SOUTHERN BANK has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan SOUTHERN BANK EMPLOYEE LIFE & ANCILLARY BENEFIT PLAN
401k plan membership statisitcs for SOUTHERN BANK EMPLOYEE LIFE & ANCILLARY BENEFIT PLAN
Measure | Date | Value |
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2016: SOUTHERN BANK EMPLOYEE LIFE & ANCILLARY BENEFIT PLAN 2016 401k membership |
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Total participants, beginning-of-year | 2016-03-01 | 309 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-03-01 | 0 |
Number of retired or separated participants receiving benefits | 2016-03-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2016-03-01 | 0 |
Total of all active and inactive participants | 2016-03-01 | 0 |
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2016-03-01 | 0 |
Total participants | 2016-03-01 | 0 |
2015: SOUTHERN BANK EMPLOYEE LIFE & ANCILLARY BENEFIT PLAN 2015 401k membership |
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Total participants, beginning-of-year | 2015-03-01 | 293 |
Total number of active participants reported on line 7a of the Form 5500 | 2015-03-01 | 282 |
Total of all active and inactive participants | 2015-03-01 | 282 |
Total participants | 2015-03-01 | 282 |
2014: SOUTHERN BANK EMPLOYEE LIFE & ANCILLARY BENEFIT PLAN 2014 401k membership |
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Total participants, beginning-of-year | 2014-03-01 | 205 |
Total number of active participants reported on line 7a of the Form 5500 | 2014-03-01 | 295 |
Total of all active and inactive participants | 2014-03-01 | 295 |
Total participants | 2014-03-01 | 295 |
2013: SOUTHERN BANK EMPLOYEE LIFE & ANCILLARY BENEFIT PLAN 2013 401k membership |
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Total participants, beginning-of-year | 2013-03-01 | 175 |
Total number of active participants reported on line 7a of the Form 5500 | 2013-03-01 | 205 |
Total of all active and inactive participants | 2013-03-01 | 205 |
Total participants | 2013-03-01 | 205 |
2012: SOUTHERN BANK EMPLOYEE LIFE & ANCILLARY BENEFIT PLAN 2012 401k membership |
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Total participants, beginning-of-year | 2012-03-01 | 181 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-03-01 | 175 |
Total of all active and inactive participants | 2012-03-01 | 175 |
Total participants | 2012-03-01 | 175 |
2011: SOUTHERN BANK EMPLOYEE LIFE & ANCILLARY BENEFIT PLAN 2011 401k membership |
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Total participants, beginning-of-year | 2011-03-01 | 111 |
Total number of active participants reported on line 7a of the Form 5500 | 2011-03-01 | 181 |
Total of all active and inactive participants | 2011-03-01 | 181 |
Total participants | 2011-03-01 | 181 |
2010: SOUTHERN BANK EMPLOYEE LIFE & ANCILLARY BENEFIT PLAN 2010 401k membership |
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Total participants, beginning-of-year | 2010-09-01 | 78 |
Total number of active participants reported on line 7a of the Form 5500 | 2010-09-01 | 111 |
Total of all active and inactive participants | 2010-09-01 | 111 |
Total participants | 2010-09-01 | 111 |
2009: SOUTHERN BANK EMPLOYEE LIFE & ANCILLARY BENEFIT PLAN 2009 401k membership |
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Total participants, beginning-of-year | 2009-09-01 | 70 |
Total number of active participants reported on line 7a of the Form 5500 | 2009-09-01 | 78 |
Total of all active and inactive participants | 2009-09-01 | 78 |
Total participants | 2009-09-01 | 78 |
2016: SOUTHERN BANK EMPLOYEE LIFE & ANCILLARY BENEFIT PLAN 2016 form 5500 responses |
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2016-03-01 | Type of plan entity | Single employer plan |
2016-03-01 | Submission has been amended | No |
2016-03-01 | This submission is the final filing | Yes |
2016-03-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
2016-03-01 | Plan is a collectively bargained plan | No |
2016-03-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2016-03-01 | Plan benefit arrangement – Insurance | Yes |
2015: SOUTHERN BANK EMPLOYEE LIFE & ANCILLARY BENEFIT PLAN 2015 form 5500 responses |
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2015-03-01 | Type of plan entity | Single employer plan |
2015-03-01 | First time form 5500 has been submitted | Yes |
2015-03-01 | Submission has been amended | No |
2015-03-01 | This submission is the final filing | No |
2015-03-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2015-03-01 | Plan is a collectively bargained plan | No |
2015-03-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2015-03-01 | Plan benefit arrangement – Insurance | Yes |
2014: SOUTHERN BANK EMPLOYEE LIFE & ANCILLARY BENEFIT PLAN 2014 form 5500 responses |
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2014-03-01 | Type of plan entity | Single employer plan |
2014-03-01 | First time form 5500 has been submitted | Yes |
2014-03-01 | Submission has been amended | No |
2014-03-01 | This submission is the final filing | No |
2014-03-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2014-03-01 | Plan is a collectively bargained plan | No |
