HAMPTON UNIVERSITY has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan LIFE AND ACCIDENTAL DEATH & DISMEMBERMENT INSURANCE PLAN
401k plan membership statisitcs for LIFE AND ACCIDENTAL DEATH & DISMEMBERMENT INSURANCE PLAN
| Measure | Date | Value |
|---|
| 2022: LIFE AND ACCIDENTAL DEATH & DISMEMBERMENT INSURANCE PLAN 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-01-01 | 446 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 430 |
| Number of retired or separated participants receiving benefits | 2022-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2022-01-01 | 0 |
| Total of all active and inactive participants | 2022-01-01 | 430 |
| Number of employers contributing to the scheme | 2022-01-01 | 0 |
| 2021: LIFE AND ACCIDENTAL DEATH & DISMEMBERMENT INSURANCE PLAN 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-01-01 | 473 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 446 |
| Number of retired or separated participants receiving benefits | 2021-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2021-01-01 | 0 |
| Total of all active and inactive participants | 2021-01-01 | 446 |
| Number of employers contributing to the scheme | 2021-01-01 | 0 |
| 2020: LIFE AND ACCIDENTAL DEATH & DISMEMBERMENT INSURANCE PLAN 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-01-01 | 563 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 473 |
| Number of retired or separated participants receiving benefits | 2020-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2020-01-01 | 0 |
| Total of all active and inactive participants | 2020-01-01 | 473 |
| Number of employers contributing to the scheme | 2020-01-01 | 0 |
| 2019: LIFE AND ACCIDENTAL DEATH & DISMEMBERMENT INSURANCE PLAN 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-01-01 | 579 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 563 |
| Number of retired or separated participants receiving benefits | 2019-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2019-01-01 | 0 |
| Total of all active and inactive participants | 2019-01-01 | 563 |
| Number of employers contributing to the scheme | 2019-01-01 | 0 |
| 2018: LIFE AND ACCIDENTAL DEATH & DISMEMBERMENT INSURANCE PLAN 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-01-01 | 493 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 579 |
| Number of retired or separated participants receiving benefits | 2018-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2018-01-01 | 0 |
| Total of all active and inactive participants | 2018-01-01 | 579 |
| Number of employers contributing to the scheme | 2018-01-01 | 0 |
| 2017: LIFE AND ACCIDENTAL DEATH & DISMEMBERMENT INSURANCE PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-01-01 | 503 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 493 |
| Number of retired or separated participants receiving benefits | 2017-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2017-01-01 | 0 |
| Total of all active and inactive participants | 2017-01-01 | 493 |
| 2016: LIFE AND ACCIDENTAL DEATH & DISMEMBERMENT INSURANCE PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-01-01 | 496 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 494 |
| Number of retired or separated participants receiving benefits | 2016-01-01 | 9 |
| Total of all active and inactive participants | 2016-01-01 | 503 |
| Total participants | 2016-01-01 | 503 |
| 2015: LIFE AND ACCIDENTAL DEATH & DISMEMBERMENT INSURANCE PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-01-01 | 517 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 485 |
| Number of retired or separated participants receiving benefits | 2015-01-01 | 11 |
| Total of all active and inactive participants | 2015-01-01 | 496 |
| Total participants | 2015-01-01 | 496 |
| 2014: LIFE AND ACCIDENTAL DEATH & DISMEMBERMENT INSURANCE PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-01-01 | 503 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 506 |
| Number of other retired or separated participants entitled to future benefits | 2014-01-01 | 11 |
| Total of all active and inactive participants | 2014-01-01 | 517 |
| Total participants | 2014-01-01 | 517 |
| 2013: LIFE AND ACCIDENTAL DEATH & DISMEMBERMENT INSURANCE PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-01-01 | 550 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 503 |
| Number of other retired or separated participants entitled to future benefits | 2013-01-01 | 11 |
| Total of all active and inactive participants | 2013-01-01 | 514 |
| Total participants | 2013-01-01 | 514 |
| 2012: LIFE AND ACCIDENTAL DEATH & DISMEMBERMENT INSURANCE PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-01-01 | 607 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 537 |
| Number of other retired or separated participants entitled to future benefits | 2012-01-01 | 13 |
| Total of all active and inactive participants | 2012-01-01 | 550 |
