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NATIONAL INSURANCE CRIME BUREAU VISION SERVICE PLAN 401k Plan overview

Plan NameNATIONAL INSURANCE CRIME BUREAU VISION SERVICE PLAN
Plan identification number 503

NATIONAL INSURANCE CRIME BUREAU VISION SERVICE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover

401k Sponsoring company profile

NATIONAL INSURANCE CRIME BUREAU has sponsored the creation of one or more 401k plans.

Company Name:NATIONAL INSURANCE CRIME BUREAU
Employer identification number (EIN):363776789
NAIC Classification:813000
NAIC Description: Religious, Grantmaking, Civic, Professional, and Similar Organizations

Additional information about NATIONAL INSURANCE CRIME BUREAU

Jurisdiction of Incorporation: Texas Secretary of State
Incorporation Date: 1992-03-02
Company Identification Number: 0009073207
Legal Registered Office Address: 1999 BRYAN ST STE 900

DALLAS
United States of America (USA)
75201

More information about NATIONAL INSURANCE CRIME BUREAU

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NATIONAL INSURANCE CRIME BUREAU VISION SERVICE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5032022-01-01
5032021-01-01
5032020-01-01
5032019-01-01
5032018-01-01BARBARA LOW ROBERT JACHNICKI2019-06-27
5032014-01-01BARBARA LOW ROBERT JACHNICKI2015-07-23
5032013-01-01BARBARA LOW ROBERT JACHNICKI2014-07-22
5032012-01-01BARBARA LOW ROBERT JACHNICKI2013-07-29
5032011-01-01BARBARA LOW ROBERT JACHNICKI2012-07-25
5032010-01-01BARBARA LOW ROBERT JACHNICKI2011-06-22
5032009-01-01ERIK PIENKOS
5032008-01-01ERIK PIENKOS
5032007-01-01ERIK PIENKOS
5032006-01-01ERIK PIENKOS
5032005-01-01ERIK PIENKOS
5032004-01-01ERIK PIENKOS
5032003-01-01ERIK PIENKOS
5032002-01-01ERIK PIENKOS
5032001-01-01ERIK PIENKOS
5032000-01-01ERIK PIENKOS
5031999-01-01ERIK PIENKOS
5031998-01-01ERIK PIENKOS
5031997-02-01ERIK PIENKOS
5031996-02-01ERIK PIENKOS

Plan Statistics for NATIONAL INSURANCE CRIME BUREAU VISION SERVICE PLAN

401k plan membership statisitcs for NATIONAL INSURANCE CRIME BUREAU VISION SERVICE PLAN