2014-03-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2014-03-01 | Plan benefit arrangement – Insurance | Yes |
2013: SOUTHERN BANK EMPLOYEE LIFE & ANCILLARY BENEFIT PLAN 2013 form 5500 responses |
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2013-03-01 | Type of plan entity | Single employer plan |
2013-03-01 | First time form 5500 has been submitted | Yes |
2013-03-01 | Submission has been amended | No |
2013-03-01 | This submission is the final filing | No |
2013-03-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2013-03-01 | Plan is a collectively bargained plan | No |
2013-03-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2013-03-01 | Plan benefit arrangement – Insurance | Yes |
2012: SOUTHERN BANK EMPLOYEE LIFE & ANCILLARY BENEFIT PLAN 2012 form 5500 responses |
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2012-03-01 | Type of plan entity | Single employer plan |
2012-03-01 | First time form 5500 has been submitted | Yes |
2012-03-01 | Submission has been amended | No |
2012-03-01 | This submission is the final filing | No |
2012-03-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2012-03-01 | Plan is a collectively bargained plan | No |
2012-03-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2012-03-01 | Plan benefit arrangement – Insurance | Yes |
2011: SOUTHERN BANK EMPLOYEE LIFE & ANCILLARY BENEFIT PLAN 2011 form 5500 responses |
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2011-03-01 | Type of plan entity | Single employer plan |
2011-03-01 | First time form 5500 has been submitted | Yes |
2011-03-01 | Submission has been amended | No |
2011-03-01 | This submission is the final filing | No |
2011-03-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2011-03-01 | Plan is a collectively bargained plan | No |
2011-03-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2011-03-01 | Plan benefit arrangement – Insurance | Yes |
2010: SOUTHERN BANK EMPLOYEE LIFE & ANCILLARY BENEFIT PLAN 2010 form 5500 responses |
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2010-09-01 | Type of plan entity | Single employer plan |
2010-09-01 | First time form 5500 has been submitted | Yes |
2010-09-01 | Submission has been amended | No |
2010-09-01 | This submission is the final filing | No |
2010-09-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
2010-09-01 | Plan is a collectively bargained plan | No |
2010-09-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2010-09-01 | Plan benefit arrangement – Insurance | Yes |
2009: SOUTHERN BANK EMPLOYEE LIFE & ANCILLARY BENEFIT PLAN 2009 form 5500 responses |
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2009-09-01 | Type of plan entity | Single employer plan |
2009-09-01 | Submission has been amended | No |
2009-09-01 | This submission is the final filing | No |
2009-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2009-09-01 | Plan is a collectively bargained plan | No |
2009-09-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2009-09-01 | Plan benefit arrangement – Insurance | Yes |
USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
Policy contract number | 50002882 |
Policy instance | 4 |
Insurance contract or identification number | 50002882 | Number of Individuals Covered | 43 | Insurance policy start date | 2015-03-01 | Insurance policy end date | 2016-02-29 | Total amount of commissions paid to insurance broker | USD $3,231 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $16,157 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,424 | Insurance broker organization code? | 3 | Additional information about fees paid to insurance broker | 3 | Insurance broker name | MARTIN MCCALL |
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USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
Policy contract number | 50002882 |
Policy instance | 3 |
Insurance contract or identification number | 50002882 | Number of Individuals Covered | 282 | Insurance policy start date | 2015-03-01 | Insurance policy end date | 2016-02-29 | Total amount of commissions paid to insurance broker | USD $9,575 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $47,874 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $7,181 | Insurance broker organization code? | 3 | Insurance broker name | MARTIN MCCALL |
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USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
Policy contract number | 50002882 |
Policy instance | 2 |
Insurance contract or identification number | 50002882 | Number of Individuals Covered | 186 | Insurance policy start date | 2015-03-01 | Insurance policy end date | 2016-02-29 | Total amount of commissions paid to insurance broker | USD $1,130 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | VOLUNTARY ACCIDENTAL DEATH & DISMEMBERMENT | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $5,648 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $847 | Insurance broker organization code? | 3 | Insurance broker name | MARTIN MCCALL |
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USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
Policy contract number | 50002882 |
Policy instance | 1 |
