LETTUCE ENTERTAIN YOU ENTERPRISES, INC. has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan LETTUCE LONG TERM DISABILITY PLAN
Measure | Date | Value |
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2018: LETTUCE LONG TERM DISABILITY PLAN 2018 401k membership |
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Total participants, beginning-of-year | 2018-10-01 | 894 |
Total number of active participants reported on line 7a of the Form 5500 | 2018-10-01 | 937 |
Number of retired or separated participants receiving benefits | 2018-10-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2018-10-01 | 0 |
Total of all active and inactive participants | 2018-10-01 | 937 |
2017: LETTUCE LONG TERM DISABILITY PLAN 2017 401k membership |
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Total participants, beginning-of-year | 2017-10-01 | 854 |
Total number of active participants reported on line 7a of the Form 5500 | 2017-10-01 | 894 |
Number of retired or separated participants receiving benefits | 2017-10-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2017-10-01 | 0 |
Total of all active and inactive participants | 2017-10-01 | 894 |
2016: LETTUCE LONG TERM DISABILITY PLAN 2016 401k membership |
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Total participants, beginning-of-year | 2016-10-01 | 860 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-10-01 | 854 |
Number of retired or separated participants receiving benefits | 2016-10-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2016-10-01 | 0 |
Total of all active and inactive participants | 2016-10-01 | 854 |
2015: LETTUCE LONG TERM DISABILITY PLAN 2015 401k membership |
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Total participants, beginning-of-year | 2015-10-01 | 776 |
Total number of active participants reported on line 7a of the Form 5500 | 2015-10-01 | 860 |
Number of retired or separated participants receiving benefits | 2015-10-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2015-10-01 | 0 |
Total of all active and inactive participants | 2015-10-01 | 860 |
2014: LETTUCE LONG TERM DISABILITY PLAN 2014 401k membership |
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Total participants, beginning-of-year | 2014-10-01 | 716 |
Total number of active participants reported on line 7a of the Form 5500 | 2014-10-01 | 776 |
Number of retired or separated participants receiving benefits | 2014-10-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2014-10-01 | 0 |
Total of all active and inactive participants | 2014-10-01 | 776 |
2013: LETTUCE LONG TERM DISABILITY PLAN 2013 401k membership |
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Total participants, beginning-of-year | 2013-10-01 | 665 |
Total number of active participants reported on line 7a of the Form 5500 | 2013-10-01 | 716 |
Number of retired or separated participants receiving benefits | 2013-10-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2013-10-01 | 0 |
Total of all active and inactive participants | 2013-10-01 | 716 |
2012: LETTUCE LONG TERM DISABILITY PLAN 2012 401k membership |
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Total participants, beginning-of-year | 2012-10-01 | 596 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-10-01 | 665 |
Number of retired or separated participants receiving benefits | 2012-10-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2012-10-01 | 0 |
Total of all active and inactive participants | 2012-10-01 | 665 |
2011: LETTUCE LONG TERM DISABILITY PLAN 2011 401k membership |
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Total participants, beginning-of-year | 2011-10-01 | 578 |
Total number of active participants reported on line 7a of the Form 5500 | 2011-10-01 | 596 |
Total of all active and inactive participants | 2011-10-01 | 596 |
2010: LETTUCE LONG TERM DISABILITY PLAN 2010 401k membership |
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Total participants, beginning-of-year | 2010-10-01 | 625 |
Total number of active participants reported on line 7a of the Form 5500 | 2010-10-01 | 578 |
Total of all active and inactive participants | 2010-10-01 | 578 |
2009: LETTUCE LONG TERM DISABILITY PLAN 2009 401k membership |
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Total participants, beginning-of-year | 2009-10-01 | 589 |
Total number of active participants reported on line 7a of the Form 5500 | 2009-10-01 | 625 |
Total of all active and inactive participants | 2009-10-01 | 625 |
2018: LETTUCE LONG TERM DISABILITY PLAN 2018 form 5500 responses |
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2018-10-01 | Type of plan entity | Single employer plan |
2018-10-01 | Submission has been amended | No |
2018-10-01 | This submission is the final filing | No |
2018-10-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2018-10-01 | Plan is a collectively bargained plan | No |
2018-10-01 | Plan funding arrangement – Insurance | Yes |
2018-10-01 | Plan benefit arrangement – Insurance | Yes |
2017: LETTUCE LONG TERM DISABILITY PLAN 2017 form 5500 responses |
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2017-10-01 | Type of plan entity | Single employer plan |
2017-10-01 | Submission has been amended | No |
2017-10-01 | This submission is the final filing | No |
2017-10-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2017-10-01 | Plan is a collectively bargained plan | No |
2017-10-01 | Plan funding arrangement – Insurance | Yes |
2017-10-01 | Plan benefit arrangement – Insurance | Yes |
2016: LETTUCE LONG TERM DISABILITY PLAN 2016 form 5500 responses |
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2016-10-01 | Type of plan entity | Single employer plan |
2016-10-01 | Submission has been amended | No |
2016-10-01 | This submission is the final filing | No |
2016-10-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2016-10-01 | Plan is a collectively bargained plan | No |
2016-10-01 | Plan funding arrangement – Insurance | Yes |
2016-10-01 | Plan benefit arrangement – Insurance | Yes |
2015: LETTUCE LONG TERM DISABILITY PLAN 2015 form 5500 responses |
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2015-10-01 | Type of plan entity | Single employer plan |
2015-10-01 | Submission has been amended | No |
2015-10-01 | This submission is the final filing | No |
2015-10-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2015-10-01 | Plan is a collectively bargained plan | No |
2015-10-01 | Plan funding arrangement – Insurance | Yes |