| Total participants | 2012-01-01 | 550 |
| 2011: LIFE AND ACCIDENTAL DEATH & DISMEMBERMENT INSURANCE PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-01-01 | 668 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 593 |
| Number of retired or separated participants receiving benefits | 2011-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2011-01-01 | 14 |
| Total of all active and inactive participants | 2011-01-01 | 607 |
| Total participants | 2011-01-01 | 607 |
| 2009: LIFE AND ACCIDENTAL DEATH & DISMEMBERMENT INSURANCE PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-01-01 | 816 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 694 |
| Number of retired or separated participants receiving benefits | 2009-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2009-01-01 | 0 |
| Total of all active and inactive participants | 2009-01-01 | 694 |
| Total participants | 2009-01-01 | 694 |
| 2022: LIFE AND ACCIDENTAL DEATH & DISMEMBERMENT 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: LIFE AND ACCIDENTAL DEATH & DISMEMBERMENT 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: LIFE AND ACCIDENTAL DEATH & DISMEMBERMENT INSURANCE PLAN 2020 form 5500 responses |
|---|
| 2020-01-01 | Type of plan entity | Single employer plan |
| 2020-01-01 | Plan funding arrangement – Insurance | Yes |
| 2020-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2019: LIFE AND ACCIDENTAL DEATH & DISMEMBERMENT INSURANCE PLAN 2019 form 5500 responses |
|---|
| 2019-01-01 | Type of plan entity | Single employer plan |
| 2019-01-01 | Plan funding arrangement – Insurance | Yes |
| 2019-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: LIFE AND ACCIDENTAL DEATH & DISMEMBERMENT INSURANCE PLAN 2018 form 5500 responses |
|---|
| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | Plan funding arrangement – Insurance | Yes |
| 2018-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: LIFE AND ACCIDENTAL DEATH & DISMEMBERMENT INSURANCE PLAN 2017 form 5500 responses |
|---|
| 2017-01-01 | Type of plan entity | Single employer plan |
| 2017-01-01 | Plan funding arrangement – Insurance | Yes |
| 2017-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: LIFE AND ACCIDENTAL DEATH & DISMEMBERMENT INSURANCE PLAN 2016 form 5500 responses |
|---|
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | Plan funding arrangement – Insurance | Yes |
| 2016-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: LIFE AND ACCIDENTAL DEATH & DISMEMBERMENT INSURANCE PLAN 2015 form 5500 responses |
|---|
| 2015-01-01 | Type of plan entity | Single employer plan |
| 2015-01-01 | Plan funding arrangement – Insurance | Yes |
| 2015-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: LIFE AND ACCIDENTAL DEATH & DISMEMBERMENT INSURANCE PLAN 2014 form 5500 responses |
|---|
| 2014-01-01 | Type of plan entity | Single employer plan |
| 2014-01-01 | Plan funding arrangement – Insurance | Yes |
| 2014-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: LIFE AND ACCIDENTAL DEATH & DISMEMBERMENT INSURANCE PLAN 2013 form 5500 responses |
|---|
| 2013-01-01 | Type of plan entity | Single employer plan |
| 2013-01-01 | Plan funding arrangement – Insurance | Yes |
| 2013-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: LIFE AND ACCIDENTAL DEATH & DISMEMBERMENT INSURANCE PLAN 2012 form 5500 responses |
|---|
| 2012-01-01 | Type of plan entity | Single employer plan |
| 2012-01-01 | Plan funding arrangement – Insurance | Yes |
| 2012-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: LIFE AND ACCIDENTAL DEATH & DISMEMBERMENT INSURANCE PLAN 2011 form 5500 responses |
|---|
| 2011-01-01 | Type of plan entity | Single employer plan |
| 2011-01-01 | Plan funding arrangement – Insurance | Yes |
| 2011-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: LIFE AND ACCIDENTAL DEATH & DISMEMBERMENT INSURANCE PLAN 2009 form 5500 responses |
|---|
| 2009-01-01 | Type of plan entity | Single employer plan |
| 2009-01-01 | Plan funding arrangement – Insurance | Yes |
| 2009-01-01 | Plan benefit arrangement – Insurance | Yes |
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 530248 |
| Policy instance | 2 |
| Insurance contract or identification number | 530248 | | Number of Individuals Covered | 212 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $20,042 | | Total amount of fees paid to insurance company | USD $2,217 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $95,436 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $14,315 | | Amount paid for insurance broker fees | 2217 | | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | | Insurance broker organization code? | 3 |
|
| ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 ) |
| Policy contract number | 23152000V |
| Policy instance | 1 |
