FOOD INGREDIENTS TECHNOLOGY CO., LLC has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan FOOD INGREDIENTS TECHNOLOGY COMPANY, LLC GROUP HEALTH INSURANCE PLAN
401k plan membership statisitcs for FOOD INGREDIENTS TECHNOLOGY COMPANY, LLC GROUP HEALTH INSURANCE PLAN
| Measure | Date | Value |
|---|
| 2022: FOOD INGREDIENTS TECHNOLOGY COMPANY, LLC GROUP HEALTH INSURANCE PLAN 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-01-01 | 106 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 123 |
| Total of all active and inactive participants | 2022-01-01 | 123 |
| Total participants | 2022-01-01 | 123 |
| 2021: FOOD INGREDIENTS TECHNOLOGY COMPANY, LLC GROUP HEALTH INSURANCE PLAN 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-01-01 | 104 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 106 |
| Total of all active and inactive participants | 2021-01-01 | 106 |
| Total participants | 2021-01-01 | 106 |
| 2020: FOOD INGREDIENTS TECHNOLOGY COMPANY, LLC GROUP HEALTH INSURANCE PLAN 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-11-01 | 109 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-11-01 | 104 |
| Total of all active and inactive participants | 2020-11-01 | 104 |
| Total participants | 2020-11-01 | 104 |
| 2019: FOOD INGREDIENTS TECHNOLOGY COMPANY, LLC GROUP HEALTH INSURANCE PLAN 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-11-01 | 105 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-11-01 | 109 |
| Number of retired or separated participants receiving benefits | 2019-11-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2019-11-01 | 0 |
| Total of all active and inactive participants | 2019-11-01 | 109 |
| 2018: FOOD INGREDIENTS TECHNOLOGY COMPANY, LLC GROUP HEALTH INSURANCE PLAN 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-11-01 | 96 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-11-01 | 105 |
| Number of retired or separated participants receiving benefits | 2018-11-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2018-11-01 | 0 |
| Total of all active and inactive participants | 2018-11-01 | 105 |
| 2017: FOOD INGREDIENTS TECHNOLOGY COMPANY, LLC GROUP HEALTH INSURANCE PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-11-01 | 98 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-11-01 | 96 |
| Number of retired or separated participants receiving benefits | 2017-11-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2017-11-01 | 0 |
| Total of all active and inactive participants | 2017-11-01 | 96 |
| 2016: FOOD INGREDIENTS TECHNOLOGY COMPANY, LLC GROUP HEALTH INSURANCE PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-11-01 | 103 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-11-01 | 98 |
| Number of retired or separated participants receiving benefits | 2016-11-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2016-11-01 | 0 |
| Total of all active and inactive participants | 2016-11-01 | 98 |
| 2015: FOOD INGREDIENTS TECHNOLOGY COMPANY, LLC GROUP HEALTH INSURANCE PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-11-01 | 102 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-11-01 | 103 |
| Number of retired or separated participants receiving benefits | 2015-11-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2015-11-01 | 0 |
| Total of all active and inactive participants | 2015-11-01 | 103 |
| 2014: FOOD INGREDIENTS TECHNOLOGY COMPANY, LLC GROUP HEALTH INSURANCE PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-11-01 | 97 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-11-01 | 102 |
| Number of retired or separated participants receiving benefits | 2014-11-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2014-11-01 | 0 |
| Total of all active and inactive participants | 2014-11-01 | 102 |
| 2013: FOOD INGREDIENTS TECHNOLOGY COMPANY, LLC GROUP HEALTH INSURANCE PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-11-01 | 95 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-11-01 | 97 |
| Total of all active and inactive participants | 2013-11-01 | 97 |
| 2012: FOOD INGREDIENTS TECHNOLOGY COMPANY, LLC GROUP HEALTH INSURANCE PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-11-01 | 104 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-11-01 | 95 |
| Total of all active and inactive participants | 2012-11-01 | 95 |
| 2011: FOOD INGREDIENTS TECHNOLOGY COMPANY, LLC GROUP HEALTH INSURANCE PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-11-01 | 109 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-11-01 | 104 |
| Total of all active and inactive participants | 2011-11-01 | 104 |
| 2009: FOOD INGREDIENTS TECHNOLOGY COMPANY, LLC GROUP HEALTH INSURANCE PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-11-01 | 110 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-11-01 | 101 |
| Total of all active and inactive participants | 2009-11-01 | 101 |
| 2022: FOOD INGREDIENTS TECHNOLOGY COMPANY, LLC GROUP HEALTH INSURANCE PLAN 2022 form 5500 responses |
|---|
| 2022-01-01 | Type of plan entity | Single employer plan |
| 2022-01-01 | Plan funding arrangement – Insurance | Yes |
| 2022-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2021: FOOD INGREDIENTS TECHNOLOGY COMPANY, LLC GROUP HEALTH INSURANCE PLAN 2021 form 5500 responses |
|---|