2015-10-01 | Plan benefit arrangement – Insurance | Yes |
2014: LETTUCE LONG TERM DISABILITY PLAN 2014 form 5500 responses |
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2014-10-01 | Type of plan entity | Single employer plan |
2014-10-01 | Submission has been amended | No |
2014-10-01 | This submission is the final filing | No |
2014-10-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2014-10-01 | Plan is a collectively bargained plan | No |
2014-10-01 | Plan funding arrangement – Insurance | Yes |
2014-10-01 | Plan benefit arrangement – Insurance | Yes |
2013: LETTUCE LONG TERM DISABILITY PLAN 2013 form 5500 responses |
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2013-10-01 | Type of plan entity | Single employer plan |
2013-10-01 | Submission has been amended | No |
2013-10-01 | This submission is the final filing | No |
2013-10-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2013-10-01 | Plan is a collectively bargained plan | No |
2013-10-01 | Plan funding arrangement – Insurance | Yes |
2013-10-01 | Plan benefit arrangement – Insurance | Yes |
2012: LETTUCE LONG TERM DISABILITY PLAN 2012 form 5500 responses |
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2012-10-01 | Type of plan entity | Single employer plan |
2012-10-01 | Submission has been amended | No |
2012-10-01 | This submission is the final filing | No |
2012-10-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2012-10-01 | Plan is a collectively bargained plan | No |
2012-10-01 | Plan funding arrangement – Insurance | Yes |
2012-10-01 | Plan benefit arrangement – Insurance | Yes |
2011: LETTUCE LONG TERM DISABILITY PLAN 2011 form 5500 responses |
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2011-10-01 | Type of plan entity | Single employer plan |
2011-10-01 | Plan funding arrangement – Insurance | Yes |
2011-10-01 | Plan benefit arrangement – Insurance | Yes |
2010: LETTUCE LONG TERM DISABILITY PLAN 2010 form 5500 responses |
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2010-10-01 | Type of plan entity | Single employer plan |
2010-10-01 | Plan funding arrangement – Insurance | Yes |
2010-10-01 | Plan benefit arrangement – Insurance | Yes |
2009: LETTUCE LONG TERM DISABILITY PLAN 2009 form 5500 responses |
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2009-10-01 | Type of plan entity | Single employer plan |
2009-10-01 | This submission is the final filing | No |
2009-10-01 | Plan funding arrangement – Insurance | Yes |
2009-10-01 | Plan benefit arrangement – Insurance | Yes |
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 10192591 |
Policy instance | 1 |
Insurance contract or identification number | 10192591 | Number of Individuals Covered | 937 | Insurance policy start date | 2018-09-01 | Insurance policy end date | 2019-08-31 | Total amount of commissions paid to insurance broker | USD $8,377 | Total amount of fees paid to insurance company | USD $2,824 | 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 | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | 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 $155,992 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $8,377 | Insurance broker organization code? | 3 | Amount paid for insurance broker fees | 2422 | Additional information about fees paid to insurance broker | FEES |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 10192591 |
Policy instance | 1 |
Insurance contract or identification number | 10192591 | Number of Individuals Covered | 894 | Insurance policy start date | 2017-09-01 | Insurance policy end date | 2018-08-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $3,056 | 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 | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | 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 $170,805 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 10192591 |
Policy instance | 1 |
Insurance contract or identification number | 10192591 | Number of Individuals Covered | 860 | Insurance policy start date | 2015-09-01 | Insurance policy end date | 2016-08-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $3,347 | 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 | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | 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 $152,507 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 2288 | Additional information about fees paid to insurance broker | FEES | Insurance broker organization code? | 3 | Insurance broker name | THE HORTON GROUP INC |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 10192590 |
Policy instance | 2 |
Insurance contract or identification number | 10192590 | Number of Individuals Covered | 51 | Insurance policy start date | 2014-09-01 | Insurance policy end date | 2015-08-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $119 | 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 | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENTAL LIFE | 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 $1,026 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 104 | Additional information about fees paid to insurance broker | BROKER BONUS | Insurance broker organization code? | 3 | Insurance broker name | ASSUREX AGENCY INC |
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) |
Policy contract number | 10192591 |
Policy instance | 1 |
Insurance contract or identification number | 10192591 | Number of Individuals Covered | 776 | Insurance policy start date | 2014-09-01 | Insurance policy end date | 2015-08-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $8,521 | 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 | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | 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 $116,295 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 6777 | Additional information about fees paid to insurance broker | BROKER BONUS | Insurance broker organization code? | 3 | Insurance broker name | ASSUREX AGENCY INC |
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LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
Policy contract number | FLX964142 |
Policy instance | 3 |
Insurance contract or identification number | FLX964142 | Number of Individuals Covered | 111 | Insurance policy start date | 2013-09-01 | Insurance policy end date | 2014-08-31 | Total amount of commissions paid to insurance broker | USD $3,134 | Total amount of fees paid to insurance company | USD $0 | 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 | No | Unemployment Insurance Welfare Benefit | No | 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 $71,089 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,134 | Insurance broker organization code? | 3 | Insurance broker name | THE HORTON GROUP INC |