| Insurance contract or identification number | 23152000V | | Number of Individuals Covered | 430 | | Insurance policy start date | 2021-11-01 | | Insurance policy end date | 2022-10-31 | | Total amount of commissions paid to insurance broker | USD $2,838 | | Total amount of fees paid to insurance company | USD $424 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $37,799 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,838 | | Amount paid for insurance broker fees | 424 | | Additional information about fees paid to insurance broker | FEES | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 530248 |
| Policy instance | 2 |
| Insurance contract or identification number | 530248 | | Number of Individuals Covered | 190 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $19,551 | | Total amount of fees paid to insurance company | USD $1,605 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $91,693 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $13,754 | | Amount paid for insurance broker fees | 1605 | | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | | Insurance broker organization code? | 3 |
|
| ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 ) |
| Policy contract number | 23152000V |
| Policy instance | 1 |
| Insurance contract or identification number | 23152000V | | Number of Individuals Covered | 446 | | Insurance policy start date | 2020-11-01 | | Insurance policy end date | 2021-10-31 | | Total amount of commissions paid to insurance broker | USD $4,384 | | Total amount of fees paid to insurance company | USD $1,065 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $43,964 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $4,384 | | Amount paid for insurance broker fees | 1065 | | Additional information about fees paid to insurance broker | FEES | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 530248 |
| Policy instance | 2 |
| Insurance contract or identification number | 530248 | | Number of Individuals Covered | 89 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $14,017 | | Total amount of fees paid to insurance company | USD $1,550 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $84,925 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $14,017 | | Amount paid for insurance broker fees | 1550 | | Additional information about fees paid to insurance broker | FEES | | Insurance broker organization code? | 3 |
|
| ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 ) |
| Policy contract number | 23152000V |
| Policy instance | 1 |
| Insurance contract or identification number | 23152000V | | Number of Individuals Covered | 473 | | Insurance policy start date | 2019-11-01 | | Insurance policy end date | 2020-10-31 | | Total amount of commissions paid to insurance broker | USD $1,810 | | Total amount of fees paid to insurance company | USD $472 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $51,326 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,810 | | Amount paid for insurance broker fees | 472 | | Additional information about fees paid to insurance broker | FEES | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 530248 |
| Policy instance | 2 |
| Insurance contract or identification number | 530248 | | Number of Individuals Covered | 154 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $12,569 | | Total amount of fees paid to insurance company | USD $628 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $100,640 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $12,569 | | Amount paid for insurance broker fees | 628 | | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | | Insurance broker organization code? | 3 |
|
| ANTHEM BLUE CROSS AND BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 71835 ) |
| Policy contract number | 406706 |
| Policy instance | 1 |
| Insurance contract or identification number | 406706 | | Number of Individuals Covered | 563 | | Insurance policy start date | 2018-11-01 | | Insurance policy end date | 2019-10-31 | | Total amount of commissions paid to insurance broker | USD $2,491 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $249,054 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | | Commission paid to Insurance Broker | USD $2,491 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| ANTHEM BLUE CROSS AND BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 71835 ) |
| Policy contract number | 406706 |
| Policy instance | 1 |
| Insurance contract or identification number | 406706 | | Number of Individuals Covered | 560 | | Insurance policy start date | 2017-11-01 | | Insurance policy end date | 2018-10-31 | | Total amount of commissions paid to insurance broker | USD $2,684 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $268,396 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes | | Commission paid to Insurance Broker | USD $2,684 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 530248 |
| Policy instance | 2 |