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | Plan funding arrangement – Insurance | Yes |
| 2021-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2020: FOOD INGREDIENTS TECHNOLOGY COMPANY, LLC GROUP HEALTH INSURANCE PLAN 2020 form 5500 responses |
|---|
| 2020-11-01 | Type of plan entity | Single employer plan |
| 2020-11-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2020-11-01 | Plan funding arrangement – Insurance | Yes |
| 2020-11-01 | Plan benefit arrangement – Insurance | Yes |
| 2019: FOOD INGREDIENTS TECHNOLOGY COMPANY, LLC GROUP HEALTH INSURANCE PLAN 2019 form 5500 responses |
|---|
| 2019-11-01 | Type of plan entity | Single employer plan |
| 2019-11-01 | Plan funding arrangement – Insurance | Yes |
| 2019-11-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: FOOD INGREDIENTS TECHNOLOGY COMPANY, LLC GROUP HEALTH INSURANCE PLAN 2018 form 5500 responses |
|---|
| 2018-11-01 | Type of plan entity | Single employer plan |
| 2018-11-01 | Plan funding arrangement – Insurance | Yes |
| 2018-11-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: FOOD INGREDIENTS TECHNOLOGY COMPANY, LLC GROUP HEALTH INSURANCE PLAN 2017 form 5500 responses |
|---|
| 2017-11-01 | Type of plan entity | Single employer plan |
| 2017-11-01 | Plan funding arrangement – Insurance | Yes |
| 2017-11-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: FOOD INGREDIENTS TECHNOLOGY COMPANY, LLC GROUP HEALTH INSURANCE PLAN 2016 form 5500 responses |
|---|
| 2016-11-01 | Type of plan entity | Single employer plan |
| 2016-11-01 | Plan funding arrangement – Insurance | Yes |
| 2016-11-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: FOOD INGREDIENTS TECHNOLOGY COMPANY, LLC GROUP HEALTH INSURANCE PLAN 2015 form 5500 responses |
|---|
| 2015-11-01 | Type of plan entity | Single employer plan |
| 2015-11-01 | Plan funding arrangement – Insurance | Yes |
| 2015-11-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: FOOD INGREDIENTS TECHNOLOGY COMPANY, LLC GROUP HEALTH INSURANCE PLAN 2014 form 5500 responses |
|---|
| 2014-11-01 | Type of plan entity | Single employer plan |
| 2014-11-01 | Plan funding arrangement – Insurance | Yes |
| 2014-11-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: FOOD INGREDIENTS TECHNOLOGY COMPANY, LLC GROUP HEALTH INSURANCE PLAN 2013 form 5500 responses |
|---|
| 2013-11-01 | Type of plan entity | Single employer plan |
| 2013-11-01 | Plan funding arrangement – Insurance | Yes |
| 2013-11-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: FOOD INGREDIENTS TECHNOLOGY COMPANY, LLC GROUP HEALTH INSURANCE PLAN 2012 form 5500 responses |
|---|
| 2012-11-01 | Type of plan entity | Single employer plan |
| 2012-11-01 | Plan funding arrangement – Insurance | Yes |
| 2012-11-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: FOOD INGREDIENTS TECHNOLOGY COMPANY, LLC GROUP HEALTH INSURANCE PLAN 2011 form 5500 responses |
|---|
| 2011-11-01 | Type of plan entity | Single employer plan |
| 2011-11-01 | Plan funding arrangement – Insurance | Yes |
| 2011-11-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: FOOD INGREDIENTS TECHNOLOGY COMPANY, LLC GROUP HEALTH INSURANCE PLAN 2009 form 5500 responses |
|---|
| 2009-11-01 | Type of plan entity | Single employer plan |
| 2009-11-01 | This submission is the final filing | No |
| 2009-11-01 | Plan funding arrangement – Insurance | Yes |
| 2009-11-01 | Plan benefit arrangement – Insurance | Yes |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 44633-Y |
| Policy instance | 5 |
| Insurance contract or identification number | 44633-Y | | Number of Individuals Covered | 38 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Other welfare benefits provided | PAID LEAVE | | Welfare Benefit Premiums Paid to Carrier | USD $13,857 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 44633-3 |
| Policy instance | 4 |
| Insurance contract or identification number | 44633-3 | | Number of Individuals Covered | 1611 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $157,867 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $915,753 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $14,318 | | Additional information about fees paid to insurance broker | SUPPLEMENTAL COMMISSIONS | | Insurance broker organization code? | 3 |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 44633-2 |
| Policy instance | 3 |
| Insurance contract or identification number | 44633-2 | | Number of Individuals Covered | 1147 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $414,249 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) |
| Policy contract number | 44633-1 |
| Policy instance | 2 |
| Insurance contract or identification number | 44633-1 | | Number of Individuals Covered | 1636 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Life Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUE CROSS BLUE SHIELD OF ALABAMA (National Association of Insurance Commissioners NAIC id number: 55433 ) |
| Policy contract number | 0044569 |
| Policy instance | 1 |
| Insurance contract or identification number | 0044569 | | Number of Individuals Covered | 190 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Other welfare benefits provided | BABY, AIRMED | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | LK-0751802 |
| Policy instance | 2 |
