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CELLTRON, INC. 125 PLAN 401k Plan overview

Plan NameCELLTRON, INC. 125 PLAN
Plan identification number 502

CELLTRON, INC. 125 PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover

401k Sponsoring company profile

CELLTRON, INC. has sponsored the creation of one or more 401k plans.

Company Name:CELLTRON, INC.
Employer identification number (EIN):480947467
NAIC Classification:335900

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CELLTRON, INC. 125 PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022022-01-01
5022021-01-01TRISH CRANE2022-08-15
5022020-01-01STACEY WILLIAMS2021-07-08
5022019-01-01STACEY WILLIAMS2020-06-26
5022018-01-01
5022017-01-01
5022016-01-01
5022015-01-01STACEY WILLIAMS STACEY WILLIAMS2016-06-23
5022014-01-01STACEY WILLIAMS STACEY WILLIAMS2015-07-23
5022013-01-01STACEY WILLIAMS STACEY WILLIAMS2014-10-09
5022012-01-01STACEY WILLIAMS
5022011-01-01STACEY WILLIAMS
5022009-01-01STACEY WILLIAMS

Plan Statistics for CELLTRON, INC. 125 PLAN

401k plan membership statisitcs for CELLTRON, INC. 125 PLAN

Measure Date Value
2022: CELLTRON, INC. 125 PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01346
Total number of active participants reported on line 7a of the Form 55002022-01-01436
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-01436
Total participants2022-01-01436
2021: CELLTRON, INC. 125 PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01295
Total number of active participants reported on line 7a of the Form 55002021-01-01346
Total of all active and inactive participants2021-01-01346
2020: CELLTRON, INC. 125 PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01239
Total number of active participants reported on line 7a of the Form 55002020-01-01295
Total of all active and inactive participants2020-01-01295
2019: CELLTRON, INC. 125 PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01222
Total number of active participants reported on line 7a of the Form 55002019-01-01239
Total of all active and inactive participants2019-01-01239
2018: CELLTRON, INC. 125 PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01222
Total number of active participants reported on line 7a of the Form 55002018-01-01222
Total of all active and inactive participants2018-01-01222
2017: CELLTRON, INC. 125 PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01181
Total number of active participants reported on line 7a of the Form 55002017-01-01222
Total of all active and inactive participants2017-01-01222
2016: CELLTRON, INC. 125 PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01185
Total number of active participants reported on line 7a of the Form 55002016-01-01181
Total of all active and inactive participants2016-01-01181
2015: CELLTRON, INC. 125 PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01207
Total number of active participants reported on line 7a of the Form 55002015-01-01185
Total of all active and inactive participants2015-01-01185
2014: CELLTRON, INC. 125 PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01207
Total number of active participants reported on line 7a of the Form 55002014-01-01207
Total of all active and inactive participants2014-01-01207
2013: CELLTRON, INC. 125 PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01207
Total number of active participants reported on line 7a of the Form 55002013-01-01207
Total of all active and inactive participants2013-01-01207
2012: CELLTRON, INC. 125 PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01258
Total number of active participants reported on line 7a of the Form 55002012-01-01207
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 participants2012-01-01207
2011: CELLTRON, INC. 125 PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01297
Total number of active participants reported on line 7a of the Form 55002011-01-01258
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 participants2011-01-01258
2009: CELLTRON, INC. 125 PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01308
Total number of active participants reported on line 7a of the Form 55002009-01-01320
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 participants2009-01-01320

Form 5500 Responses for CELLTRON, INC. 125 PLAN

2022: CELLTRON, INC. 125 PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: CELLTRON, INC. 125 PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: CELLTRON, INC. 125 PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes
2019: CELLTRON, INC. 125 PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – General assets of the sponsorYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – General assets of the sponsorYes
2018: CELLTRON, INC. 125 PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – General assets of the sponsorYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – General assets of the sponsorYes
2017: CELLTRON, INC. 125 PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – General assets of the sponsorYes
2016: CELLTRON, INC. 125 PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – General assets of the sponsorYes
2015: CELLTRON, INC. 125 PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – General assets of the sponsorYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – General assets of the sponsorYes
2014: CELLTRON, INC. 125 PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – General assets of the sponsorYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – General assets of the sponsorYes
2013: CELLTRON, INC. 125 PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – General assets of the sponsorYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – General assets of the sponsorYes
2012: CELLTRON, INC. 125 PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedYes
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 funding arrangement – General assets of the sponsorYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – General assets of the sponsorYes
2011: CELLTRON, INC. 125 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
2009: CELLTRON, INC. 125 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 funding arrangement – General assets of the sponsorYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

