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ZINK DISTRIBUTING COMPANY, LLC SHORT-TERM DISABILITY PLAN 401k Plan overview

Plan NameZINK DISTRIBUTING COMPANY, LLC SHORT-TERM DISABILITY PLAN
Plan identification number 505

ZINK DISTRIBUTING COMPANY, LLC SHORT-TERM DISABILITY PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Temporary disability (accident and sickness)

401k Sponsoring company profile

ZINK DISTRIBUTING COMPANY, LLC has sponsored the creation of one or more 401k plans.

Company Name:ZINK DISTRIBUTING COMPANY, LLC
Employer identification number (EIN):352143892
NAIC Classification:424800

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ZINK DISTRIBUTING COMPANY, LLC SHORT-TERM DISABILITY PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5052022-01-01RANDALL R. HACKWORTH2023-06-29
5052021-01-01RANDALL HACKWORTH2022-04-25
5052020-01-01RANDALL HACKWORTH2021-08-19
5052019-01-01
5052018-01-01RANDALL HACKWORTH
5052017-01-01RANDALL HACKWORTH
5052016-01-01RANDALL HACKWORTH
5052015-01-01RANDALL HACKWORTH
5052014-01-01RANDALL HACKWORTH
5052013-01-01RANDALL HACKWORTH
5052012-01-01RANDALL HACKWORTH
5052011-01-01RANDALL HACKWORTH
5052009-01-01RANDALL HACKWORTH
5052008-01-01RANDALL HACKWORTH
5052007-01-01RANDALL HACKWORTH
5052006-01-01RANDALL HACKWORTH
5052005-01-01RANDALL HACKWORTH
5052004-01-01RANDALL HACKWORTH
5052003-01-01RANDALL HACKWORTH
5052002-01-01RANDALL HACKWORTH
5052001-07-01RANDALL HACKWORTH

Plan Statistics for ZINK DISTRIBUTING COMPANY, LLC SHORT-TERM DISABILITY PLAN

401k plan membership statisitcs for ZINK DISTRIBUTING COMPANY, LLC SHORT-TERM DISABILITY PLAN

