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COORDINATED SERVICES MANAGEMENT, INC. DISABILITY AND LIFE INSURANCE PLAN 401k Plan overview

Plan NameCOORDINATED SERVICES MANAGEMENT, INC. DISABILITY AND LIFE INSURANCE PLAN
Plan identification number 503

COORDINATED SERVICES MANAGEMENT, INC. DISABILITY AND LIFE INSURANCE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Other welfare benefit cover

401k Sponsoring company profile

COORDINATED SERVICES MANAGEMENT, INC. has sponsored the creation of one or more 401k plans.

Company Name:COORDINATED SERVICES MANAGEMENT, INC.
Employer identification number (EIN):541164589
NAIC Classification:623000
NAIC Description: Nursing and Residential Care Facilities

Additional information about COORDINATED SERVICES MANAGEMENT, INC.

Jurisdiction of Incorporation: Virginia Secretary of State
Incorporation Date: 1983-08-31
Company Identification Number: 0246001
Legal Registered Office Address: 3333 PETERS CREEK ROAD

ROANOKE
United States of America (USA)
24019

More information about COORDINATED SERVICES MANAGEMENT, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan COORDINATED SERVICES MANAGEMENT, INC. DISABILITY AND LIFE INSURANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5032022-03-01ROBERT MCNICHOLS2023-11-29 ROBERT MCNICHOLS2023-11-29
5032021-03-01
5032020-03-01
5032019-03-01
5032018-03-01
5032017-03-01ROBERT MCNICHOLS ROBERT MCNICHOLS2018-11-14
5032016-03-01ROBERT MCNICHOLS ROBERT MCNICHOLS2017-09-27
5032015-03-01ROBERT MCNICHOLS ROBERT MCNICHOLS2016-09-27
5032014-03-01ROBERT MCNICHOLS ROBERT MCNICHOLS2015-09-28
5032013-03-01ROBERT MCNICHOLS ROBERT MCNICHOLS2014-09-22
5032012-03-01ROBERT MCNICHOLS ROBERT MCNICHOLS2013-09-24
5032011-03-01ROBERT MCNICHOLS ROBERT MCNICHOLS2012-08-22
5032010-03-01ROBERT MCNICHOLS ROBERT MCNICHOLS2011-09-21
5032009-03-01ROBERT MCNICHOLS ROBERT MCNICHOLS2010-09-02

Plan Statistics for COORDINATED SERVICES MANAGEMENT, INC. DISABILITY AND LIFE INSURANCE PLAN

401k plan membership statisitcs for COORDINATED SERVICES MANAGEMENT, INC. DISABILITY AND LIFE INSURANCE PLAN