Measure Date Value
2022: NATIONAL INSURANCE CRIME BUREAU VISION SERVICE PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01405
Total number of active participants reported on line 7a of the Form 55002022-01-01382
Number of retired or separated participants receiving benefits2022-01-0131
Total of all active and inactive participants2022-01-01413
Total participants2022-01-01413
2021: NATIONAL INSURANCE CRIME BUREAU VISION SERVICE PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01420
Total number of active participants reported on line 7a of the Form 55002021-01-01367
Number of retired or separated participants receiving benefits2021-01-0138
Total of all active and inactive participants2021-01-01405
Total participants2021-01-01405
2020: NATIONAL INSURANCE CRIME BUREAU VISION SERVICE PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01119
Total number of active participants reported on line 7a of the Form 55002020-01-01374
Number of retired or separated participants receiving benefits2020-01-0146
Total of all active and inactive participants2020-01-01420
Total participants2020-01-01420
2019: NATIONAL INSURANCE CRIME BUREAU VISION SERVICE PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01116
Total number of active participants reported on line 7a of the Form 55002019-01-01119
Total of all active and inactive participants2019-01-01119
Total participants2019-01-01119
2018: NATIONAL INSURANCE CRIME BUREAU VISION SERVICE PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01118
Total number of active participants reported on line 7a of the Form 55002018-01-01116
Total of all active and inactive participants2018-01-01116
Total participants2018-01-01116
2014: NATIONAL INSURANCE CRIME BUREAU VISION SERVICE PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01297
Total number of active participants reported on line 7a of the Form 55002014-01-01297
Total of all active and inactive participants2014-01-01297
Total participants2014-01-01297
2013: NATIONAL INSURANCE CRIME BUREAU VISION SERVICE PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01299
Total number of active participants reported on line 7a of the Form 55002013-01-01297
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 participants2013-01-01297
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-01297
Number of participants with account balances2013-01-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010
Number of employers contributing to the scheme2013-01-010
2012: NATIONAL INSURANCE CRIME BUREAU VISION SERVICE PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01289
Total number of active participants reported on line 7a of the Form 55002012-01-01299
Number of retired or separated participants receiving benefits2012-01-010
Total of all active and inactive participants2012-01-01299
Total participants2012-01-01299
2011: NATIONAL INSURANCE CRIME BUREAU VISION SERVICE PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01284
Total number of active participants reported on line 7a of the Form 55002011-01-01289
Number of retired or separated participants receiving benefits2011-01-010
Total of all active and inactive participants2011-01-01289
Total participants2011-01-01289
2010: NATIONAL INSURANCE CRIME BUREAU VISION SERVICE PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-01261
Total number of active participants reported on line 7a of the Form 55002010-01-01284
Total of all active and inactive participants2010-01-01284
Total participants2010-01-01284
2009: NATIONAL INSURANCE CRIME BUREAU VISION SERVICE PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01261
Total number of active participants reported on line 7a of the Form 55002009-01-01261