Insurance contract or identification number | 50002882 | Number of Individuals Covered | 272 | Insurance policy start date | 2015-03-01 | Insurance policy end date | 2016-02-29 | Total amount of commissions paid to insurance broker | USD $432 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $9,341 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $279 | Insurance broker organization code? | 3 | Insurance broker name | MARTIN MCCALL |
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USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
Policy contract number | 50002882 |
Policy instance | 4 |
Insurance contract or identification number | 50002882 | Number of Individuals Covered | 57 | Insurance policy start date | 2014-03-01 | Insurance policy end date | 2015-02-28 | Total amount of commissions paid to insurance broker | USD $2,262 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $11,307 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,696 | Insurance broker organization code? | 3 | Insurance broker name | MARTIN MCCALL |
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USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
Policy contract number | 50002882 |
Policy instance | 3 |
Insurance contract or identification number | 50002882 | Number of Individuals Covered | 293 | Insurance policy start date | 2014-03-01 | Insurance policy end date | 2015-02-28 | Total amount of commissions paid to insurance broker | USD $5,683 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $28,414 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,262 | Insurance broker organization code? | 3 | Insurance broker name | MARTIN MCCALL |
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USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
Policy contract number | 50002882 |
Policy instance | 2 |
Insurance contract or identification number | 50002882 | Number of Individuals Covered | 215 | Insurance policy start date | 2014-03-01 | Insurance policy end date | 2015-02-28 | Total amount of commissions paid to insurance broker | USD $838 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | VOLUNTARY ACCIDENTAL DEATH & DISMEMBERMENT | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $4,191 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $629 | Insurance broker organization code? | 3 | Insurance broker name | MARTIN MCCALL |
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USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
Policy contract number | 50002882 |
Policy instance | 1 |
Insurance contract or identification number | 50002882 | Number of Individuals Covered | 274 | Insurance policy start date | 2014-03-01 | Insurance policy end date | 2015-02-28 | Total amount of commissions paid to insurance broker | USD $282 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $5,533 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $177 | Insurance broker organization code? | 3 | Insurance broker name | MARTIN MCCALL |
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USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
Policy contract number | 50002882 |
Policy instance | 4 |
Insurance contract or identification number | 50002882 | Number of Individuals Covered | 34 | Insurance policy start date | 2013-03-01 | Insurance policy end date | 2014-02-28 | Total amount of commissions paid to insurance broker | USD $2,344 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $11,718 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,758 | Insurance broker organization code? | 3 | Insurance broker name | MARTIN MCCALL |
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USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
Policy contract number | 50002882 |
Policy instance | 3 |
Insurance contract or identification number | 50002882 | Number of Individuals Covered | 205 | Insurance policy start date | 2013-03-01 | Insurance policy end date | 2014-02-28 | Total amount of commissions paid to insurance broker | USD $5,864 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $29,318 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,398 | Insurance broker organization code? | 3 | Insurance broker name | MARTIN MCCALL |
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USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
Policy contract number | 50002882 |
Policy instance | 2 |
Insurance contract or identification number | 50002882 | Number of Individuals Covered | 187 | Insurance policy start date | 2013-03-01 | Insurance policy end date | 2014-02-28 | Total amount of commissions paid to insurance broker | USD $309 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $5,384 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $186 | Insurance broker organization code? | 3 | Insurance broker name | MARTIN MCCALL |
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USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
Policy contract number | 50002882 |
Policy instance | 1 |
Insurance contract or identification number | 50002882 | Number of Individuals Covered | 147 | Insurance policy start date | 2013-03-01 | Insurance policy end date | 2014-02-28 | Total amount of commissions paid to insurance broker | USD $664 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | VOLUNTARY ACCIDENTAL DEATH & DISMEMBERMENT | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $3,322 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $498 | Insurance broker organization code? | 3 | Insurance broker name | MARTIN MCCALL |
