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DRAKE ENTERPRISES, LTD EMPLOYEES LIFE AND AD&D PLAN 401k Plan overview

Plan NameDRAKE ENTERPRISES, LTD EMPLOYEES LIFE AND AD&D PLAN
Plan identification number 502

DRAKE ENTERPRISES, LTD EMPLOYEES LIFE AND AD&D PLAN Benefits

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

401k Sponsoring company profile

DRAKE SOFTWARE LLC has sponsored the creation of one or more 401k plans.

Company Name:DRAKE SOFTWARE LLC
Employer identification number (EIN):561494243
NAIC Classification:541511
NAIC Description:Custom Computer Programming Services

Additional information about DRAKE SOFTWARE LLC

Jurisdiction of Incorporation: North Carolina Secretary of State
Incorporation Date:
Company Identification Number: 0175704

More information about DRAKE SOFTWARE LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan DRAKE ENTERPRISES, LTD EMPLOYEES LIFE AND AD&D PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022022-01-01MIKE MCFERRIN2023-10-11
5022021-01-01MIKE MCFERRIN2022-10-11
5022020-01-01PAUL MARTIN2021-09-27
5022019-01-01PAUL MARTIN2020-10-07
5022018-01-01PAUL MARTIN2019-07-17
5022017-01-01
5022016-01-01
5022015-01-01
5022014-01-01
5022013-01-01
5022012-01-01PAUL H. MARTIN
5022011-01-01PAUL H. MARTIN
5022010-01-01PAUL H. MARTIN
5022009-01-01PAUL H. MARTIN

Plan Statistics for DRAKE ENTERPRISES, LTD EMPLOYEES LIFE AND AD&D PLAN

401k plan membership statisitcs for DRAKE ENTERPRISES, LTD EMPLOYEES LIFE AND AD&D PLAN

Measure Date Value
2022: DRAKE ENTERPRISES, LTD EMPLOYEES LIFE AND AD&D PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-0199
Total number of active participants reported on line 7a of the Form 55002022-01-0195
Total of all active and inactive participants2022-01-0195
2021: DRAKE ENTERPRISES, LTD EMPLOYEES LIFE AND AD&D PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01675
Total number of active participants reported on line 7a of the Form 55002021-01-0199
Total of all active and inactive participants2021-01-0199
2020: DRAKE ENTERPRISES, LTD EMPLOYEES LIFE AND AD&D PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01684
Total number of active participants reported on line 7a of the Form 55002020-01-01675
Total of all active and inactive participants2020-01-01675
2019: DRAKE ENTERPRISES, LTD EMPLOYEES LIFE AND AD&D PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01632
Total number of active participants reported on line 7a of the Form 55002019-01-01684
Total of all active and inactive participants2019-01-01684
2018: DRAKE ENTERPRISES, LTD EMPLOYEES LIFE AND AD&D PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01619
Total number of active participants reported on line 7a of the Form 55002018-01-01632
Total of all active and inactive participants2018-01-01632
2017: DRAKE ENTERPRISES, LTD EMPLOYEES LIFE AND AD&D PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01638
Total number of active participants reported on line 7a of the Form 55002017-01-01619
Total of all active and inactive participants2017-01-01619
2016: DRAKE ENTERPRISES, LTD EMPLOYEES LIFE AND AD&D PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01664
Total number of active participants reported on line 7a of the Form 55002016-01-01638
Total of all active and inactive participants2016-01-01638
Total participants2016-01-01638
2015: DRAKE ENTERPRISES, LTD EMPLOYEES LIFE AND AD&D PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01408
Total number of active participants reported on line 7a of the Form 55002015-01-01664
Total of all active and inactive participants2015-01-01664
Total participants2015-01-01664
2014: DRAKE ENTERPRISES, LTD EMPLOYEES LIFE AND AD&D PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01404
Total number of active participants reported on line 7a of the Form 55002014-01-01408
Total of all active and inactive participants2014-01-01408
Total participants2014-01-01408
2013: DRAKE ENTERPRISES, LTD EMPLOYEES LIFE AND AD&D PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01406
Total number of active participants reported on line 7a of the Form 55002013-01-01404
Total of all active and inactive participants2013-01-01404
2012: DRAKE ENTERPRISES, LTD EMPLOYEES LIFE AND AD&D PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01395
Total number of active participants reported on line 7a of the Form 55002012-01-01406
Total of all active and inactive participants2012-01-01406
2011: DRAKE ENTERPRISES, LTD EMPLOYEES LIFE AND AD&D PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01373
Total number of active participants reported on line 7a of the Form 55002011-01-01395
Total of all active and inactive participants2011-01-01395
2010: DRAKE ENTERPRISES, LTD EMPLOYEES LIFE AND AD&D PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-01353
Total number of active participants reported on line 7a of the Form 55002010-01-01373
Total of all active and inactive participants2010-01-01373
2009: DRAKE ENTERPRISES, LTD EMPLOYEES LIFE AND AD&D PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01330
Total number of active participants reported on line 7a of the Form 55002009-01-01353
Total of all active and inactive participants2009-01-01353