| Insurance contract or identification number | 530248 | | Number of Individuals Covered | 135 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $13,161 | | Total amount of fees paid to insurance company | USD $658 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $79,413 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $13,161 | | Amount paid for insurance broker fees | 658 | | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | | Insurance broker organization code? | 3 |
|
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) |
| Policy contract number | 530248 |
| Policy instance | 2 |
| Insurance contract or identification number | 530248 | | Number of Individuals Covered | 134 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $6,500 | | Total amount of fees paid to insurance company | USD $325 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $78,104 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $6,500 | | Amount paid for insurance broker fees | 325 | | Additional information about fees paid to insurance broker | ADDITIONAL COMPENSATION | | Insurance broker organization code? | 3 | | Insurance broker name | USI INSURANCE SERVICES LLC |
|
| ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 ) |
| Policy contract number | 23152000V |
| Policy instance | 1 |
| Insurance contract or identification number | 23152000V | | Number of Individuals Covered | 493 | | Insurance policy start date | 2016-11-01 | | Insurance policy end date | 2017-10-31 | | Total amount of commissions paid to insurance broker | USD $7,173 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $47,006 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $7,035 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 | | Insurance broker name | USI INSURANCE SERVICES LLC |
|
| ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 ) |
| Policy contract number | 406706 |
| Policy instance | 1 |
| Insurance contract or identification number | 406706 | | Number of Individuals Covered | 496 | | Insurance policy start date | 2014-11-01 | | Insurance policy end date | 2015-10-31 | | Total amount of commissions paid to insurance broker | USD $5,938 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $39,490 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $5,938 | | Insurance broker organization code? | 3 | | Insurance broker name | UNIVERSITY INSURANCE AGENCY LLC |
|
| ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 ) |
| Policy contract number | 406706 |
| Policy instance | 1 |
| Insurance contract or identification number | 406706 | | Number of Individuals Covered | 506 | | Insurance policy start date | 2013-11-01 | | Insurance policy end date | 2014-10-31 | | Total amount of commissions paid to insurance broker | USD $2,966 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $33,575 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,966 | | Insurance broker organization code? | 3 | | Insurance broker name | UNIVERSITY INSURANCE AGENCY LLC |
|
| ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 ) |
| Policy contract number | 406706 |
| Policy instance | 1 |
| Insurance contract or identification number | 406706 | | Number of Individuals Covered | 503 | | Insurance policy start date | 2012-11-01 | | Insurance policy end date | 2013-10-31 | | Total amount of commissions paid to insurance broker | USD $7,145 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $43,691 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $7,145 | | Insurance broker organization code? | 3 | | Insurance broker name | UNIVERSITY INSURANCE AGENCY LLC |
|
| ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 ) |
| Policy contract number | 406706 |
| Policy instance | 1 |
| Insurance contract or identification number | 406706 | | Number of Individuals Covered | 550 | | Insurance policy start date | 2011-11-01 | | Insurance policy end date | 2012-10-31 | | Total amount of commissions paid to insurance broker | USD $10,249 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $40,492 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $10,249 | | Insurance broker organization code? | 3 | | Insurance broker name | UNIVERSITY INSURANCE AGENCY LLC |
|
| DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
| Policy contract number | F001237 |
| Policy instance | 1 |
| Insurance contract or identification number | F001237 | | Number of Individuals Covered | 607 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-10-31 | | Total amount of commissions paid to insurance broker | USD $3,590 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $44,241 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 ) |
| Policy contract number | F001237 |
| Policy instance | 1 |
| Insurance contract or identification number | F001237 | | Number of Individuals Covered | 668 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $4,486 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH & DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $58,964 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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