Measure Date Value
2022: COORDINATED SERVICES MANAGEMENT, INC. DISABILITY AND LIFE INSURANCE PLAN 2022 401k membership
Total participants, beginning-of-year2022-03-01899
Total number of active participants reported on line 7a of the Form 55002022-03-01851
Number of retired or separated participants receiving benefits2022-03-010
Number of other retired or separated participants entitled to future benefits2022-03-010
Total of all active and inactive participants2022-03-01851
2021: COORDINATED SERVICES MANAGEMENT, INC. DISABILITY AND LIFE INSURANCE PLAN 2021 401k membership
Total participants, beginning-of-year2021-03-01927
Total number of active participants reported on line 7a of the Form 55002021-03-01899
Number of retired or separated participants receiving benefits2021-03-010
Total of all active and inactive participants2021-03-01899
2020: COORDINATED SERVICES MANAGEMENT, INC. DISABILITY AND LIFE INSURANCE PLAN 2020 401k membership
Total participants, beginning-of-year2020-03-01983
Total number of active participants reported on line 7a of the Form 55002020-03-01927
Total of all active and inactive participants2020-03-01927
2019: COORDINATED SERVICES MANAGEMENT, INC. DISABILITY AND LIFE INSURANCE PLAN 2019 401k membership
Total participants, beginning-of-year2019-03-011,006
Total number of active participants reported on line 7a of the Form 55002019-03-01983
Total of all active and inactive participants2019-03-01983
2018: COORDINATED SERVICES MANAGEMENT, INC. DISABILITY AND LIFE INSURANCE PLAN 2018 401k membership
Total participants, beginning-of-year2018-03-011,014
Total number of active participants reported on line 7a of the Form 55002018-03-011,006
Total of all active and inactive participants2018-03-011,006
2017: COORDINATED SERVICES MANAGEMENT, INC. DISABILITY AND LIFE INSURANCE PLAN 2017 401k membership
Total participants, beginning-of-year2017-03-01931
Total number of active participants reported on line 7a of the Form 55002017-03-011,014
Total of all active and inactive participants2017-03-011,014
2016: COORDINATED SERVICES MANAGEMENT, INC. DISABILITY AND LIFE INSURANCE PLAN 2016 401k membership
Total participants, beginning-of-year2016-03-01932
Total number of active participants reported on line 7a of the Form 55002016-03-01931
Total of all active and inactive participants2016-03-01931
2015: COORDINATED SERVICES MANAGEMENT, INC. DISABILITY AND LIFE INSURANCE PLAN 2015 401k membership
Total participants, beginning-of-year2015-03-01998
Total number of active participants reported on line 7a of the Form 55002015-03-01932
Total of all active and inactive participants2015-03-01932
2014: COORDINATED SERVICES MANAGEMENT, INC. DISABILITY AND LIFE INSURANCE PLAN 2014 401k membership
Total participants, beginning-of-year2014-03-01984
Total number of active participants reported on line 7a of the Form 55002014-03-01998
Total of all active and inactive participants2014-03-01998
2013: COORDINATED SERVICES MANAGEMENT, INC. DISABILITY AND LIFE INSURANCE PLAN 2013 401k membership
Total participants, beginning-of-year2013-03-01920
Total number of active participants reported on line 7a of the Form 55002013-03-01984
Total of all active and inactive participants2013-03-01984
2012: COORDINATED SERVICES MANAGEMENT, INC. DISABILITY AND LIFE INSURANCE PLAN 2012 401k membership
Total participants, beginning-of-year2012-03-01924
Total number of active participants reported on line 7a of the Form 55002012-03-01920
Total of all active and inactive participants2012-03-01920
2011: COORDINATED SERVICES MANAGEMENT, INC. DISABILITY AND LIFE INSURANCE PLAN 2011 401k membership
Total participants, beginning-of-year2011-03-01932
Total number of active participants reported on line 7a of the Form 55002011-03-01924
Total of all active and inactive participants2011-03-01924
2010: COORDINATED SERVICES MANAGEMENT, INC. DISABILITY AND LIFE INSURANCE PLAN 2010 401k membership
Total participants, beginning-of-year2010-03-01896
Total number of active participants reported on line 7a of the Form 55002010-03-01932
Total of all active and inactive participants2010-03-01932
2009: COORDINATED SERVICES MANAGEMENT, INC. DISABILITY AND LIFE INSURANCE PLAN 2009 401k membership
Total participants, beginning-of-year2009-03-01828
Total number of active participants reported on line 7a of the Form 55002009-03-01896
Total of all active and inactive participants2009-03-01896