Total of all active and inactive participants2009-01-01261
2008: NATIONAL INSURANCE CRIME BUREAU VISION SERVICE PLAN 2008 401k membership
Total participants, beginning-of-year2008-01-01253
Total number of active participants reported on line 7a of the Form 55002008-01-01261
Total of all active and inactive participants2008-01-01261
2007: NATIONAL INSURANCE CRIME BUREAU VISION SERVICE PLAN 2007 401k membership
Total participants, beginning-of-year2007-01-01258
Total number of active participants reported on line 7a of the Form 55002007-01-01253
Total of all active and inactive participants2007-01-01253
2006: NATIONAL INSURANCE CRIME BUREAU VISION SERVICE PLAN 2006 401k membership
Total participants, beginning-of-year2006-01-01252
Total number of active participants reported on line 7a of the Form 55002006-01-01258
Total of all active and inactive participants2006-01-01258
2005: NATIONAL INSURANCE CRIME BUREAU VISION SERVICE PLAN 2005 401k membership
Total participants, beginning-of-year2005-01-01249
Total number of active participants reported on line 7a of the Form 55002005-01-01252
Total of all active and inactive participants2005-01-01252
2004: NATIONAL INSURANCE CRIME BUREAU VISION SERVICE PLAN 2004 401k membership
Total participants, beginning-of-year2004-01-01252
Total number of active participants reported on line 7a of the Form 55002004-01-01249
Total of all active and inactive participants2004-01-01249
2003: NATIONAL INSURANCE CRIME BUREAU VISION SERVICE PLAN 2003 401k membership
Total participants, beginning-of-year2003-01-01252
Total number of active participants reported on line 7a of the Form 55002003-01-01252
Total of all active and inactive participants2003-01-01252
2002: NATIONAL INSURANCE CRIME BUREAU VISION SERVICE PLAN 2002 401k membership
Total participants, beginning-of-year2002-01-01217
Total number of active participants reported on line 7a of the Form 55002002-01-01252
Total of all active and inactive participants2002-01-01252
2001: NATIONAL INSURANCE CRIME BUREAU VISION SERVICE PLAN 2001 401k membership
Total participants, beginning-of-year2001-01-01217
Total number of active participants reported on line 7a of the Form 55002001-01-01217
Total of all active and inactive participants2001-01-01217
2000: NATIONAL INSURANCE CRIME BUREAU VISION SERVICE PLAN 2000 401k membership
Total participants, beginning-of-year2000-01-01178
Total number of active participants reported on line 7a of the Form 55002000-01-01217
Total of all active and inactive participants2000-01-01217
1999: NATIONAL INSURANCE CRIME BUREAU VISION SERVICE PLAN 1999 401k membership
Total participants, beginning-of-year1999-01-01246
Total number of active participants reported on line 7a of the Form 55001999-01-01178
Total of all active and inactive participants1999-01-01178
1998: NATIONAL INSURANCE CRIME BUREAU VISION SERVICE PLAN 1998 401k membership
Total participants, beginning-of-year1998-01-01243
Total number of active participants reported on line 7a of the Form 55001998-01-01246
Total of all active and inactive participants1998-01-01246
1997: NATIONAL INSURANCE CRIME BUREAU VISION SERVICE PLAN 1997 401k membership
Total participants, beginning-of-year1997-02-01320
Total number of active participants reported on line 7a of the Form 55001997-02-01243
Total of all active and inactive participants1997-02-01243
1996: NATIONAL INSURANCE CRIME BUREAU VISION SERVICE PLAN 1996 401k membership
Total participants, beginning-of-year1996-02-01323
Total number of active participants reported on line 7a of the Form 55001996-02-01320
Total of all active and inactive participants1996-02-01320