EBMS RE-BENCHMARK INSURANCE CO (National Association of Insurance Commissioners NAIC id number: 41394 )
Policy contract numberBIC-SL-0058
Policy instance 2
Insurance contract or identification numberBIC-SL-0058
Number of Individuals Covered241
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
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 BenefitNo
Temporary Disability Insurance Welfare BenefitNo
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 $792,724
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberTS05395621
Policy instance 1
Insurance contract or identification numberTS05395621
Number of Individuals Covered436
Insurance policy start date2022-04-01
Insurance policy end date2023-03-31
Total amount of commissions paid to insurance brokerUSD $19,798
Total amount of fees paid to insurance companyUSD $3,356
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 BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedADD
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 $106,931
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,976
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
GRANULAR INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93521 )
Policy contract number2021-020-KS
Policy instance 1
Insurance contract or identification number2021-020-KS
Number of Individuals Covered284
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $62,249
Total amount of fees paid to insurance companyUSD $51,135
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $715,864
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees51135
Additional information about fees paid to insurance brokerBENEFIT PAYMENT ADMINISTRATION
Insurance broker organization code?5
Commission paid to Insurance BrokerUSD $38,906
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSGM606394
Policy instance 2
Insurance contract or identification numberSGM606394
Number of Individuals Covered346
Insurance policy start date2020-04-01
Insurance policy end date2021-04-01
Total amount of commissions paid to insurance brokerUSD $2,519
Total amount of fees paid to insurance companyUSD $154
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $25,186
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,519
Insurance broker organization code?3
Amount paid for insurance broker fees154
Additional information about fees paid to insurance brokerOVERRIDE
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSOK604516
Policy instance 3
Insurance contract or identification numberSOK604516
Number of Individuals Covered346
Insurance policy start date2020-04-01
Insurance policy end date2021-04-01
Total amount of commissions paid to insurance brokerUSD $317
Total amount of fees paid to insurance companyUSD $19
Other welfare benefits providedACCIDENTAL DEATH
Welfare Benefit Premiums Paid to CarrierUSD $3,167
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $317
Insurance broker organization code?3
Amount paid for insurance broker fees19
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSGD606601
Policy instance 4
Insurance contract or identification numberSGD606601
Number of Individuals Covered59
Insurance policy start date2020-04-01
Insurance policy end date2021-04-01
Total amount of commissions paid to insurance brokerUSD $480
Total amount of fees paid to insurance companyUSD $21
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,200
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $480
Insurance broker organization code?3
Amount paid for insurance broker fees21
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSGM608295
Policy instance 5
Insurance contract or identification numberSGM608295
Number of Individuals Covered137
Insurance policy start date2020-08-01
Insurance policy end date2021-08-01
Total amount of commissions paid to insurance brokerUSD $4,919
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $32,793
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,919
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSOK606064
Policy instance 6
Insurance contract or identification numberSOK606064
Number of Individuals Covered137
Insurance policy start date2020-08-01
Insurance policy end date2021-08-01
Total amount of commissions paid to insurance brokerUSD $410
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedACCIDENTAL DEATH
Welfare Benefit Premiums Paid to CarrierUSD $2,735
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $410
Insurance broker organization code?3
EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract numberSL20000290-201
Policy instance 1
Insurance contract or identification numberSL20000290-201
Number of Individuals Covered250
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $46,762
Total amount of fees paid to insurance companyUSD $45,090
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $537,764
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees45090
Additional information about fees paid to insurance brokerBENEFIT PAYMENT ADMINISTRATION
Insurance broker organization code?5
Commission paid to Insurance BrokerUSD $29,226
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSGM606394
Policy instance 2
Insurance contract or identification numberSGM606394
Number of Individuals Covered295
Insurance policy start date2019-04-01
Insurance policy end date2020-04-01
Total amount of commissions paid to insurance brokerUSD $2,861
Total amount of fees paid to insurance companyUSD $402
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $28,606
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,861
Insurance broker organization code?3
Amount paid for insurance broker fees402
Additional information about fees paid to insurance brokerOVERRIDE
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSOK604516
Policy instance 3
Insurance contract or identification numberSOK604516
Number of Individuals Covered295
Insurance policy start date2019-04-01
Insurance policy end date2020-04-01
Total amount of commissions paid to insurance brokerUSD $358
Total amount of fees paid to insurance companyUSD $50
Other welfare benefits providedACCIDENTAL DEATH
Welfare Benefit Premiums Paid to CarrierUSD $3,576
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $358