Form 5500 Responses for COORDINATED SERVICES MANAGEMENT, INC. DISABILITY AND LIFE INSURANCE PLAN

2022: COORDINATED SERVICES MANAGEMENT, INC. DISABILITY AND LIFE INSURANCE PLAN 2022 form 5500 responses
2022-03-01Type of plan entitySingle employer plan
2022-03-01Submission has been amendedNo
2022-03-01This submission is the final filingNo
2022-03-01This return/report is a short plan year return/report (less than 12 months)No
2022-03-01Plan is a collectively bargained planNo
2022-03-01Plan funding arrangement – InsuranceYes
2022-03-01Plan benefit arrangement – InsuranceYes
2021: COORDINATED SERVICES MANAGEMENT, INC. DISABILITY AND LIFE INSURANCE PLAN 2021 form 5500 responses
2021-03-01Type of plan entitySingle employer plan
2021-03-01Submission has been amendedNo
2021-03-01This submission is the final filingNo
2021-03-01This return/report is a short plan year return/report (less than 12 months)No
2021-03-01Plan is a collectively bargained planNo
2021-03-01Plan funding arrangement – InsuranceYes
2021-03-01Plan benefit arrangement – InsuranceYes
2020: COORDINATED SERVICES MANAGEMENT, INC. DISABILITY AND LIFE INSURANCE PLAN 2020 form 5500 responses
2020-03-01Type of plan entitySingle employer plan
2020-03-01Submission has been amendedNo
2020-03-01This submission is the final filingNo
2020-03-01This return/report is a short plan year return/report (less than 12 months)No
2020-03-01Plan is a collectively bargained planNo
2020-03-01Plan funding arrangement – InsuranceYes
2020-03-01Plan benefit arrangement – InsuranceYes
2019: COORDINATED SERVICES MANAGEMENT, INC. DISABILITY AND LIFE INSURANCE PLAN 2019 form 5500 responses
2019-03-01Type of plan entitySingle employer plan
2019-03-01Plan funding arrangement – InsuranceYes
2019-03-01Plan benefit arrangement – InsuranceYes
2018: COORDINATED SERVICES MANAGEMENT, INC. DISABILITY AND LIFE INSURANCE PLAN 2018 form 5500 responses
2018-03-01Type of plan entitySingle employer plan
2018-03-01Plan funding arrangement – InsuranceYes
2018-03-01Plan benefit arrangement – InsuranceYes
2017: COORDINATED SERVICES MANAGEMENT, INC. DISABILITY AND LIFE INSURANCE PLAN 2017 form 5500 responses
2017-03-01Type of plan entitySingle employer plan
2017-03-01Plan funding arrangement – InsuranceYes
2017-03-01Plan benefit arrangement – InsuranceYes
2016: COORDINATED SERVICES MANAGEMENT, INC. DISABILITY AND LIFE INSURANCE PLAN 2016 form 5500 responses
2016-03-01Type of plan entitySingle employer plan
2016-03-01Plan funding arrangement – InsuranceYes
2016-03-01Plan benefit arrangement – InsuranceYes
2015: COORDINATED SERVICES MANAGEMENT, INC. DISABILITY AND LIFE INSURANCE PLAN 2015 form 5500 responses
2015-03-01Type of plan entitySingle employer plan
2015-03-01Plan funding arrangement – InsuranceYes
2015-03-01Plan benefit arrangement – InsuranceYes
2014: COORDINATED SERVICES MANAGEMENT, INC. DISABILITY AND LIFE INSURANCE PLAN 2014 form 5500 responses
2014-03-01Type of plan entitySingle employer plan
2014-03-01Plan funding arrangement – InsuranceYes
2014-03-01Plan benefit arrangement – InsuranceYes
2013: COORDINATED SERVICES MANAGEMENT, INC. DISABILITY AND LIFE INSURANCE PLAN 2013 form 5500 responses
2013-03-01Type of plan entityMulitple employer plan
2013-03-01Plan funding arrangement – InsuranceYes
2013-03-01Plan benefit arrangement – InsuranceYes
2012: COORDINATED SERVICES MANAGEMENT, INC. DISABILITY AND LIFE INSURANCE PLAN 2012 form 5500 responses
2012-03-01Type of plan entityMulitple employer plan
2012-03-01Plan funding arrangement – InsuranceYes
2012-03-01Plan benefit arrangement – InsuranceYes
2011: COORDINATED SERVICES MANAGEMENT, INC. DISABILITY AND LIFE INSURANCE PLAN 2011 form 5500 responses
2011-03-01Type of plan entityMulitple employer plan
2011-03-01Plan funding arrangement – InsuranceYes
2011-03-01Plan benefit arrangement – InsuranceYes
2010: COORDINATED SERVICES MANAGEMENT, INC. DISABILITY AND LIFE INSURANCE PLAN 2010 form 5500 responses
2010-03-01Type of plan entityMulitple employer plan
2010-03-01Plan funding arrangement – InsuranceYes
2010-03-01Plan benefit arrangement – InsuranceYes
2009: COORDINATED SERVICES MANAGEMENT, INC. DISABILITY AND LIFE INSURANCE PLAN 2009 form 5500 responses
2009-03-01Type of plan entityMulitple employer plan
2009-03-01This submission is the final filingNo
2009-03-01Plan funding arrangement – InsuranceYes
2009-03-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract numberER00002197
Policy instance 2
Insurance contract or identification numberER00002197
Number of Individuals Covered26
Insurance policy start date2022-03-01
Insurance policy end date2023-02-28
Total amount of commissions paid to insurance brokerUSD $399
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
Other welfare benefits providedCANCER
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 $7,056
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $261
Insurance broker organization code?3
ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )
Policy contract numberAL00006099
Policy instance 1
Insurance contract or identification numberAL00006099
Number of Individuals Covered914
Insurance policy start date2022-03-01
Insurance policy end date2023-02-28
Total amount of commissions paid to insurance brokerUSD $4,878
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $530,912
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,878
Insurance broker organization code?3
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract numberER00002197
Policy instance 2
Insurance contract or identification numberER00002197
Number of Individuals Covered28
Insurance policy start date2021-03-01
Insurance policy end date2022-02-28
Total amount of commissions paid to insurance brokerUSD $422
