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HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. LIFE & DISABILITY PLAN 401k Plan overview

Plan NameHOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. LIFE & DISABILITY PLAN
Plan identification number 502

HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. LIFE & DISABILITY PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Temporary disability (accident and sickness)
  • Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. has sponsored the creation of one or more 401k plans.

Company Name:HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC.
Employer identification number (EIN):370860281
NAIC Classification:622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. LIFE & DISABILITY PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022018-01-01
5022017-01-01MARTIN ADAMS
5022016-01-01
5022015-01-01
5022014-01-01MARTIN ADAMS2018-10-02
5022013-01-01MARTIN ADAMS
5022012-01-01MARTIN ADAMS
5022011-01-01MARTIN ADAMS
5022010-01-01MARTIN ADAMS
5022009-01-01MARTIN ADAMS
5022008-01-01MARTIN ADAMS
5022007-01-01MARTIN ADAMS
5022006-01-01MARTIN ADAMS
5022005-01-01MARTIN ADAMS
5022004-01-01MARTIN ADAMS
5022003-01-01MARTIN ADAMS
5022002-01-01MARTIN ADAMS
5022001-01-01MARTIN ADAMS
5022000-01-01MARTIN ADAMS
5021999-01-01MARTIN ADAMS
5021998-01-01MARTIN ADAMS
5021997-01-01MARTIN ADAMS
5021996-01-01MARTIN ADAMS
5021995-01-01MARTIN ADAMS
5021994-01-01MARTIN ADAMS
5021993-01-01MARTIN ADAMS
5021992-01-01MARTIN ADAMS
5021991-01-01MARTIN ADAMS
5021990-01-01MARTIN ADAMS
5021989-01-01MARTIN ADAMS
5021988-01-01MARTIN ADAMS

Plan Statistics for HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. LIFE & DISABILITY PLAN

401k plan membership statisitcs for HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. LIFE & DISABILITY PLAN

Measure Date Value
2018: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. LIFE & DISABILITY PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01290
Total number of active participants reported on line 7a of the Form 55002018-01-010
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 participants2018-01-010
2017: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. LIFE & DISABILITY PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01259
Total number of active participants reported on line 7a of the Form 55002017-01-01290
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 participants2017-01-01290
2016: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. LIFE & DISABILITY PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01233
Total number of active participants reported on line 7a of the Form 55002016-01-01259
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 participants2016-01-01259
2015: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. LIFE & DISABILITY PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01204
Total number of active participants reported on line 7a of the Form 55002015-01-01233
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 participants2015-01-01233
2014: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. LIFE & DISABILITY PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01185
Total number of active participants reported on line 7a of the Form 55002014-01-01204
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 participants2014-01-01204
2013: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. LIFE & DISABILITY PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01187
Total number of active participants reported on line 7a of the Form 55002013-01-01185
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 participants2013-01-01185
2012: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. LIFE & DISABILITY PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01182
Total number of active participants reported on line 7a of the Form 55002012-01-01187
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 participants2012-01-01187
2011: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. LIFE & DISABILITY PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01175
Total number of active participants reported on line 7a of the Form 55002011-01-01182
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 participants2011-01-01182
2010: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. LIFE & DISABILITY PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-01177
Total number of active participants reported on line 7a of the Form 55002010-01-01175
Number of retired or separated participants receiving benefits2010-01-010
Number of other retired or separated participants entitled to future benefits2010-01-010
Total of all active and inactive participants2010-01-01175
2009: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. LIFE & DISABILITY PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01174
Total number of active participants reported on line 7a of the Form 55002009-01-01172
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 participants2009-01-01172
2008: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. LIFE & DISABILITY PLAN 2008 401k membership
Total participants, beginning-of-year2008-01-01192
Total number of active participants reported on line 7a of the Form 55002008-01-01174
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 participants2008-01-01174
2007: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. LIFE & DISABILITY PLAN 2007 401k membership
Total participants, beginning-of-year2007-01-01178
Total number of active participants reported on line 7a of the Form 55002007-01-01174
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 participants2007-01-01174
2006: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. LIFE & DISABILITY PLAN 2006 401k membership
Total participants, beginning-of-year2006-01-01134