Insurance broker organization code?3
Amount paid for insurance broker fees50
Additional information about fees paid to insurance brokerOVERRIDE
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSGD606601
Policy instance 4
Insurance contract or identification numberSGD606601
Number of Individuals Covered54
Insurance policy start date2019-04-01
Insurance policy end date2020-04-01
Total amount of commissions paid to insurance brokerUSD $573
Total amount of fees paid to insurance companyUSD $60
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,822
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $573
Insurance broker organization code?3
Amount paid for insurance broker fees60
Additional information about fees paid to insurance brokerOVERRIDE
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSGM608295
Policy instance 5
Insurance contract or identification numberSGM608295
Number of Individuals Covered123
Insurance policy start date2019-08-01
Insurance policy end date2020-08-01
Total amount of commissions paid to insurance brokerUSD $3,429
Total amount of fees paid to insurance companyUSD $147
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $22,857
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,429
Insurance broker organization code?3
Amount paid for insurance broker fees147
Additional information about fees paid to insurance brokerOVERRIDE
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSOK606064
Policy instance 6
Insurance contract or identification numberSOK606064
Number of Individuals Covered123
Insurance policy start date2019-08-01
Insurance policy end date2020-08-01
Total amount of commissions paid to insurance brokerUSD $302
Total amount of fees paid to insurance companyUSD $13
Other welfare benefits providedACCIDENTAL DEATH
Welfare Benefit Premiums Paid to CarrierUSD $2,015
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $302
Insurance broker organization code?3
Amount paid for insurance broker fees13
Additional information about fees paid to insurance brokerOVERRIDE
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSOK606064
Policy instance 6
Insurance contract or identification numberSOK606064
Number of Individuals Covered140
Insurance policy start date2018-08-01
Insurance policy end date2019-08-01
Total amount of commissions paid to insurance brokerUSD $370
Total amount of fees paid to insurance companyUSD $35
Other welfare benefits providedACCIDENTAL DEATH
Welfare Benefit Premiums Paid to CarrierUSD $2,470
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $370
Insurance broker organization code?3
Amount paid for insurance broker fees35
Additional information about fees paid to insurance brokerOVERRIDE
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSGM608295
Policy instance 5
Insurance contract or identification numberSGM608295
Number of Individuals Covered140
Insurance policy start date2018-08-01
Insurance policy end date2019-08-01
Total amount of commissions paid to insurance brokerUSD $4,462
Total amount of fees paid to insurance companyUSD $388
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $29,749
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,462
Insurance broker organization code?3
Amount paid for insurance broker fees388
Additional information about fees paid to insurance brokerOVERRIDE
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSGD606601
Policy instance 4
Insurance contract or identification numberSGD606601
Number of Individuals Covered52
Insurance policy start date2018-04-01
Insurance policy end date2019-04-01
Total amount of commissions paid to insurance brokerUSD $503
Total amount of fees paid to insurance companyUSD $65
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,357
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $503
Insurance broker organization code?3
Amount paid for insurance broker fees65
Additional information about fees paid to insurance brokerOVERRIDE
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSOK604516
Policy instance 3
Insurance contract or identification numberSOK604516
Number of Individuals Covered239
Insurance policy start date2018-04-01
Insurance policy end date2019-04-01
Total amount of commissions paid to insurance brokerUSD $281
Total amount of fees paid to insurance companyUSD $56
Other welfare benefits providedACCIDENTAL DEATH
Welfare Benefit Premiums Paid to CarrierUSD $2,812
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $281
Insurance broker organization code?3
Amount paid for insurance broker fees56
Additional information about fees paid to insurance brokerOVERRIDE
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSGM606394
Policy instance 2
Insurance contract or identification numberSGM606394
Number of Individuals Covered239
Insurance policy start date2018-04-01
Insurance policy end date2019-04-01
Total amount of commissions paid to insurance brokerUSD $2,250
Total amount of fees paid to insurance companyUSD $446
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $22,496
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,250
Insurance broker organization code?3
Amount paid for insurance broker fees446
Additional information about fees paid to insurance brokerOVERRIDE
SIRIUS AMERICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 38776 )
Policy contract numberS1019-2019
Policy instance 1
Insurance contract or identification numberS1019-2019
Number of Individuals Covered216
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $35,568
Total amount of fees paid to insurance companyUSD $38,895
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $409,027
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees38895
Additional information about fees paid to insurance brokerBENEFIT PAYMENT ADMINISTRATION
Insurance broker organization code?5
Commission paid to Insurance BrokerUSD $22,230
US FIRE (National Association of Insurance Commissioners NAIC id number: 21113 )
Policy contract numberUS746190
Policy instance 1
Insurance contract or identification numberUS746190
Number of Individuals Covered222
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $30,172
Total amount of fees paid to insurance companyUSD $33,930
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $346,972