Measure Date Value
2022: ZINK DISTRIBUTING COMPANY, LLC SHORT-TERM DISABILITY PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01169
Total number of active participants reported on line 7a of the Form 55002022-01-01169
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-01169
Number of employers contributing to the scheme2022-01-010
2021: ZINK DISTRIBUTING COMPANY, LLC SHORT-TERM DISABILITY PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01169
Total number of active participants reported on line 7a of the Form 55002021-01-01169
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-01169
Number of employers contributing to the scheme2021-01-010
2020: ZINK DISTRIBUTING COMPANY, LLC SHORT-TERM DISABILITY PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01174
Total number of active participants reported on line 7a of the Form 55002020-01-01169
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-01169
Number of employers contributing to the scheme2020-01-010
2019: ZINK DISTRIBUTING COMPANY, LLC SHORT-TERM DISABILITY PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01177
Total number of active participants reported on line 7a of the Form 55002019-01-01174
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-01174
2018: ZINK DISTRIBUTING COMPANY, LLC SHORT-TERM DISABILITY PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01144
Total number of active participants reported on line 7a of the Form 55002018-01-01170
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 participants2018-01-01170
2017: ZINK DISTRIBUTING COMPANY, LLC SHORT-TERM DISABILITY PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01149
Total number of active participants reported on line 7a of the Form 55002017-01-01147
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-01147
2016: ZINK DISTRIBUTING COMPANY, LLC SHORT-TERM DISABILITY PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01153
Total number of active participants reported on line 7a of the Form 55002016-01-01148
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-01148
2015: ZINK DISTRIBUTING COMPANY, LLC SHORT-TERM DISABILITY PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01148
Total number of active participants reported on line 7a of the Form 55002015-01-01153
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-01153
2014: ZINK DISTRIBUTING COMPANY, LLC SHORT-TERM DISABILITY PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01156
Total number of active participants reported on line 7a of the Form 55002014-01-01144
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-01144
2013: ZINK DISTRIBUTING COMPANY, LLC SHORT-TERM DISABILITY PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01156
Total number of active participants reported on line 7a of the Form 55002013-01-01156
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-01156
2012: ZINK DISTRIBUTING COMPANY, LLC SHORT-TERM DISABILITY PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01156
Total number of active participants reported on line 7a of the Form 55002012-01-01156
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 participants2012-01-01156
2011: ZINK DISTRIBUTING COMPANY, LLC SHORT-TERM DISABILITY PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01156
Total number of active participants reported on line 7a of the Form 55002011-01-01156
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-010
Total of all active and inactive participants2011-01-01156
2009: ZINK DISTRIBUTING COMPANY, LLC SHORT-TERM DISABILITY PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01153
Total number of active participants reported on line 7a of the Form 55002009-01-01165
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-01165
2008: ZINK DISTRIBUTING COMPANY, LLC SHORT-TERM DISABILITY PLAN 2008 401k membership
Total participants, beginning-of-year2008-01-01100
Total number of active participants reported on line 7a of the Form 55002008-01-01153
Number of retired or separated participants receiving benefits2008-01-010
Number of other retired or separated participants entitled to future benefits2008-01-010
Total of all active and inactive participants2008-01-01153
2007: ZINK DISTRIBUTING COMPANY, LLC SHORT-TERM DISABILITY PLAN 2007 401k membership
Total participants, beginning-of-year2007-01-01100
Total number of active participants reported on line 7a of the Form 55002007-01-01100
Number of retired or separated participants receiving benefits2007-01-010
Number of other retired or separated participants entitled to future benefits2007-01-010
Total of all active and inactive participants2007-01-01100
2006: ZINK DISTRIBUTING COMPANY, LLC SHORT-TERM DISABILITY PLAN 2006 401k membership
Total participants, beginning-of-year2006-01-01100
Total number of active participants reported on line 7a of the Form 55002006-01-01100
Number of retired or separated participants receiving benefits2006-01-010
Number of other retired or separated participants entitled to future benefits2006-01-010
Total of all active and inactive participants2006-01-01100
2005: ZINK DISTRIBUTING COMPANY, LLC SHORT-TERM DISABILITY PLAN 2005 401k membership
Total participants, beginning-of-year2005-01-01100
Total number of active participants reported on line 7a of the Form 55002005-01-01100
Number of retired or separated participants receiving benefits2005-01-010
Number of other retired or separated participants entitled to future benefits2005-01-010
Total of all active and inactive participants2005-01-01100
2004: ZINK DISTRIBUTING COMPANY, LLC SHORT-TERM DISABILITY PLAN 2004 401k membership
Total participants, beginning-of-year2004-01-01100
Total number of active participants reported on line 7a of the Form 55002004-01-01100
Number of retired or separated participants receiving benefits2004-01-010
Number of other retired or separated participants entitled to future benefits2004-01-010
Total of all active and inactive participants2004-01-01100
2003: ZINK DISTRIBUTING COMPANY, LLC SHORT-TERM DISABILITY PLAN 2003 401k membership
Total participants, beginning-of-year2003-01-01100
Total number of active participants reported on line 7a of the Form 55002003-01-01100
Number of retired or separated participants receiving benefits2003-01-010
Number of other retired or separated participants entitled to future benefits2003-01-010
Total of all active and inactive participants2003-01-01100
2002: ZINK DISTRIBUTING COMPANY, LLC SHORT-TERM DISABILITY PLAN 2002 401k membership
Total participants, beginning-of-year2002-01-01100
Total number of active participants reported on line 7a of the Form 55002002-01-01100
Number of retired or separated participants receiving benefits2002-01-010
Number of other retired or separated participants entitled to future benefits2002-01-010
Total of all active and inactive participants2002-01-01100
2001: ZINK DISTRIBUTING COMPANY, LLC SHORT-TERM DISABILITY PLAN 2001 401k membership
Total participants, beginning-of-year2001-07-01100
Total number of active participants reported on line 7a of the Form 55002001-07-01100
Number of retired or separated participants receiving benefits2001-07-010
Number of other retired or separated participants entitled to future benefits2001-07-010
Total of all active and inactive participants2001-07-01100

Form 5500 Responses for ZINK DISTRIBUTING COMPANY, LLC SHORT-TERM DISABILITY PLAN