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USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
Policy contract number | 50002882 |
Policy instance | 2 |
Insurance contract or identification number | 50002882 | Number of Individuals Covered | 175 | Insurance policy start date | 2012-03-01 | Insurance policy end date | 2013-02-28 | Total amount of commissions paid to insurance broker | USD $4,786 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $23,929 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,589 | Insurance broker organization code? | 3 | Insurance broker name | MARTIN MCCALL |
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USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
Policy contract number | 50002882 |
Policy instance | 3 |
Insurance contract or identification number | 50002882 | Number of Individuals Covered | 121 | Insurance policy start date | 2012-03-01 | Insurance policy end date | 2013-02-28 | Total amount of commissions paid to insurance broker | USD $516 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | VOLUNTARY ACCIDENTAL DEATH/DISMEMBERMENT | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $2,578 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $387 | Insurance broker organization code? | 3 | Insurance broker name | MARTIN MCCALL |
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USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
Policy contract number | 50002882 |
Policy instance | 1 |
Insurance contract or identification number | 50002882 | Number of Individuals Covered | 32 | Insurance policy start date | 2012-03-01 | Insurance policy end date | 2013-02-28 | Total amount of commissions paid to insurance broker | USD $2,252 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $11,260 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,689 | Insurance broker organization code? | 3 | Insurance broker name | MARTIN MCCALL |
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USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) |
Policy contract number | 50002882 |
Policy instance | 1 |
Insurance contract or identification number | 50002882 | Number of Individuals Covered | 156 | Insurance policy start date | 2011-03-01 | Insurance policy end date | 2012-02-28 | Total amount of commissions paid to insurance broker | USD $79 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $4,398 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $57 | Insurance broker organization code? | 3 | Insurance broker name | MARTIN MCCALL |
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ARKANSAS BLUE CROSS BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 83470 ) |
Policy contract number | 27157 |
Policy instance | 3 |
Insurance contract or identification number | 27157 | Number of Individuals Covered | 15 | Insurance policy start date | 2011-03-01 | Insurance policy end date | 2012-02-28 | Total amount of commissions paid to insurance broker | USD $334 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $334 | Insurance broker organization code? | 3 | Insurance broker name | HEARTLAND GROUP INSURANCE AGENCY |
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ARKANSAS BLUE CROSS BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 83470 ) |
Policy contract number | 27159 |
Policy instance | 2 |
Insurance contract or identification number | 27159 | Number of Individuals Covered | 107 | Insurance policy start date | 2011-03-01 | Insurance policy end date | 2012-02-28 | Total amount of commissions paid to insurance broker | USD $2,103 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | Commission paid to Insurance Broker | USD $2,103 | Insurance broker organization code? | 3 | Insurance broker name | HEARTLAND GROUP INSURANCE AGENCY |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00351599 |
Policy instance | 1 |
Insurance contract or identification number | 00351599 | Number of Individuals Covered | 111 | Insurance policy start date | 2010-09-01 | Insurance policy end date | 2011-02-28 | Total amount of commissions paid to insurance broker | USD $1,307 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $10,507 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $1,289 | Insurance broker organization code? | 3 | Insurance broker name | DAVID BOYKIN LUTCF CLTC |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 00351599 |
Policy instance | 1 |
Insurance contract or identification number | 00351599 | Number of Individuals Covered | 78 | Insurance policy start date | 2009-09-01 | Insurance policy end date | 2010-08-31 | Total amount of commissions paid to insurance broker | USD $3,035 | Total amount of fees paid to insurance company | USD $699 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | Yes | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $24,925 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $2,975 | Amount paid for insurance broker fees | 699 | Additional information about fees paid to insurance broker | BONUS | Insurance broker organization code? | 3 | Insurance broker name | DAN R BREWER |
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