| Insurance contract or identification number | LK-0751802 | | Number of Individuals Covered | 103 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Other welfare benefits provided | SHORT TERM DISABILITY | | Welfare Benefit Premiums Paid to Carrier | USD $40,232 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | OK 968176 |
| Policy instance | 3 |
| Insurance contract or identification number | OK 968176 | | Number of Individuals Covered | 173 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Other welfare benefits provided | BASIC & VOLUNTARY AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $5,293 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | FLX-0966655 |
| Policy instance | 4 |
| Insurance contract or identification number | FLX-0966655 | | Number of Individuals Covered | 182 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $50,258 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | LK-0964575 |
| Policy instance | 5 |
| Insurance contract or identification number | LK-0964575 | | Number of Individuals Covered | 20 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $3,094 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUE CROSS BLUE SHIELD OF ALABAMA (National Association of Insurance Commissioners NAIC id number: 55433 ) |
| Policy contract number | 0044569 |
| Policy instance | 1 |
| Insurance contract or identification number | 0044569 | | Number of Individuals Covered | 193 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Other welfare benefits provided | BABY, AIRMED | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUE CROSS BLUE SHIELD OF ALABAMA (National Association of Insurance Commissioners NAIC id number: 55433 ) |
| Policy contract number | 44569 |
| Policy instance | 1 |
| Insurance contract or identification number | 44569 | | Number of Individuals Covered | 189 | | Insurance policy start date | 2020-11-01 | | Insurance policy end date | 2020-12-31 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Other welfare benefits provided | BABY, AIRMED | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | LK964575 |
| Policy instance | 5 |
| Insurance contract or identification number | LK964575 | | Number of Individuals Covered | 109 | | Insurance policy start date | 2020-11-01 | | Insurance policy end date | 2020-12-31 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $516 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | FLX966655 |
| Policy instance | 4 |
| Insurance contract or identification number | FLX966655 | | Number of Individuals Covered | 109 | | Insurance policy start date | 2020-11-01 | | Insurance policy end date | 2020-12-31 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $8,376 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | OK 968176 |
| Policy instance | 3 |
| Insurance contract or identification number | OK 968176 | | Number of Individuals Covered | 109 | | Insurance policy start date | 2020-11-01 | | Insurance policy end date | 2020-12-31 | | Other welfare benefits provided | ACCIDENTAL DEATH | | Welfare Benefit Premiums Paid to Carrier | USD $882 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | LK 751802 |
| Policy instance | 2 |
| Insurance contract or identification number | LK 751802 | | Number of Individuals Covered | 109 | | Insurance policy start date | 2020-11-01 | | Insurance policy end date | 2020-12-31 | | Other welfare benefits provided | SHORT TERM DISABILITY | | Welfare Benefit Premiums Paid to Carrier | USD $6,705 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUE CROSS BLUE SHIELD OF ALABAMA (National Association of Insurance Commissioners NAIC id number: 55433 ) |
| Policy contract number | 44569 |
| Policy instance | 1 |
| Insurance contract or identification number | 44569 | | Number of Individuals Covered | 109 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Other welfare benefits provided | BABY, AIRMED | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | OK 968176 |
| Policy instance | 3 |
| Insurance contract or identification number | OK 968176 | | Number of Individuals Covered | 109 | | Insurance policy start date | 2019-04-01 | | Insurance policy end date | 2020-01-01 | | Other welfare benefits provided | ACCIDENTAL DEATH | | Welfare Benefit Premiums Paid to Carrier | USD $4,977 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Additional information about fees paid to insurance broker | ADMIN FEES | | Insurance broker organization code? | 5 |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | LK 751802 |
| Policy instance | 2 |
| Insurance contract or identification number | LK 751802 | | Number of Individuals Covered | 109 | | Insurance policy start date | 2019-04-01 | | Insurance policy end date | 2020-01-01 | | Other welfare benefits provided | SHORT TERM DISABILITY | | Welfare Benefit Premiums Paid to Carrier | USD $30,744 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Additional information about fees paid to insurance broker | ADMIN FEES | | Insurance broker organization code? | 5 |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | FLX966655 |
| Policy instance | 4 |