2022: ZINK DISTRIBUTING COMPANY, LLC SHORT-TERM DISABILITY PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: ZINK DISTRIBUTING COMPANY, LLC SHORT-TERM DISABILITY PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: ZINK DISTRIBUTING COMPANY, LLC SHORT-TERM DISABILITY PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – InsuranceYes
2019: ZINK DISTRIBUTING COMPANY, LLC SHORT-TERM DISABILITY PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: ZINK DISTRIBUTING COMPANY, LLC SHORT-TERM DISABILITY 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 filingNo
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: ZINK DISTRIBUTING COMPANY, LLC SHORT-TERM DISABILITY 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: ZINK DISTRIBUTING COMPANY, LLC SHORT-TERM DISABILITY 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: ZINK DISTRIBUTING COMPANY, LLC SHORT-TERM DISABILITY 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: ZINK DISTRIBUTING COMPANY, LLC SHORT-TERM DISABILITY 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: ZINK DISTRIBUTING COMPANY, LLC SHORT-TERM DISABILITY 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: ZINK DISTRIBUTING COMPANY, LLC SHORT-TERM DISABILITY 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: ZINK DISTRIBUTING COMPANY, LLC SHORT-TERM DISABILITY 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
2009: ZINK DISTRIBUTING COMPANY, LLC SHORT-TERM DISABILITY PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes
2008: ZINK DISTRIBUTING COMPANY, LLC SHORT-TERM DISABILITY PLAN 2008 form 5500 responses
2008-01-01Type of plan entitySingle employer plan
2008-01-01Submission has been amendedNo
2008-01-01This submission is the final filingNo
2008-01-01This return/report is a short plan year return/report (less than 12 months)No
2008-01-01Plan is a collectively bargained planNo
2008-01-01Plan funding arrangement – InsuranceYes
2008-01-01Plan benefit arrangement – InsuranceYes
2007: ZINK DISTRIBUTING COMPANY, LLC SHORT-TERM DISABILITY PLAN 2007 form 5500 responses
2007-01-01Type of plan entitySingle employer plan
2007-01-01Submission has been amendedNo
2007-01-01This submission is the final filingNo
2007-01-01This return/report is a short plan year return/report (less than 12 months)No
2007-01-01Plan is a collectively bargained planNo
2007-01-01Plan funding arrangement – InsuranceYes
2007-01-01Plan benefit arrangement – InsuranceYes
2006: ZINK DISTRIBUTING COMPANY, LLC SHORT-TERM DISABILITY PLAN 2006 form 5500 responses
2006-01-01Type of plan entitySingle employer plan
2006-01-01Submission has been amendedNo
2006-01-01This submission is the final filingNo
2006-01-01This return/report is a short plan year return/report (less than 12 months)No
2006-01-01Plan is a collectively bargained planNo
2006-01-01Plan funding arrangement – InsuranceYes
2006-01-01Plan benefit arrangement – InsuranceYes
2005: ZINK DISTRIBUTING COMPANY, LLC SHORT-TERM DISABILITY PLAN 2005 form 5500 responses
2005-01-01Type of plan entitySingle employer plan
2005-01-01Submission has been amendedNo
2005-01-01This submission is the final filingNo
2005-01-01This return/report is a short plan year return/report (less than 12 months)No
2005-01-01Plan is a collectively bargained planNo
2005-01-01Plan funding arrangement – InsuranceYes
2005-01-01Plan benefit arrangement – InsuranceYes
2004: ZINK DISTRIBUTING COMPANY, LLC SHORT-TERM DISABILITY PLAN 2004 form 5500 responses
2004-01-01Type of plan entitySingle employer plan
2004-01-01Submission has been amendedNo
2004-01-01This submission is the final filingNo
2004-01-01This return/report is a short plan year return/report (less than 12 months)No
2004-01-01Plan is a collectively bargained planNo
2004-01-01Plan funding arrangement – InsuranceYes
2004-01-01Plan benefit arrangement – InsuranceYes
2003: ZINK DISTRIBUTING COMPANY, LLC SHORT-TERM DISABILITY PLAN 2003 form 5500 responses
2003-01-01Type of plan entitySingle employer plan
2003-01-01Submission has been amendedNo
2003-01-01This submission is the final filingNo
2003-01-01This return/report is a short plan year return/report (less than 12 months)No
2003-01-01Plan is a collectively bargained planNo
2003-01-01Plan funding arrangement – InsuranceYes
2003-01-01Plan benefit arrangement – InsuranceYes
2002: ZINK DISTRIBUTING COMPANY, LLC SHORT-TERM DISABILITY PLAN 2002 form 5500 responses
2002-01-01Type of plan entitySingle employer plan
2002-01-01Submission has been amendedNo
2002-01-01This submission is the final filingNo
2002-01-01This return/report is a short plan year return/report (less than 12 months)No
2002-01-01Plan is a collectively bargained planNo
2002-01-01Plan funding arrangement – InsuranceYes
2002-01-01Plan benefit arrangement – InsuranceYes
2001: ZINK DISTRIBUTING COMPANY, LLC SHORT-TERM DISABILITY PLAN 2001 form 5500 responses
2001-07-01Type of plan entitySingle employer plan
2001-07-01First time form 5500 has been submittedYes
2001-07-01Submission has been amendedNo
2001-07-01This submission is the final filingNo
2001-07-01This return/report is a short plan year return/report (less than 12 months)No
2001-07-01Plan is a collectively bargained planNo
2001-07-01Plan funding arrangement – InsuranceYes
2001-07-01Plan 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 number236946
Policy instance 1
Insurance contract or identification number236946
Number of Individuals Covered169
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $2,885
Total amount of fees paid to insurance companyUSD $0
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $19,229
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,442
Amount paid for insurance broker fees0
Insurance broker organization code?3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number236946
Policy instance 1
Insurance contract or identification number236946
Number of Individuals Covered162
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $2,844
Total amount of fees paid to insurance companyUSD $191
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $18,959
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,422
Insurance broker organization code?3
Amount paid for insurance broker fees191
Additional information about fees paid to insurance brokerBONUS
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number236946
Policy instance 1
Insurance contract or identification number236946
Number of Individuals Covered167
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $2,648
Total amount of fees paid to insurance companyUSD $142
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $17,651
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,324
Insurance broker organization code?3
Amount paid for insurance broker fees142
Additional information about fees paid to insurance brokerBONUS
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number236946
Policy instance 1
Insurance contract or identification number236946
Number of Individuals Covered137
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $2,474
Total amount of fees paid to insurance companyUSD $166
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $16,490
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,237
Insurance broker organization code?3
Amount paid for insurance broker fees166
Additional information about fees paid to insurance brokerBONUS
Insurance broker nameMJ INSURANCE INC

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