Total number of active participants reported on line 7a of the Form 55002006-01-01178
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 participants2006-01-01178
2005: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. LIFE & DISABILITY PLAN 2005 401k membership
Total participants, beginning-of-year2005-01-01127
Total number of active participants reported on line 7a of the Form 55002005-01-01134
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 participants2005-01-01134
2004: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. LIFE & DISABILITY PLAN 2004 401k membership
Total participants, beginning-of-year2004-01-01127
Total number of active participants reported on line 7a of the Form 55002004-01-01127
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 participants2004-01-01127
2003: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. LIFE & DISABILITY PLAN 2003 401k membership
Total participants, beginning-of-year2003-01-01109
Total number of active participants reported on line 7a of the Form 55002003-01-01127
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 participants2003-01-01127
2002: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. LIFE & DISABILITY PLAN 2002 401k membership
Total participants, beginning-of-year2002-01-0198
Total number of active participants reported on line 7a of the Form 55002002-01-01109
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 participants2002-01-01109
2001: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. LIFE & DISABILITY PLAN 2001 401k membership
Total participants, beginning-of-year2001-01-0197
Total number of active participants reported on line 7a of the Form 55002001-01-0198
Number of retired or separated participants receiving benefits2001-01-010
Number of other retired or separated participants entitled to future benefits2001-01-010
Total of all active and inactive participants2001-01-0198
2000: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. LIFE & DISABILITY PLAN 2000 401k membership
Total participants, beginning-of-year2000-01-01120
Total number of active participants reported on line 7a of the Form 55002000-01-0197
Number of retired or separated participants receiving benefits2000-01-010
Number of other retired or separated participants entitled to future benefits2000-01-010
Total of all active and inactive participants2000-01-0197
1999: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. LIFE & DISABILITY PLAN 1999 401k membership
Total participants, beginning-of-year1999-01-01127
Total number of active participants reported on line 7a of the Form 55001999-01-01120
Number of retired or separated participants receiving benefits1999-01-010
Number of other retired or separated participants entitled to future benefits1999-01-010
Total of all active and inactive participants1999-01-01120
1998: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. LIFE & DISABILITY PLAN 1998 401k membership
Total participants, beginning-of-year1998-01-01133
Total number of active participants reported on line 7a of the Form 55001998-01-01127
Number of retired or separated participants receiving benefits1998-01-010
Number of other retired or separated participants entitled to future benefits1998-01-010
Total of all active and inactive participants1998-01-01127
1997: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. LIFE & DISABILITY PLAN 1997 401k membership
Total participants, beginning-of-year1997-01-01104
Total number of active participants reported on line 7a of the Form 55001997-01-01133
Number of retired or separated participants receiving benefits1997-01-010
Number of other retired or separated participants entitled to future benefits1997-01-010
Total of all active and inactive participants1997-01-01133
1996: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. LIFE & DISABILITY PLAN 1996 401k membership
Total participants, beginning-of-year1996-01-01104
Total number of active participants reported on line 7a of the Form 55001996-01-01104
Number of retired or separated participants receiving benefits1996-01-010
Number of other retired or separated participants entitled to future benefits1996-01-010
Total of all active and inactive participants1996-01-01104
1995: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. LIFE & DISABILITY PLAN 1995 401k membership
Total participants, beginning-of-year1995-01-01104
Total number of active participants reported on line 7a of the Form 55001995-01-01104
Number of retired or separated participants receiving benefits1995-01-010
Number of other retired or separated participants entitled to future benefits1995-01-010
Total of all active and inactive participants1995-01-01104
1994: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. LIFE & DISABILITY PLAN 1994 401k membership
Total participants, beginning-of-year1994-01-01104
Total number of active participants reported on line 7a of the Form 55001994-01-01104
Number of retired or separated participants receiving benefits1994-01-010
Number of other retired or separated participants entitled to future benefits1994-01-010
Total of all active and inactive participants1994-01-01104
1993: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. LIFE & DISABILITY PLAN 1993 401k membership
Total participants, beginning-of-year1993-01-01104
Total number of active participants reported on line 7a of the Form 55001993-01-01104
Number of retired or separated participants receiving benefits1993-01-010
Number of other retired or separated participants entitled to future benefits1993-01-010
Total of all active and inactive participants1993-01-01104
1992: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. LIFE & DISABILITY PLAN 1992 401k membership
Total participants, beginning-of-year1992-01-01104
Total number of active participants reported on line 7a of the Form 55001992-01-01104