Form 5500 Responses for NATIONAL INSURANCE CRIME BUREAU VISION SERVICE PLAN

2022: NATIONAL INSURANCE CRIME BUREAU VISION SERVICE PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: NATIONAL INSURANCE CRIME BUREAU VISION SERVICE PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: NATIONAL INSURANCE CRIME BUREAU VISION SERVICE PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes
2019: NATIONAL INSURANCE CRIME BUREAU VISION SERVICE 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 funding arrangement – General assets of the sponsorYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – General assets of the sponsorYes
2018: NATIONAL INSURANCE CRIME BUREAU VISION SERVICE PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01First time form 5500 has been submittedYes
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 funding arrangement – General assets of the sponsorYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – General assets of the sponsorYes
2014: NATIONAL INSURANCE CRIME BUREAU VISION SERVICE 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 funding arrangement – General assets of the sponsorYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – General assets of the sponsorYes
2013: NATIONAL INSURANCE CRIME BUREAU VISION SERVICE 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: NATIONAL INSURANCE CRIME BUREAU VISION SERVICE 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: NATIONAL INSURANCE CRIME BUREAU VISION SERVICE 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
2010: NATIONAL INSURANCE CRIME BUREAU VISION SERVICE PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – InsuranceYes
2009: NATIONAL INSURANCE CRIME BUREAU VISION SERVICE 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: NATIONAL INSURANCE CRIME BUREAU VISION SERVICE 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: NATIONAL INSURANCE CRIME BUREAU VISION SERVICE 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: NATIONAL INSURANCE CRIME BUREAU VISION SERVICE 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: NATIONAL INSURANCE CRIME BUREAU VISION SERVICE 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: NATIONAL INSURANCE CRIME BUREAU VISION SERVICE 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: NATIONAL INSURANCE CRIME BUREAU VISION SERVICE 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: NATIONAL INSURANCE CRIME BUREAU VISION SERVICE 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: NATIONAL INSURANCE CRIME BUREAU VISION SERVICE PLAN 2001 form 5500 responses
2001-01-01Type of plan entitySingle employer plan
2001-01-01Submission has been amendedNo
2001-01-01This submission is the final filingNo
2001-01-01This return/report is a short plan year return/report (less than 12 months)No
2001-01-01Plan is a collectively bargained planNo
2001-01-01Plan funding arrangement – InsuranceYes
2001-01-01Plan benefit arrangement – InsuranceYes
2000: NATIONAL INSURANCE CRIME BUREAU VISION SERVICE PLAN 2000 form 5500 responses
2000-01-01Type of plan entitySingle employer plan
2000-01-01Submission has been amendedNo
2000-01-01This submission is the final filingNo
2000-01-01This return/report is a short plan year return/report (less than 12 months)No
2000-01-01Plan is a collectively bargained planNo
2000-01-01Plan funding arrangement – InsuranceYes
2000-01-01Plan benefit arrangement – InsuranceYes
1999: NATIONAL INSURANCE CRIME BUREAU VISION SERVICE PLAN 1999 form 5500 responses
1999-01-01Type of plan entitySingle employer plan
1999-01-01Submission has been amendedNo
1999-01-01This submission is the final filingNo
1999-01-01This return/report is a short plan year return/report (less than 12 months)No
1999-01-01Plan is a collectively bargained planNo
1999-01-01Plan funding arrangement – InsuranceYes
1999-01-01Plan benefit arrangement – InsuranceYes
1998: NATIONAL INSURANCE CRIME BUREAU VISION SERVICE PLAN 1998 form 5500 responses
1998-01-01Type of plan entitySingle employer plan
1998-01-01Submission has been amendedNo
1998-01-01This submission is the final filingNo
1998-01-01This return/report is a short plan year return/report (less than 12 months)No
1998-01-01Plan is a collectively bargained planNo
1998-01-01Plan funding arrangement – InsuranceYes
1998-01-01Plan benefit arrangement – InsuranceYes
1997: NATIONAL INSURANCE CRIME BUREAU VISION SERVICE PLAN 1997 form 5500 responses
1997-02-01Type of plan entitySingle employer plan
1997-02-01Submission has been amendedNo
1997-02-01This submission is the final filingNo
1997-02-01This return/report is a short plan year return/report (less than 12 months)Yes
1997-02-01Plan is a collectively bargained planNo
1997-02-01Plan funding arrangement – InsuranceYes
1997-02-01Plan benefit arrangement – InsuranceYes
1996: NATIONAL INSURANCE CRIME BUREAU VISION SERVICE PLAN 1996 form 5500 responses
1996-02-01Type of plan entitySingle employer plan
1996-02-01First time form 5500 has been submittedYes
1996-02-01Submission has been amendedNo
1996-02-01This submission is the final filingNo
1996-02-01This return/report is a short plan year return/report (less than 12 months)No
1996-02-01Plan is a collectively bargained planNo
1996-02-01Plan funding arrangement – InsuranceYes
1996-02-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00544189
Policy instance 1
Insurance contract or identification number00544189
Number of Individuals Covered1038
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $7,753
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 BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D, ACCIDENT INS, CANCER INS, VOLUNTARY CRITICAL ILLNESS INS
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 $888,573
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,753
Additional information about fees paid to insurance brokerCONSULTING COMMISSIONS
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00544189
Policy instance 1
Insurance contract or identification number00544189
Number of Individuals Covered1023
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $9,755
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 BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D, ACCIDENT INS, CANCER INS, VOLUNTARY CRITICAL ILLNESS INC
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 $880,088
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,755
Amount paid for insurance broker fees1209
Additional information about fees paid to insurance brokerCONSULTING FEES/COMMISSIONS
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00544189
Policy instance 1
Insurance contract or identification number00544189
Number of Individuals Covered1025
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $5,856
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 BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D, ACCIDENT INS, CANCER INS, VOLUNTARY CRITICAL ILLNESS INS
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 $895,536
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00544189
Policy instance 1
Insurance contract or identification number00544189
Number of Individuals Covered119
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
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 BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENT, CANCER, VOLUNTARY CRITICAL ILLNESS
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 $76,920
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00544189
Policy instance 1
Insurance contract or identification number00544189
Number of Individuals Covered116
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
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 BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENT, CANCER, VOLUNTARY CRITICAL ILLNESS
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 $90,802
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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