance contract or identification number | G000992E GVTL | | Number of Individuals Covered | 58 | | Insurance policy start date | 2010-05-01 | | Insurance policy end date | 2011-05-01 | | Total amount of commissions paid to insurance broker | USD $3,557 | | Total amount of fees paid to insurance company | USD $947 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $18,937 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000992E GLTD |
| Policy instance | 3 |
| Insurance contract or identification number | G000992E GLTD | | Number of Individuals Covered | 97 | | Insurance policy start date | 2009-05-01 | | Insurance policy end date | 2010-05-01 | | Total amount of commissions paid to insurance broker | USD $1,995 | | Total amount of fees paid to insurance company | USD $539 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $10,782 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,995 | | Amount paid for insurance broker fees | 539 | | Additional information about fees paid to insurance broker | OTHER COMPENSATION | | Insurance broker organization code? | 3 | | Insurance broker name | JK HALEY & ASSOCIATES |
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| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000992E GUG |
| Policy instance | 2 |
| Insurance contract or identification number | G000992E GUG | | Number of Individuals Covered | 63 | | Insurance policy start date | 2009-05-01 | | Insurance policy end date | 2010-05-01 | | Total amount of commissions paid to insurance broker | USD $3,978 | | Total amount of fees paid to insurance company | USD $1,088 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $21,758 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,978 | | Amount paid for insurance broker fees | 1088 | | Additional information about fees paid to insurance broker | OTHER COMPENSATION | | Insurance broker organization code? | 3 | | Insurance broker name | JK HALEY & ASSOCIATES |
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| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) |
| Policy contract number | G000992E GVTL |
| Policy instance | 1 |
| Insurance contract or identification number | G000992E GVTL | | Number of Individuals Covered | 58 | | Insurance policy start date | 2009-05-01 | | Insurance policy end date | 2010-05-01 | | Total amount of commissions paid to insurance broker | USD $3,537 | | Total amount of fees paid to insurance company | USD $958 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $19,160 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,537 | | Amount paid for insurance broker fees | 958 | | Additional information about fees paid to insurance broker | OTHER COMPENSATION | | Insurance broker organization code? | 3 | | Insurance broker name | JK HALEY & ASSOCIATES |
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