Number of retired or separated participants receiving benefits1992-01-010
Number of other retired or separated participants entitled to future benefits1992-01-010
Total of all active and inactive participants1992-01-01104
1991: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. LIFE & DISABILITY PLAN 1991 401k membership
Total participants, beginning-of-year1991-01-01104
Total number of active participants reported on line 7a of the Form 55001991-01-01104
Number of retired or separated participants receiving benefits1991-01-010
Number of other retired or separated participants entitled to future benefits1991-01-010
Total of all active and inactive participants1991-01-01104
1990: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. LIFE & DISABILITY PLAN 1990 401k membership
Total participants, beginning-of-year1990-01-01104
Total number of active participants reported on line 7a of the Form 55001990-01-01104
Number of retired or separated participants receiving benefits1990-01-010
Number of other retired or separated participants entitled to future benefits1990-01-010
Total of all active and inactive participants1990-01-01104
1989: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. LIFE & DISABILITY PLAN 1989 401k membership
Total participants, beginning-of-year1989-01-01104
Total number of active participants reported on line 7a of the Form 55001989-01-01104
Number of retired or separated participants receiving benefits1989-01-010
Number of other retired or separated participants entitled to future benefits1989-01-010
Total of all active and inactive participants1989-01-01104
1988: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. LIFE & DISABILITY PLAN 1988 401k membership
Total participants, beginning-of-year1988-01-01104
Total number of active participants reported on line 7a of the Form 55001988-01-01104
Number of retired or separated participants receiving benefits1988-01-010
Number of other retired or separated participants entitled to future benefits1988-01-010
Total of all active and inactive participants1988-01-01104

Form 5500 Responses for HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. LIFE & DISABILITY PLAN

2018: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. LIFE & 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 filingYes
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: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. LIFE & 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: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. LIFE & 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: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. LIFE & 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: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. LIFE & 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: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. LIFE & 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: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. LIFE & 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: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. LIFE & 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
2010: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. LIFE & DISABILITY 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: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. LIFE & 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: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. LIFE & 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: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. LIFE & 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: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. LIFE & 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: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. LIFE & 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: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. LIFE & 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: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. LIFE & 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: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. LIFE & 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: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. LIFE & DISABILITY 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: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. LIFE & DISABILITY 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: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. LIFE & DISABILITY 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: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. LIFE & DISABILITY 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: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. LIFE & DISABILITY PLAN 1997 form 5500 responses
1997-01-01Type of plan entitySingle employer plan
1997-01-01Submission has been amendedNo
1997-01-01This submission is the final filingNo
1997-01-01This return/report is a short plan year return/report (less than 12 months)No
1997-01-01Plan is a collectively bargained planNo
1997-01-01Plan funding arrangement – InsuranceYes
1997-01-01Plan benefit arrangement – InsuranceYes
1996: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. LIFE & DISABILITY PLAN 1996 form 5500 responses
1996-01-01Type of plan entitySingle employer plan
1996-01-01Submission has been amendedNo
1996-01-01This submission is the final filingNo
1996-01-01This return/report is a short plan year return/report (less than 12 months)No
1996-01-01Plan is a collectively bargained planNo
1996-01-01Plan funding arrangement – InsuranceYes
1996-01-01Plan benefit arrangement – InsuranceYes
1995: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. LIFE & DISABILITY PLAN 1995 form 5500 responses
1995-01-01Type of plan entitySingle employer plan