Financial Data on DRAKE ENTERPRISES, LTD EMPLOYEES LIFE AND AD&D PLAN

Measure Date Value
2016 : DRAKE ENTERPRISES, LTD EMPLOYEES LIFE AND AD&D PLAN 2016 401k financial data
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Was this plan covered by a fidelity bond2016-12-31No
If this is an individual account plan, was there a blackout period2016-12-31No
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31No
Was there a failure to transmit to the plan any participant contributions2016-12-31No
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32016-12-31No
Did the plan have assets held for investment2016-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No

Form 5500 Responses for DRAKE ENTERPRISES, LTD EMPLOYEES LIFE AND AD&D PLAN

2022: DRAKE ENTERPRISES, LTD EMPLOYEES 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: DRAKE ENTERPRISES, LTD EMPLOYEES 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: DRAKE ENTERPRISES, LTD EMPLOYEES 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: DRAKE ENTERPRISES, LTD EMPLOYEES 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: DRAKE ENTERPRISES, LTD EMPLOYEES 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: DRAKE ENTERPRISES, LTD EMPLOYEES 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: DRAKE ENTERPRISES, LTD EMPLOYEES 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: DRAKE ENTERPRISES, LTD EMPLOYEES 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: DRAKE ENTERPRISES, LTD EMPLOYEES 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: DRAKE ENTERPRISES, LTD EMPLOYEES 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: DRAKE ENTERPRISES, LTD EMPLOYEES 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: DRAKE ENTERPRISES, LTD EMPLOYEES 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: DRAKE ENTERPRISES, LTD EMPLOYEES 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: DRAKE ENTERPRISES, LTD EMPLOYEES 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

