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N. KOHL GROCER CO., INC. LIFE INSURANCE 401k Plan overview

Plan NameN. KOHL GROCER CO., INC. LIFE INSURANCE
Plan identification number 502

N. KOHL GROCER CO., INC. LIFE INSURANCE Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover

401k Sponsoring company profile

N. KOHL GROCER CO., INC. has sponsored the creation of one or more 401k plans.

Company Name:N. KOHL GROCER CO., INC.
Employer identification number (EIN):370370260
NAIC Classification:424400

Form 5500 Filing Information

Submission information for form 5500 for 401k plan N. KOHL GROCER CO., INC. LIFE INSURANCE

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022022-01-01
5022021-01-01
5022020-01-01
5022019-01-01
5022018-01-01
5022017-01-01RICHARD M EHRHART
5022016-01-01RICHARD M EHRHART
5022015-01-01RICHARD M EHRHART
5022014-01-01RICHARD M. EHRHART
5022013-01-01RICHARD M. EHRHART
5022012-01-01RICHARD M. EHRHART
5022011-01-01RICHARD M EHRHART
5022009-01-01RICHARD EHRHART

Plan Statistics for N. KOHL GROCER CO., INC. LIFE INSURANCE

401k plan membership statisitcs for N. KOHL GROCER CO., INC. LIFE INSURANCE

Measure Date Value
2022: N. KOHL GROCER CO., INC. LIFE INSURANCE 2022 401k membership
Total participants, beginning-of-year2022-01-01403
Total number of active participants reported on line 7a of the Form 55002022-01-01366
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 participants2022-01-01366
2021: N. KOHL GROCER CO., INC. LIFE INSURANCE 2021 401k membership
Total participants, beginning-of-year2021-01-01399
Total number of active participants reported on line 7a of the Form 55002021-01-01403
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 participants2021-01-01403
2020: N. KOHL GROCER CO., INC. LIFE INSURANCE 2020 401k membership
Total participants, beginning-of-year2020-01-01399
Total number of active participants reported on line 7a of the Form 55002020-01-01399
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 participants2020-01-01399
2019: N. KOHL GROCER CO., INC. LIFE INSURANCE 2019 401k membership
Total participants, beginning-of-year2019-01-01388
Total number of active participants reported on line 7a of the Form 55002019-01-01399
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 participants2019-01-01399
2018: N. KOHL GROCER CO., INC. LIFE INSURANCE 2018 401k membership
Total participants, beginning-of-year2018-01-01368
Total number of active participants reported on line 7a of the Form 55002018-01-01388
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 participants2018-01-01388
2017: N. KOHL GROCER CO., INC. LIFE INSURANCE 2017 401k membership
Total participants, beginning-of-year2017-01-01368
Total number of active participants reported on line 7a of the Form 55002017-01-01368
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 participants2017-01-01368
2016: N. KOHL GROCER CO., INC. LIFE INSURANCE 2016 401k membership
Total participants, beginning-of-year2016-01-01341
Total number of active participants reported on line 7a of the Form 55002016-01-01368
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 participants2016-01-01368
2015: N. KOHL GROCER CO., INC. LIFE INSURANCE 2015 401k membership
Total participants, beginning-of-year2015-01-01315
Total number of active participants reported on line 7a of the Form 55002015-01-01341
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 participants2015-01-01341
2014: N. KOHL GROCER CO., INC. LIFE INSURANCE 2014 401k membership
Total participants, beginning-of-year2014-01-01307
Total number of active participants reported on line 7a of the Form 55002014-01-01315
Total of all active and inactive participants2014-01-01315
Total participants2014-01-010
2013: N. KOHL GROCER CO., INC. LIFE INSURANCE 2013 401k membership
Total participants, beginning-of-year2013-01-01286
Total number of active participants reported on line 7a of the Form 55002013-01-01307
Total of all active and inactive participants2013-01-01307
Total participants2013-01-010
2012: N. KOHL GROCER CO., INC. LIFE INSURANCE 2012 401k membership
Total participants, beginning-of-year2012-01-01267
Total number of active participants reported on line 7a of the Form 55002012-01-01286
Total of all active and inactive participants2012-01-01286
Total participants2012-01-010
2011: N. KOHL GROCER CO., INC. LIFE INSURANCE 2011 401k membership
Total participants, beginning-of-year2011-01-01262
Total number of active participants reported on line 7a of the Form 55002011-01-01267
Total of all active and inactive participants2011-01-01267
Total participants2011-01-01267
2009: N. KOHL GROCER CO., INC. LIFE INSURANCE 2009 401k membership
Total participants, beginning-of-year2009-01-01229
Total number of active participants reported on line 7a of the Form 55002009-01-01255
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 participants2009-01-01255

