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KERNODLE CLINIC, INC. GROUP LIFE AND AD&D PLAN 401k Plan overview

Plan NameKERNODLE CLINIC, INC. GROUP LIFE AND AD&D PLAN
Plan identification number 503

KERNODLE CLINIC, INC. GROUP LIFE AND AD&D PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

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

Company Name:KERNODLE CLINIC, INC.
Employer identification number (EIN):560520990
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan KERNODLE CLINIC, INC. GROUP LIFE AND AD&D PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5032022-01-01EMMITT KERNODLE2023-09-11 EMMITT KERNODLE2023-09-11
5032021-01-01
5032020-01-01
5032019-01-01
5032018-01-01
5032017-01-01MICHAEL LUNCEFORD MICHAEL LUNCEFORD2018-08-09
5032016-01-01MICHAEL LUNCEFORD MICHAEL LUNCEFORD2017-08-14
5032015-01-01MICHAEL LUNCEFORD MICHAEL LUNCEFORD2016-10-13
5032014-01-01KEVIN A. BILSON KEVIN A. BILSON2015-08-10
5032013-01-01KEVIN A. BILSON KEVIN A. BILSON2014-10-10
5032012-01-01KEVIN A. BILSON KEVIN A. BILSON2013-07-25
5032011-01-01KEVIN A. BILSON KEVIN A. BILSON2012-10-19
5032010-01-01KEVIN A. BILSON KEVIN A. BILSON2011-09-27
5032009-01-01KEVIN A. BILSON
5032009-01-01KEVIN A. BILSON
5032009-01-01KEVIN A. BILSON

Plan Statistics for KERNODLE CLINIC, INC. GROUP LIFE AND AD&D PLAN

401k plan membership statisitcs for KERNODLE CLINIC, INC. GROUP LIFE AND AD&D PLAN

Measure Date Value
2022: KERNODLE CLINIC, INC. GROUP LIFE AND AD&D PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01346
Total number of active participants reported on line 7a of the Form 55002022-01-01343
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 participants2022-01-01343
2021: KERNODLE CLINIC, INC. GROUP LIFE AND AD&D PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01324
Total number of active participants reported on line 7a of the Form 55002021-01-01346
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-01346
2020: KERNODLE CLINIC, INC. GROUP LIFE AND AD&D PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01326
Total number of active participants reported on line 7a of the Form 55002020-01-01324
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-01324
2019: KERNODLE CLINIC, INC. GROUP LIFE AND AD&D PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01310
Total number of active participants reported on line 7a of the Form 55002019-01-01326
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-01326
2018: KERNODLE CLINIC, INC. GROUP LIFE AND AD&D PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01289
Total number of active participants reported on line 7a of the Form 55002018-01-01310
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-01310
2017: KERNODLE CLINIC, INC. GROUP LIFE AND AD&D PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01280
Total number of active participants reported on line 7a of the Form 55002017-01-01289
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-01289
2016: KERNODLE CLINIC, INC. GROUP LIFE AND AD&D PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01275
Total number of active participants reported on line 7a of the Form 55002016-01-01280
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-01280
2015: KERNODLE CLINIC, INC. GROUP LIFE AND AD&D PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01260
Total number of active participants reported on line 7a of the Form 55002015-01-01275
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-01275
2014: KERNODLE CLINIC, INC. GROUP LIFE AND AD&D PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01250
Total number of active participants reported on line 7a of the Form 55002014-01-01260
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-01260
2013: KERNODLE CLINIC, INC. GROUP LIFE AND AD&D PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01314
Total number of active participants reported on line 7a of the Form 55002013-01-01250
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-01250
2012: KERNODLE CLINIC, INC. GROUP LIFE AND AD&D PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01301
Total number of active participants reported on line 7a of the Form 55002012-01-01314
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 participants2012-01-01314
2011: KERNODLE CLINIC, INC. GROUP LIFE AND AD&D PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01298
Total number of active participants reported on line 7a of the Form 55002011-01-01301
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 participants2011-01-01301
2010: KERNODLE CLINIC, INC. GROUP LIFE AND AD&D PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-01305
Total number of active participants reported on line 7a of the Form 55002010-01-01298
Number of retired or separated participants receiving benefits2010-01-010
Number of other retired or separated participants entitled to future benefits2010-01-010
Total of all active and inactive participants2010-01-01298
2009: KERNODLE CLINIC, INC. GROUP LIFE AND AD&D PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01300
Total number of active participants reported on line 7a of the Form 55002009-01-01305
Total of all active and inactive participants2009-01-01305