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees33930
Additional information about fees paid to insurance brokerBENEFIT PAYMENT ADMINISTRATION
Insurance broker organization code?5
Commission paid to Insurance BrokerUSD $15,086
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSGM606394
Policy instance 2
Insurance contract or identification numberSGM606394
Number of Individuals Covered222
Insurance policy start date2017-04-01
Insurance policy end date2018-04-01
Total amount of commissions paid to insurance brokerUSD $2,566
Total amount of fees paid to insurance companyUSD $402
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $25,658
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,566
Insurance broker organization code?3
Amount paid for insurance broker fees402
Additional information about fees paid to insurance brokerOVERRIDE
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSOK604516
Policy instance 3
Insurance contract or identification numberSOK604516
Number of Individuals Covered222
Insurance policy start date2017-04-01
Insurance policy end date2018-04-01
Total amount of commissions paid to insurance brokerUSD $321
Total amount of fees paid to insurance companyUSD $50
Other welfare benefits providedACCIDENTAL DEATH
Welfare Benefit Premiums Paid to CarrierUSD $3,207
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $321
Insurance broker organization code?3
Amount paid for insurance broker fees50
Additional information about fees paid to insurance brokerOVERRIDE
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSGD606601
Policy instance 4
Insurance contract or identification numberSGD606601
Number of Individuals Covered48
Insurance policy start date2017-04-01
Insurance policy end date2018-04-01
Total amount of commissions paid to insurance brokerUSD $566
Total amount of fees paid to insurance companyUSD $58
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,775
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $566
Insurance broker organization code?3
Amount paid for insurance broker fees58
Additional information about fees paid to insurance brokerOVERRIDE
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSGM608295
Policy instance 5
Insurance contract or identification numberSGM608295
Number of Individuals Covered126
Insurance policy start date2017-08-01
Insurance policy end date2018-08-01
Total amount of commissions paid to insurance brokerUSD $2,993
Total amount of fees paid to insurance companyUSD $1,157
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $19,952
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,993
Insurance broker organization code?3
Amount paid for insurance broker fees1157
Additional information about fees paid to insurance brokerOVERRIDE
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSOK606064
Policy instance 6
Insurance contract or identification numberSOK606064
Number of Individuals Covered126
Insurance policy start date2017-08-01
Insurance policy end date2018-08-01
Total amount of commissions paid to insurance brokerUSD $303
Total amount of fees paid to insurance companyUSD $107
Other welfare benefits providedACCIDENTAL DEATH
Welfare Benefit Premiums Paid to CarrierUSD $2,020
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $303
Insurance broker organization code?3
Amount paid for insurance broker fees107
Additional information about fees paid to insurance brokerOVERRIDE
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSGD606601
Policy instance 4
Insurance contract or identification numberSGD606601
Number of Individuals Covered45
Insurance policy start date2016-04-01
Insurance policy end date2017-04-01
Total amount of commissions paid to insurance brokerUSD $505
Total amount of fees paid to insurance companyUSD $145
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,368
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $505
Insurance broker organization code?3
Amount paid for insurance broker fees145
Additional information about fees paid to insurance brokerOVERRIDE
Insurance broker nameLOCKTON COMPANIES LLC
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSOK604516
Policy instance 3
Insurance contract or identification numberSOK604516
Number of Individuals Covered222
Insurance policy start date2016-04-01
Insurance policy end date2017-04-01
Total amount of commissions paid to insurance brokerUSD $295
Total amount of fees paid to insurance companyUSD $105
Other welfare benefits providedACCIDENTAL DEATH
Welfare Benefit Premiums Paid to CarrierUSD $2,955
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $295
Insurance broker organization code?3
Amount paid for insurance broker fees105
Additional information about fees paid to insurance brokerOVERRIDE
Insurance broker nameLOCKTON COMPANIES LLC
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSGM606394
Policy instance 2
Insurance contract or identification numberSGM606394
Number of Individuals Covered222
Insurance policy start date2016-04-01
Insurance policy end date2017-04-01
Total amount of commissions paid to insurance brokerUSD $2,364
Total amount of fees paid to insurance companyUSD $842
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $23,638
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,364
Insurance broker organization code?3
Amount paid for insurance broker fees842
Additional information about fees paid to insurance brokerOVERRIDE
Insurance broker nameLOCKTON COMPANIES LLC
US FIRE (National Association of Insurance Commissioners NAIC id number: 21113 )
Policy contract numberUS746190
Policy instance 1
Insurance contract or identification numberUS746190
Number of Individuals Covered176
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $31,600
Total amount of fees paid to insurance companyUSD $32,190
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $284,399
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees32190
Additional information about fees paid to insurance brokerBENEFIT PAYMENT ADMINISTRATION
Insurance broker organization code?5
Commission paid to Insurance BrokerUSD $15,800
Insurance broker nameBEIMDIEK INSURANCE AGENCY

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