1995-01-01Submission has been amendedNo
1995-01-01This submission is the final filingNo
1995-01-01This return/report is a short plan year return/report (less than 12 months)No
1995-01-01Plan is a collectively bargained planNo
1995-01-01Plan funding arrangement – InsuranceYes
1995-01-01Plan benefit arrangement – InsuranceYes
1994: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. LIFE & DISABILITY PLAN 1994 form 5500 responses
1994-01-01Type of plan entitySingle employer plan
1994-01-01Submission has been amendedNo
1994-01-01This submission is the final filingNo
1994-01-01This return/report is a short plan year return/report (less than 12 months)No
1994-01-01Plan is a collectively bargained planNo
1994-01-01Plan funding arrangement – InsuranceYes
1994-01-01Plan benefit arrangement – InsuranceYes
1993: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. LIFE & DISABILITY PLAN 1993 form 5500 responses
1993-01-01Type of plan entitySingle employer plan
1993-01-01Submission has been amendedNo
1993-01-01This submission is the final filingNo
1993-01-01This return/report is a short plan year return/report (less than 12 months)No
1993-01-01Plan is a collectively bargained planNo
1993-01-01Plan funding arrangement – InsuranceYes
1993-01-01Plan benefit arrangement – InsuranceYes
1992: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. LIFE & DISABILITY PLAN 1992 form 5500 responses
1992-01-01Type of plan entitySingle employer plan
1992-01-01Submission has been amendedNo
1992-01-01This submission is the final filingNo
1992-01-01This return/report is a short plan year return/report (less than 12 months)No
1992-01-01Plan is a collectively bargained planNo
1992-01-01Plan funding arrangement – InsuranceYes
1992-01-01Plan benefit arrangement – InsuranceYes
1991: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. LIFE & DISABILITY PLAN 1991 form 5500 responses
1991-01-01Type of plan entitySingle employer plan
1991-01-01Submission has been amendedNo
1991-01-01This submission is the final filingNo
1991-01-01This return/report is a short plan year return/report (less than 12 months)No
1991-01-01Plan is a collectively bargained planNo
1991-01-01Plan funding arrangement – InsuranceYes
1991-01-01Plan benefit arrangement – InsuranceYes
1990: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. LIFE & DISABILITY PLAN 1990 form 5500 responses
1990-01-01Type of plan entitySingle employer plan
1990-01-01Submission has been amendedNo
1990-01-01This submission is the final filingNo
1990-01-01This return/report is a short plan year return/report (less than 12 months)No
1990-01-01Plan is a collectively bargained planNo
1990-01-01Plan funding arrangement – InsuranceYes
1990-01-01Plan benefit arrangement – InsuranceYes
1989: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. LIFE & DISABILITY PLAN 1989 form 5500 responses
1989-01-01Type of plan entitySingle employer plan
1989-01-01Submission has been amendedNo
1989-01-01This submission is the final filingNo
1989-01-01This return/report is a short plan year return/report (less than 12 months)No
1989-01-01Plan is a collectively bargained planNo
1989-01-01Plan funding arrangement – InsuranceYes
1989-01-01Plan benefit arrangement – InsuranceYes
1988: HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. LIFE & DISABILITY PLAN 1988 form 5500 responses
1988-01-01Type of plan entitySingle employer plan
1988-01-01First time form 5500 has been submittedYes
1988-01-01Submission has been amendedNo
1988-01-01This submission is the final filingNo
1988-01-01This return/report is a short plan year return/report (less than 12 months)No
1988-01-01Plan is a collectively bargained planNo
1988-01-01Plan funding arrangement – InsuranceYes
1988-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberF014545
Policy instance 1
Insurance contract or identification numberF014545
Number of Individuals Covered321
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $19,911
Total amount of fees paid to insurance companyUSD $5,670
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 BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
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 $132,649
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $19,911
Amount paid for insurance broker fees5670
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
Insurance broker nameDIMOND BROS INSURANCE LLC
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberTM05997054
Policy instance 1
Insurance contract or identification numberTM05997054
Number of Individuals Covered651
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $11,661
Total amount of fees paid to insurance companyUSD $0
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 BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
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 $90,495
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,661
Insurance broker organization code?3
Insurance broker nameLARRY DYKES
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberN71909
Policy instance 3
Insurance contract or identification numberN71909
Number of Individuals Covered351
Insurance policy start date2012-12-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $427
Total amount of fees paid to insurance companyUSD $0
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 BenefitYes
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 $4,271
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $427
Insurance broker organization code?3
Insurance broker nameLARRY W DYKES
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberF149633
Policy instance 2
Insurance contract or identification numberF149633
Number of Individuals Covered142
Insurance policy start date2011-08-01
Insurance policy end date2012-07-31