| Insurance contract or identification number | FLX966655 | | Number of Individuals Covered | 109 | | Insurance policy start date | 2019-04-01 | | Insurance policy end date | 2020-01-01 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $36,557 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Additional information about fees paid to insurance broker | ADMIN FEES | | Insurance broker organization code? | 5 |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | LK 964575 |
| Policy instance | 5 |
| Insurance contract or identification number | LK 964575 | | Number of Individuals Covered | 109 | | Insurance policy start date | 2019-04-01 | | Insurance policy end date | 2020-01-01 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $4,604 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Additional information about fees paid to insurance broker | ADMIN FEES | | Insurance broker organization code? | 5 |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | FLX966655 |
| Policy instance | 4 |
| Insurance contract or identification number | FLX966655 | | Number of Individuals Covered | 105 | | Insurance policy start date | 2018-04-01 | | Insurance policy end date | 2019-04-01 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $37,700 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Additional information about fees paid to insurance broker | ADMIN FEES | | Insurance broker organization code? | 5 |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | LK 964575 |
| Policy instance | 5 |
| Insurance contract or identification number | LK 964575 | | Number of Individuals Covered | 105 | | Insurance policy start date | 2018-04-01 | | Insurance policy end date | 2019-04-01 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $5,119 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Additional information about fees paid to insurance broker | ADMIN FEES | | Insurance broker organization code? | 5 |
|
| BLUE CROSS BLUE SHIELD OF ALABAMA (National Association of Insurance Commissioners NAIC id number: 55433 ) |
| Policy contract number | 44569 |
| Policy instance | 1 |
| Insurance contract or identification number | 44569 | | Number of Individuals Covered | 105 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Other welfare benefits provided | BABY, AIRMED | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | LK 751802 |
| Policy instance | 2 |
| Insurance contract or identification number | LK 751802 | | Number of Individuals Covered | 105 | | Insurance policy start date | 2018-04-01 | | Insurance policy end date | 2019-04-01 | | Other welfare benefits provided | SHORT TERM DISABILITY | | Welfare Benefit Premiums Paid to Carrier | USD $34,215 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Additional information about fees paid to insurance broker | ADMIN FEES | | Insurance broker organization code? | 5 |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | OK 968176 |
| Policy instance | 3 |
| Insurance contract or identification number | OK 968176 | | Number of Individuals Covered | 105 | | Insurance policy start date | 2018-04-01 | | Insurance policy end date | 2019-04-01 | | Other welfare benefits provided | ACCIDENTAL DEATH | | Welfare Benefit Premiums Paid to Carrier | USD $5,343 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Additional information about fees paid to insurance broker | ADMIN FEES | | Insurance broker organization code? | 5 |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | LK 964575 |
| Policy instance | 5 |
| Insurance contract or identification number | LK 964575 | | Number of Individuals Covered | 96 | | Insurance policy start date | 2017-04-01 | | Insurance policy end date | 2018-04-01 | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $3,008 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | FLX966655 |
| Policy instance | 4 |
| Insurance contract or identification number | FLX966655 | | Number of Individuals Covered | 96 | | Insurance policy start date | 2017-04-01 | | Insurance policy end date | 2018-04-01 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $21,773 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | OK 968176 |
| Policy instance | 3 |
| Insurance contract or identification number | OK 968176 | | Number of Individuals Covered | 96 | | Insurance policy start date | 2017-04-01 | | Insurance policy end date | 2018-04-01 | | Other welfare benefits provided | ACCIDENTAL DEATH | | Welfare Benefit Premiums Paid to Carrier | USD $3,138 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) |
| Policy contract number | LK 751802 |
| Policy instance | 2 |
| Insurance contract or identification number | LK 751802 | | Number of Individuals Covered | 96 | | Insurance policy start date | 2017-04-01 | | Insurance policy end date | 2018-04-01 | | Other welfare benefits provided | SHORT TERM DISABILITY | | Welfare Benefit Premiums Paid to Carrier | USD $18,618 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUE CROSS BLUE SHIELD OF ALABAMA (National Association of Insurance Commissioners NAIC id number: 55433 ) |
| Policy contract number | 44569 |
| Policy instance | 1 |
| Insurance contract or identification number | 44569 | | Number of Individuals Covered | 96 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Other welfare benefits provided | EPS, BABY, AIRMED | | Welfare Benefit Premiums Paid to Carrier | USD $9,875 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