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1153191
Policy instance 1
Insurance contract or identification number1153191
Number of Individuals Covered95
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $24,350
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $141,471
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,076
Insurance broker organization code?3
AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )
Policy contract numberG00618585
Policy instance 1
Insurance contract or identification numberG00618585
Number of Individuals Covered99
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $11,577
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $96,769
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,577
Insurance broker organization code?3
AMERICAN UNITED LIFE INSURANCE (National Association of Insurance Commissioners NAIC id number: 60895 )
Policy contract numberG00618585
Policy instance 1
Insurance contract or identification numberG00618585
Number of Individuals Covered675
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $36,650
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $309,360
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $36,650
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number0009N559
Policy instance 2
Insurance contract or identification number0009N559
Number of Individuals Covered561
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $15,946
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $106,305
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,946
Insurance broker organization code?3
AMERICAN UNITED LIFE INSURANCE (National Association of Insurance Commissioners NAIC id number: 60895 )
Policy contract numberG00618585
Policy instance 1
Insurance contract or identification numberG00618585
Number of Individuals Covered684
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $20,156
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $169,393
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $20,156
Insurance broker organization code?3
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract numberACC
Policy instance 2
Insurance contract or identification numberACC
Number of Individuals Covered326
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $15,108
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $62,007
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,401
Additional information about fees paid to insurance brokerWRITING AGENT
Insurance broker organization code?3
Insurance broker nameDIGITAL INS INC
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract numberCI
Policy instance 3
Insurance contract or identification numberCI
Number of Individuals Covered298
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $27,795
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $114,359
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $22,872
Additional information about fees paid to insurance brokerWRITING AGENT
Insurance broker organization code?3
Insurance broker nameDIGITAL INS INC
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number0009N559
Policy instance 1
Insurance contract or identification number0009N559
Number of Individuals Covered619
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $45,279
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $301,861
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $45,279
Insurance broker nameDIGITAL INS INC
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number0009N559
Policy instance 1
Insurance contract or identification number0009N559
Number of Individuals Covered664
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $39,972
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $266,479
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $39,972
Insurance broker organization code?3
Insurance broker nameDIGITAL INSURANCE, INC.
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL 152095
Policy instance 1
Insurance contract or identification numberGL 152095
Number of Individuals Covered408
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $14,385
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 providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $57,538
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,385
Insurance broker organization code?3
Insurance broker nameDIGITAL INSURANCE, INC.
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberVAR 206044
Policy instance 5
Insurance contract or identification numberVAR 206044
Number of Individuals Covered343
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $2,670
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 providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $10,681
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,670
Insurance broker organization code?3
Insurance broker nameDIGITAL INSURANCE, INC.
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberVPL 301427
Policy instance 4
Insurance contract or identification numberVPL 301427
Number of Individuals Covered188
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $7,045
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 $28,179
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,045
Insurance broker organization code?3
Insurance broker nameDIGITAL INSURANCE, INC.
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL152094
Policy instance 3
Insurance contract or identification numberGL152094
Number of Individuals Covered235
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $20,939
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
Welfare Benefit Premiums Paid to CarrierUSD $83,755
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $20,939
Insurance broker organization code?3
Insurance broker nameDIGITAL INSURANCE, INC.
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberVPS 326397
Policy instance 2
Insurance contract or identification numberVPS 326397
Number of Individuals Covered171
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $15,452
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
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $61,806
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,452
Insurance broker organization code?3
Insurance broker nameDIGITAL INSURANCE, INC.
USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 )
Policy contract number201351201
Policy instance 4
Insurance contract or identification number201351201
Number of Individuals Covered5
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $141
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 providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $502
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $116
Insurance broker organization code?3
Insurance broker nameMOSIAIC GROUP
USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 )
Policy contract number50002479
Policy instance 3
Insurance contract or identification number50002479
Number of Individuals Covered5
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $261
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 $922
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $215
Insurance broker organization code?3
Insurance broker nameMOSIAIC GROUP
USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 )
Policy contract number50002479
Policy instance 2
Insurance contract or identification number50002479
Number of Individuals Covered404
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $12,399
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 providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $44,639
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,153
Insurance broker organization code?3
Insurance broker nameDIGITAL INSURANCE INC
USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 )
Policy contract number50002479
Policy instance 1
Insurance contract or identification number50002479
Number of Individuals Covered404
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $13,982
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 $50,737
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,449
Insurance broker organization code?3
Insurance broker nameDIGITAL INSURANCE INC
USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 )
Policy contract number50002479
Policy instance 1
Insurance contract or identification number50002479
Number of Individuals Covered406
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $16,173
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 $51,903
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,976
Insurance broker organization code?3
Insurance broker nameSAEGIS BENEFTS
USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 )
Policy contract number50002479
Policy instance 2
Insurance contract or identification number50002479
Number of Individuals Covered406
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $10,450
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 providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $44,205
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,727
Insurance broker organization code?3
Insurance broker nameSAEGIS BENEFITS
USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 )
Policy contract number201351201
Policy instance 3
Insurance contract or identification number201351201
Number of Individuals Covered6
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $153
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 $1,045
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $92
Insurance broker organization code?3
Insurance broker nameDORMAN L. STOUT JR.
USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 )
Policy contract number201351201
Policy instance 4
Insurance contract or identification number201351201
Number of Individuals Covered3
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $101
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 providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $797
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $59
Insurance broker organization code?3
Insurance broker nameDORMAN L. STOUT JR.
USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 )
Policy contract number116903
Policy instance 3
Insurance contract or identification number116903
Number of Individuals Covered5
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $292
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 $972
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 )
Policy contract number116903
Policy instance 1
Insurance contract or identification number116903
Number of Individuals Covered389
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $13,245
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 $48,211
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 )
Policy contract number116903
Policy instance 2
Insurance contract or identification number116903
Number of Individuals Covered390
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $9,379
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 providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $41,682
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 )
Policy contract number116903
Policy instance 4
Insurance contract or identification number116903
Number of Individuals Covered5
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $125
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 providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $502
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 number000010055691
Policy instance 2
Insurance contract or identification number000010055691
Number of Individuals Covered371
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $4,230
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 providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $35,246
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,230
Insurance broker organization code?3
Insurance broker nameDORMAN LAMARR STOUT JR.
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10055692
Policy instance 1
Insurance contract or identification number10055692
Number of Individuals Covered373
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $9,700
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 $48,501
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,700
Insurance broker organization code?3
Insurance broker nameDORMAN LAMARR STOUT JR.

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