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 BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
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 $3,533
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberN71909
Policy instance 1
Insurance contract or identification numberN71909
Number of Individuals Covered357
Insurance policy start date2011-12-01
Insurance policy end date2012-11-30
Total amount of commissions paid to insurance brokerUSD $2,456
Total amount of fees paid to insurance companyUSD $0
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 BenefitYes
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 $50,357
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,074
Insurance broker organization code?3
Insurance broker nameLARRY W DYKES
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberN71909
Policy instance 1
Insurance contract or identification numberN71909
Number of Individuals Covered154
Insurance policy start date2010-12-01
Insurance policy end date2011-11-30
Total amount of commissions paid to insurance brokerUSD $2,348
Total amount of fees paid to insurance companyUSD $0
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 BenefitYes
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 $46,595
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,348
Insurance broker organization code?3
Insurance broker nameDIMOND BROS INS AGENCY INC
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberF149633
Policy instance 2
Insurance contract or identification numberF149633
Number of Individuals Covered131
Insurance policy start date2010-08-01
Insurance policy end date2011-07-31
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 BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
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 $3,420
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberN71909
Policy instance 1
Insurance contract or identification numberN71909
Number of Individuals Covered155
Insurance policy start date2009-12-01
Insurance policy end date2010-11-30
Total amount of commissions paid to insurance brokerUSD $2,325
Total amount of fees paid to insurance companyUSD $924
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 BenefitYes
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 $45,850
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,325
Amount paid for insurance broker fees924
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameDIMOND BROS INS AGENCY INC
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberN71909
Policy instance 1
Insurance contract or identification numberN71909
Number of Individuals Covered156
Insurance policy start date2008-12-01
Insurance policy end date2009-11-30
Total amount of commissions paid to insurance brokerUSD $2,334
Total amount of fees paid to insurance companyUSD $0
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 BenefitYes
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 $46,128
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,334
Insurance broker organization code?3
Insurance broker nameDIMOND BROS INS AGENCY INC
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberN71909
Policy instance 1
Insurance contract or identification numberN71909
Number of Individuals Covered159
Insurance policy start date2007-12-01
Insurance policy end date2008-11-30
Total amount of commissions paid to insurance brokerUSD $2,312
Total amount of fees paid to insurance companyUSD $0
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 BenefitYes
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 $45,406
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,312
Insurance broker organization code?3
Insurance broker nameDIMOND BROS INS AGENCY INC
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberN71909
Policy instance 1
Insurance contract or identification numberN71909
Number of Individuals Covered154
Insurance policy start date2006-12-01
Insurance policy end date2007-11-30
Total amount of commissions paid to insurance brokerUSD $2,243
Total amount of fees paid to insurance companyUSD $0
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 BenefitYes
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 $43,100
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,243
Insurance broker organization code?3
Insurance broker nameDIMOND BROS INS AGENCY INC
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberN71909
Policy instance 1
Insurance contract or identification numberN71909
Number of Individuals Covered140
Insurance policy start date2005-12-01
Insurance policy end date2006-11-30
Total amount of commissions paid to insurance brokerUSD $2,123
Total amount of fees paid to insurance companyUSD $0
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 BenefitYes
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 $39,160
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,284
Insurance broker organization code?3
Insurance broker nameDIMOND BROS AGENCY INC
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberN71909
Policy instance 1
Insurance contract or identification numberN71909
Number of Individuals Covered134
Insurance policy start date2004-12-01
Insurance policy end date2005-11-30
Total amount of commissions paid to insurance brokerUSD $2,059
Total amount of fees paid to insurance companyUSD $0
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 BenefitYes
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 $36,884
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,663
Insurance broker organization code?3
Insurance broker nameDIMOND BROS AGENCY INC
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberN71909
Policy instance 1
Insurance contract or identification numberN71909
Number of Individuals Covered127
Insurance policy start date2003-12-01
Insurance policy end date2004-11-30
Total amount of commissions paid to insurance brokerUSD $1,999