Form 5500 Responses for KERNODLE CLINIC, INC. GROUP LIFE AND AD&D PLAN

2022: KERNODLE CLINIC, INC. GROUP LIFE AND AD&D PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – InsuranceYes
2021: KERNODLE CLINIC, INC. GROUP LIFE AND AD&D PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – InsuranceYes
2020: KERNODLE CLINIC, INC. GROUP LIFE AND AD&D PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – InsuranceYes
2019: KERNODLE CLINIC, INC. GROUP LIFE AND AD&D PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: KERNODLE CLINIC, INC. GROUP LIFE AND AD&D PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: KERNODLE CLINIC, INC. GROUP LIFE AND AD&D PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: KERNODLE CLINIC, INC. GROUP LIFE AND AD&D PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: KERNODLE CLINIC, INC. GROUP LIFE AND AD&D PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: KERNODLE CLINIC, INC. GROUP LIFE AND AD&D PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: KERNODLE CLINIC, INC. GROUP LIFE AND AD&D PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: KERNODLE CLINIC, INC. GROUP LIFE AND AD&D PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: KERNODLE CLINIC, INC. GROUP LIFE AND AD&D PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2010: KERNODLE CLINIC, INC. GROUP LIFE AND AD&D PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – InsuranceYes
2009: KERNODLE CLINIC, INC. GROUP LIFE AND AD&D PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01This submission is the final filingNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX969897
Policy instance 1
Insurance contract or identification numberFLX969897
Number of Individuals Covered343
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $22,085
Total amount of fees paid to insurance companyUSD $5,551
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $108,767
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $22,085
Insurance broker organization code?3
Amount paid for insurance broker fees5551
Additional information about fees paid to insurance brokerMISC FEES
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number5477950
Policy instance 1
Insurance contract or identification number5477950
Number of Individuals Covered346
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $7,805
Total amount of fees paid to insurance companyUSD $5,464
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $84,139
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,805
Additional information about fees paid to insurance brokerMISCELLANEOUS FEES
Insurance broker organization code?3
Amount paid for insurance broker fees5464
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number5477950
Policy instance 1
Insurance contract or identification number5477950
Number of Individuals Covered324
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $7,238
Total amount of fees paid to insurance companyUSD $5,066
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $66,287
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,238
Additional information about fees paid to insurance brokerMISCELLANEOUS FEES
Insurance broker organization code?3
Amount paid for insurance broker fees5066
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number5477950
Policy instance 1
Insurance contract or identification number5477950
Number of Individuals Covered326
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $23,300
Total amount of fees paid to insurance companyUSD $6,007
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $91,898
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $23,300
Additional information about fees paid to insurance brokerMISCELLANEOUS FEES
Insurance broker organization code?3
Amount paid for insurance broker fees6007
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number5477950
Policy instance 1
Insurance contract or identification number5477950
Number of Individuals Covered289
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $1,820
Total amount of fees paid to insurance companyUSD $662
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $14,148
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,820
Insurance broker organization code?3
Amount paid for insurance broker fees662
Insurance broker nameTHE BENEFIT COMPANY, INC.
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number115645
Policy instance 1
Insurance contract or identification number115645
Number of Individuals Covered275
Insurance policy start date2015-01-01
Insurance policy end date2015-12-01
Total amount of commissions paid to insurance brokerUSD $1,584
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $13,812
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,584
Insurance broker organization code?3
Insurance broker nameBB&T INSURANCE SERVICES, INC.
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number5477950
Policy instance 2
Insurance contract or identification number5477950
Number of Individuals Covered275
Insurance policy start date2015-12-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $1,517
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $1,356
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,517
Insurance broker organization code?3
Insurance broker nameBB&T - PBM
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number115645
Policy instance 1
Insurance contract or identification number115645
Number of Individuals Covered260
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $1,527
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $14,301
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,527
Insurance broker nameBB&T INSURANCE SERVICES, INC.
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number115645
Policy instance 1
Insurance contract or identification number115645
Number of Individuals Covered250
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $1,690
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $16,660
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,690
Insurance broker nameBB&T INSURANCE SERVICES, INC.
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number115645
Policy instance 1
Insurance contract or identification number115645
Number of Individuals Covered314
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $2,006
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $20,052
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,006
Insurance broker nameBB&T INSURANCE SERVICES, INC.
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number115645
Policy instance 1
Insurance contract or identification number115645
Number of Individuals Covered301
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $2,051
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $19,385
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number115645
Policy instance 1
Insurance contract or identification number115645
Number of Individuals Covered298
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $1,980
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $18,594
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,980
Insurance broker organization code?3
Insurance broker nameBB&T INSURANCE SERVICES, INC.

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