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LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
Policy contract number | LK962928 |
Policy instance | 2 |
Insurance contract or identification number | LK962928 | Number of Individuals Covered | 716 | Insurance policy start date | 2013-09-01 | Insurance policy end date | 2014-08-31 | Total amount of commissions paid to insurance broker | USD $6,136 | Total amount of fees paid to insurance company | USD $0 | 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 | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | 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 $141,680 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $6,136 | Insurance broker organization code? | 3 | Insurance broker name | THE HORTON GROUP INC |
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LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
Policy contract number | OK965759 |
Policy instance | 1 |
Insurance contract or identification number | OK965759 | Number of Individuals Covered | 102 | Insurance policy start date | 2013-09-01 | Insurance policy end date | 2014-08-31 | Total amount of commissions paid to insurance broker | USD $293 | Total amount of fees paid to insurance company | USD $0 | 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 | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENTAL DEATH | 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 $6,527 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $293 | Insurance broker organization code? | 3 | Insurance broker name | THE HORTON GROUP INC |
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LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
Policy contract number | LK962928 |
Policy instance | 2 |
Insurance contract or identification number | LK962928 | Number of Individuals Covered | 665 | Insurance policy start date | 2012-09-01 | Insurance policy end date | 2013-08-31 | Total amount of commissions paid to insurance broker | USD $5,651 | Total amount of fees paid to insurance company | USD $0 | 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 | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | Yes | Unemployment Insurance Welfare Benefit | No | 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 $127,614 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $5,651 | Insurance broker organization code? | 3 | Insurance broker name | JMB INSURANCE AGENCY |
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LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
Policy contract number | OK965759 |
Policy instance | 1 |
Insurance contract or identification number | OK965759 | Number of Individuals Covered | 116 | Insurance policy start date | 2012-09-01 | Insurance policy end date | 2013-08-31 | Total amount of commissions paid to insurance broker | USD $338 | Total amount of fees paid to insurance company | USD $0 | 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 | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENTAL DEATH | 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 $7,392 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $338 | Insurance broker organization code? | 3 | Insurance broker name | JMB INSURANCE AGENCY |
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LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
Policy contract number | FLX964142 |
Policy instance | 3 |
Insurance contract or identification number | FLX964142 | Number of Individuals Covered | 125 | Insurance policy start date | 2012-09-01 | Insurance policy end date | 2013-08-31 | Total amount of commissions paid to insurance broker | USD $3,170 | Total amount of fees paid to insurance company | USD $0 | 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 | No | Unemployment Insurance Welfare Benefit | No | 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 $69,181 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,170 | Insurance broker organization code? | 3 | Insurance broker name | JMB INSURANCE AGENCY |
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LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
Policy contract number | LK962928 |
Policy instance | 2 |
Insurance contract or identification number | LK962928 | Number of Individuals Covered | 596 | Insurance policy start date | 2011-09-01 | Insurance policy end date | 2012-09-01 | Total amount of commissions paid to insurance broker | USD $5,135 | Total amount of fees paid to insurance company | USD $2,604 | 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 $105,124 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
Policy contract number | FLX964142 |
Policy instance | 3 |
Insurance contract or identification number | FLX964142 | Number of Individuals Covered | 151 | Insurance policy start date | 2011-09-01 | Insurance policy end date | 2012-09-01 | Total amount of commissions paid to insurance broker | USD $2,972 | Total amount of fees paid to insurance company | USD $0 | 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 $59,436 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
Policy contract number | OK965759 |
Policy instance | 1 |
Insurance contract or identification number | OK965759 | Number of Individuals Covered | 120 | Insurance policy start date | 2011-09-01 | Insurance policy end date | 2012-09-01 | Total amount of commissions paid to insurance broker | USD $348 | Total amount of fees paid to insurance company | USD $377 | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Other welfare benefits provided | ACCIDENTAL DEATH | Welfare Benefit Premiums Paid to Carrier | USD $6,961 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) |
Policy contract number | P90892-1 |
Policy instance | 1 |
Insurance contract or identification number | P90892-1 | Number of Individuals Covered | 578 | Insurance policy start date | 2010-09-01 | Insurance policy end date | 2011-08-31 | Total amount of commissions paid to insurance broker | USD $25,405 | Total amount of fees paid to insurance company | USD $678 | 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 | Long Term Disability Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $184,707 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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