Total amount of fees paid to insurance companyUSD $0
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 BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
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 $34,958
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,999
Insurance broker organization code?3
Insurance broker nameFIRST ALLIANCE FINANCIAL GROUP INC
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberN71909
Policy instance 1
Insurance contract or identification numberN71909
Number of Individuals Covered127
Insurance policy start date2002-12-01
Insurance policy end date2003-11-30
Total amount of commissions paid to insurance brokerUSD $1,936
Total amount of fees paid to insurance companyUSD $0
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 BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
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 $32,872
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,936
Insurance broker organization code?3
Insurance broker nameFIRST ALLIANCE FINANCIAL GROUP INC
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberN71909
Policy instance 1
Insurance contract or identification numberN71909
Number of Individuals Covered109
Insurance policy start date2001-12-01
Insurance policy end date2002-11-30
Total amount of commissions paid to insurance brokerUSD $1,815
Total amount of fees paid to insurance companyUSD $0
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 BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
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 $28,828
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,815
Insurance broker organization code?3
Insurance broker nameFIRST ALLIANCE FINANCIAL GROUP INC
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberN71909
Policy instance 1
Insurance contract or identification numberN71909
Number of Individuals Covered98
Insurance policy start date2000-12-01
Insurance policy end date2001-11-30
Total amount of commissions paid to insurance brokerUSD $1,730
Total amount of fees paid to insurance companyUSD $0
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 BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
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 $26,028
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,730
Insurance broker organization code?3
Insurance broker nameFIRST ALLIANCE FINANCIAL GROUP INC
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberN71909
Policy instance 1
Insurance contract or identification numberN71909
Number of Individuals Covered97
Insurance policy start date1999-12-01
Insurance policy end date2000-11-30
Total amount of commissions paid to insurance brokerUSD $1,689
Total amount of fees paid to insurance companyUSD $0
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 BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
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 $22,672
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,689
Insurance broker organization code?3
Insurance broker nameFIRST ALLIANCE FINANCIAL GROUP INC
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberN71909
Policy instance 1
Insurance contract or identification numberN71909
Number of Individuals Covered120
Insurance policy start date1998-12-01
Insurance policy end date1999-11-30
Total amount of commissions paid to insurance brokerUSD $1,780
Total amount of fees paid to insurance companyUSD $0
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 BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
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 $27,546
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,780
Insurance broker organization code?3
Insurance broker nameFIRST ALLIANCE FINANCIAL GROUP INC
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberN71909
Policy instance 1
Insurance contract or identification numberN71909
Number of Individuals Covered127
Insurance policy start date1997-12-01
Insurance policy end date1998-11-30
Total amount of commissions paid to insurance brokerUSD $1,821
Total amount of fees paid to insurance companyUSD $0
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 BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
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 $31,303
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,821
Insurance broker organization code?3
Insurance broker nameFIRST ALLIANCE FINANCIAL GROUP INC
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberN71909
Policy instance 1
Insurance contract or identification numberN71909
Number of Individuals Covered133
Insurance policy start date1996-12-01
Insurance policy end date1997-11-30
Total amount of commissions paid to insurance brokerUSD $1,815
Total amount of fees paid to insurance companyUSD $0
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 BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
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 $28,824
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,815
Insurance broker organization code?3
Insurance broker nameFIRST ALLIANCE FINANCIAL GROUP INC
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberN71909
Policy instance 1
Insurance contract or identification numberN71909
Number of Individuals Covered104
Insurance policy start date1995-12-01
Insurance policy end date1996-11-30
Total amount of commissions paid to insurance brokerUSD $1,770
Total amount of fees paid to insurance companyUSD $0
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 BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
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 $27,328
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,770
Insurance broker organization code?3
Insurance broker nameFIRST ALLIANCE FINANCIAL GROUP INC

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