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
Other welfare benefits providedCANCER
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 $7,374
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $275
Insurance broker organization code?3
ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )
Policy contract numberAL00006099
Policy instance 1
Insurance contract or identification numberAL00006099
Number of Individuals Covered899
Insurance policy start date2021-03-01
Insurance policy end date2022-02-28
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 BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $347,016
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )
Policy contract numberAL00006099
Policy instance 1
Insurance contract or identification numberAL00006099
Number of Individuals Covered927
Insurance policy start date2020-03-01
Insurance policy end date2021-02-28
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 BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $333,643
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract numberER00002197
Policy instance 2
Insurance contract or identification numberER00002197
Number of Individuals Covered29
Insurance policy start date2020-03-01
Insurance policy end date2021-02-28
Total amount of commissions paid to insurance brokerUSD $423
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
Other welfare benefits providedCANCER
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 $8,340
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $275
Insurance broker organization code?3
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract numberER00002197
Policy instance 1
Insurance contract or identification numberER00002197
Number of Individuals Covered29
Insurance policy start date2019-03-01
Insurance policy end date2020-02-29
Total amount of commissions paid to insurance brokerUSD $392
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedCANCER
Welfare Benefit Premiums Paid to CarrierUSD $8,510
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $256
Insurance broker organization code?3
ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )
Policy contract numberAL00006099
Policy instance 2
Insurance contract or identification numberAL00006099
Number of Individuals Covered983
Insurance policy start date2019-03-01
Insurance policy end date2020-02-29
Total amount of commissions paid to insurance brokerUSD $-8,337
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $351,702
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $-8,337
Insurance broker organization code?3
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract numberER00002197
Policy instance 1
Insurance contract or identification numberER00002197
Number of Individuals Covered110
Insurance policy start date2018-03-01
Insurance policy end date2019-02-28
Total amount of commissions paid to insurance brokerUSD $439
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedCANCER
Welfare Benefit Premiums Paid to CarrierUSD $9,242
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $292
Insurance broker organization code?3
ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )
Policy contract numberAL00006099
Policy instance 2
Insurance contract or identification numberAL00006099
Number of Individuals Covered1006
Insurance policy start date2018-03-01
Insurance policy end date2019-02-28
Total amount of commissions paid to insurance brokerUSD $8,337
Total amount of fees paid to insurance companyUSD $7,957
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $287,074
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,337
Amount paid for insurance broker fees7957
Additional information about fees paid to insurance brokerINCENTIVES, EDUCATION, COMMUNICATION, AND TRAINING
Insurance broker organization code?3
ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )
Policy contract numberAL00006099
Policy instance 2
Insurance contract or identification numberAL00006099
Number of Individuals Covered1014
Insurance policy start date2017-03-01
Insurance policy end date2018-02-28
Total amount of commissions paid to insurance brokerUSD $4,448
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $266,402
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,448
Insurance broker nameBUSINESS SOLUTIONS INC.
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract numberER00002197
Policy instance 1
Insurance contract or identification numberER00002197
Number of Individuals Covered124
Insurance policy start date2017-03-01
Insurance policy end date2018-02-28
Total amount of commissions paid to insurance brokerUSD $474
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedCANCER
Welfare Benefit Premiums Paid to CarrierUSD $9,619
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $322
Insurance broker organization code?3
Insurance broker nameSCU HOUSE ACCT
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010021633
Policy instance 2
Insurance contract or identification number000010021633
Number of Individuals Covered931
Insurance policy start date2015-03-01
Insurance policy end date2016-02-29
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $113,141
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010021632
Policy instance 1
Insurance contract or identification number000010021632
Number of Individuals Covered932
Insurance policy start date2015-03-01
Insurance policy end date2016-02-29
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $164,138
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract numberER00002197
Policy instance 3
Insurance contract or identification numberER00002197
Number of Individuals Covered145
Insurance policy start date2015-03-01
Insurance policy end date2016-02-29