Form 5500 Responses for N. KOHL GROCER CO., INC. LIFE INSURANCE

2022: N. KOHL GROCER CO., INC. LIFE INSURANCE 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – InsuranceYes
2021: N. KOHL GROCER CO., INC. LIFE INSURANCE 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – InsuranceYes
2020: N. KOHL GROCER CO., INC. LIFE INSURANCE 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: N. KOHL GROCER CO., INC. LIFE INSURANCE 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: N. KOHL GROCER CO., INC. LIFE INSURANCE 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: N. KOHL GROCER CO., INC. LIFE INSURANCE 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: N. KOHL GROCER CO., INC. LIFE INSURANCE 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: N. KOHL GROCER CO., INC. LIFE INSURANCE 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: N. KOHL GROCER CO., INC. LIFE INSURANCE 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: N. KOHL GROCER CO., INC. LIFE INSURANCE 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: N. KOHL GROCER CO., INC. LIFE INSURANCE 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: N. KOHL GROCER CO., INC. LIFE INSURANCE 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2009: N. KOHL GROCER CO., INC. LIFE INSURANCE 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

Insurance Providers Used on plan

DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberF008509
Policy instance 1
Insurance contract or identification numberF008509
Number of Individuals Covered382
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $14,332
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $77,275
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,962
Insurance broker organization code?3
Additional information about fees paid to insurance brokerADDL COMPENSATION
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberF008509
Policy instance 1
Insurance contract or identification numberF008509
Number of Individuals Covered382
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $14,596
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $78,742
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,087
Insurance broker organization code?3
Additional information about fees paid to insurance brokerADDL COMPENSATION
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberF008509
Policy instance 1
Insurance contract or identification numberF008509
Number of Individuals Covered410
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $14,657
Total amount of fees paid to insurance companyUSD $1,552
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $79,383
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,996
Insurance broker organization code?3
Amount paid for insurance broker fees1552
Additional information about fees paid to insurance brokerADDL COMPENSATION
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberF008509
Policy instance 1
Insurance contract or identification numberF008509
Number of Individuals Covered390
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $14,537
Total amount of fees paid to insurance companyUSD $1,595
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $78,398
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,108
Insurance broker organization code?3
Amount paid for insurance broker fees1595
Additional information about fees paid to insurance brokerADDL COMPENSATION
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberF008509
Policy instance 1
Insurance contract or identification numberF008509
Number of Individuals Covered378
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $14,789
Total amount of fees paid to insurance companyUSD $1,486
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $79,786
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,284
Insurance broker organization code?3
Amount paid for insurance broker fees1486
Additional information about fees paid to insurance brokerADDL COMPENSATION
Insurance broker nameR W GARRETT AGENCY
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberF008509
Policy instance 1
Insurance contract or identification numberF008509
Number of Individuals Covered343
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $13,250
Total amount of fees paid to insurance companyUSD $1,196
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $71,540
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,174
Amount paid for insurance broker fees1196
Additional information about fees paid to insurance brokerADDL COMPENSATION
Insurance broker organization code?3
Insurance broker nameFAUBLE INSURANCE AGENCY INC
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberF008509
Policy instance 1
Insurance contract or identification numberF008509
Number of Individuals Covered331
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $12,028
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $65,077
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,066
Insurance broker organization code?3
Insurance broker nameR W GARRETT AGENCY
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberF008509
Policy instance 1
Insurance contract or identification numberF008509
Number of Individuals Covered323
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $11,121
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $60,213
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,301
Insurance broker organization code?3
Insurance broker nameR W GARRETT AGENCY
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberF008509
Policy instance 1
Insurance contract or identification numberF008509
Number of Individuals Covered293
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $9,935
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $54,063
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,582
Insurance broker organization code?3
Insurance broker nameFAUBLE INSURANCE AGCY INC
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberF008509
Policy instance 1
Insurance contract or identification numberF008509
Number of Individuals Covered279
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $9,113
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $52,397
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberF008509
Policy instance 1
Insurance contract or identification numberF008509
Number of Individuals Covered262
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $8,330
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $45,605
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,374
Insurance broker organization code?3
Insurance broker nameFAUBLE INSURANCE AGCY INC

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