Total amount of commissions paid to insurance brokerUSD $681
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedCANCER
Welfare Benefit Premiums Paid to CarrierUSD $13,479
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $472
Insurance broker organization code?3
Insurance broker nameSCU HOUSE ACCT
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract numberER00002197
Policy instance 3
Insurance contract or identification numberER00002197
Number of Individuals Covered147
Insurance policy start date2014-03-01
Insurance policy end date2015-02-28
Total amount of commissions paid to insurance brokerUSD $630
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Other welfare benefits providedCANCER
Welfare Benefit Premiums Paid to CarrierUSD $12,368
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $438
Insurance broker organization code?3
Insurance broker nameSCU HOUSE ACCT
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010021632
Policy instance 1
Insurance contract or identification number000010021632
Number of Individuals Covered998
Insurance policy start date2014-03-01
Insurance policy end date2015-02-28
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $151,940
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010021633
Policy instance 2
Insurance contract or identification number000010021633
Number of Individuals Covered993
Insurance policy start date2014-03-01
Insurance policy end date2015-02-28
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $105,603
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract numberER00002197
Policy instance 3
Insurance contract or identification numberER00002197
Number of Individuals Covered169
Insurance policy start date2013-03-01
Insurance policy end date2014-02-28
Total amount of commissions paid to insurance brokerUSD $662
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Other welfare benefits providedCANCER
Welfare Benefit Premiums Paid to CarrierUSD $12,255
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $464
Insurance broker organization code?3
Insurance broker nameSCU HOUSE ACCT
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010021632
Policy instance 1
Insurance contract or identification number000010021632
Number of Individuals Covered984
Insurance policy start date2013-03-01
Insurance policy end date2014-02-28
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $115,911
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010021633
Policy instance 2
Insurance contract or identification number000010021633
Number of Individuals Covered984
Insurance policy start date2013-03-01
Insurance policy end date2014-02-28
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $88,775
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010021632
Policy instance 1
Insurance contract or identification number000010021632
Number of Individuals Covered920
Insurance policy start date2012-03-01
Insurance policy end date2013-02-28
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $125,230
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract numberER00002197
Policy instance 3
Insurance contract or identification numberER00002197
Number of Individuals Covered60
Insurance policy start date2012-03-01
Insurance policy end date2013-02-28
Total amount of commissions paid to insurance brokerUSD $1,570
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Other welfare benefits providedCANCER
Welfare Benefit Premiums Paid to CarrierUSD $25,891
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,099
Additional information about fees paid to insurance brokerCOMMISSIONS
Insurance broker organization code?3
Insurance broker nameSCU HOUSE ACCT
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010021633
Policy instance 2
Insurance contract or identification number000010021633
Number of Individuals Covered920
Insurance policy start date2012-03-01
Insurance policy end date2013-02-28
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $97,007
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract numberER00002197
Policy instance 3
Insurance contract or identification numberER00002197
Number of Individuals Covered61
Insurance policy start date2011-03-01
Insurance policy end date2012-02-29
Total amount of commissions paid to insurance brokerUSD $992
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Other welfare benefits providedCANCER
Welfare Benefit Premiums Paid to CarrierUSD $14,849
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010021633
Policy instance 2
Insurance contract or identification number000010021633
Number of Individuals Covered924
Insurance policy start date2011-03-01
Insurance policy end date2012-02-29
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $102,928
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010021632
Policy instance 1
Insurance contract or identification number000010021632
Number of Individuals Covered924
Insurance policy start date2011-03-01
Insurance policy end date2012-02-29
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $132,407
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010021633
Policy instance 2
Insurance contract or identification number000010021633
Number of Individuals Covered932
Insurance policy start date2010-03-01
Insurance policy end date2011-02-28
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $93,367
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010021632
Policy instance 1
Insurance contract or identification number000010021632
Number of Individuals Covered932
Insurance policy start date2010-03-01
Insurance policy end date2011-02-28
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $119,038
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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