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PARKDALE AMERICA LLC WELFARE PLAN 401k Plan overview

Plan NamePARKDALE AMERICA LLC WELFARE PLAN
Plan identification number 502

PARKDALE AMERICA LLC WELFARE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Long-term disability cover

401k Sponsoring company profile

PARKDALE AMERICA LLC has sponsored the creation of one or more 401k plans.

Company Name:PARKDALE AMERICA LLC
Employer identification number (EIN):562034095
NAIC Classification:313000
NAIC Description: Textile Mills

Additional information about PARKDALE AMERICA LLC

Jurisdiction of Incorporation: Georgia Department of States Corporations Division
Incorporation Date:
Company Identification Number: 1485702

More information about PARKDALE AMERICA LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PARKDALE AMERICA LLC WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022022-01-01
5022021-01-01
5022020-01-01
5022019-01-01
5022018-01-01
5022017-01-01LISA BEARD
5022016-01-01RACHEL L DOVER
5022015-01-01RACHEL L DOVER
5022014-01-01RACHEL L DOVER
5022013-01-01RACHEL L DOVER
5022012-01-01RACHEL L DOVER
5022011-01-01RACHEL L DOVER
5022009-01-01RACHEL L DOVER

Plan Statistics for PARKDALE AMERICA LLC WELFARE PLAN

401k plan membership statisitcs for PARKDALE AMERICA LLC WELFARE PLAN

Measure Date Value
2022: PARKDALE AMERICA LLC WELFARE PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01596
Total number of active participants reported on line 7a of the Form 55002022-01-01970
Total of all active and inactive participants2022-01-01970
Total participants2022-01-01970
2021: PARKDALE AMERICA LLC WELFARE PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01983
Total number of active participants reported on line 7a of the Form 55002021-01-01596
Total of all active and inactive participants2021-01-01596
Total participants2021-01-01596
2020: PARKDALE AMERICA LLC WELFARE PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-011,004
Total number of active participants reported on line 7a of the Form 55002020-01-01983
Total of all active and inactive participants2020-01-01983
Total participants2020-01-01983
2019: PARKDALE AMERICA LLC WELFARE PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-011,056
Total number of active participants reported on line 7a of the Form 55002019-01-011,004
Total of all active and inactive participants2019-01-011,004
Total participants2019-01-011,004
2018: PARKDALE AMERICA LLC WELFARE PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-011,041
Total number of active participants reported on line 7a of the Form 55002018-01-011,056
Total of all active and inactive participants2018-01-011,056
Total participants2018-01-011,056
2017: PARKDALE AMERICA LLC WELFARE PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-011,216
Total number of active participants reported on line 7a of the Form 55002017-01-011,041
Total of all active and inactive participants2017-01-011,041
Total participants2017-01-011,041
2016: PARKDALE AMERICA LLC WELFARE PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-011,333
Total number of active participants reported on line 7a of the Form 55002016-01-011,216
Total of all active and inactive participants2016-01-011,216
Total participants2016-01-011,216
2015: PARKDALE AMERICA LLC WELFARE PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01979
Total number of active participants reported on line 7a of the Form 55002015-01-011,333
Total of all active and inactive participants2015-01-011,333
Total participants2015-01-010
2014: PARKDALE AMERICA LLC WELFARE PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01880
Total number of active participants reported on line 7a of the Form 55002014-01-01979
Total of all active and inactive participants2014-01-01979
Total participants2014-01-010
2013: PARKDALE AMERICA LLC WELFARE PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-011,028
Total number of active participants reported on line 7a of the Form 55002013-01-01880
Total of all active and inactive participants2013-01-01880
Total participants2013-01-010
2012: PARKDALE AMERICA LLC WELFARE PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-011,217
Total number of active participants reported on line 7a of the Form 55002012-01-011,028
Total of all active and inactive participants2012-01-011,028
Total participants2012-01-010
2011: PARKDALE AMERICA LLC WELFARE PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-011,175
Total number of active participants reported on line 7a of the Form 55002011-01-011,217
Total of all active and inactive participants2011-01-011,217
Total participants2011-01-011,217
2009: PARKDALE AMERICA LLC WELFARE PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01917
Total number of active participants reported on line 7a of the Form 55002009-01-011,279
Total of all active and inactive participants2009-01-011,279
Total participants2009-01-011,279

Form 5500 Responses for PARKDALE AMERICA LLC WELFARE PLAN

2022: PARKDALE AMERICA LLC WELFARE PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: PARKDALE AMERICA LLC WELFARE PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: PARKDALE AMERICA LLC WELFARE PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes
2019: PARKDALE AMERICA LLC WELFARE PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – General assets of the sponsorYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – General assets of the sponsorYes
2018: PARKDALE AMERICA LLC WELFARE PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – General assets of the sponsorYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – General assets of the sponsorYes
2017: PARKDALE AMERICA LLC WELFARE PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – General assets of the sponsorYes
2016: PARKDALE AMERICA LLC WELFARE PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – General assets of the sponsorYes
2015: PARKDALE AMERICA LLC WELFARE PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – General assets of the sponsorYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – General assets of the sponsorYes
2014: PARKDALE AMERICA LLC WELFARE PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – General assets of the sponsorYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – General assets of the sponsorYes
2013: PARKDALE AMERICA LLC WELFARE PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – General assets of the sponsorYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – General assets of the sponsorYes
2012: PARKDALE AMERICA LLC WELFARE PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – General assets of the sponsorYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – General assets of the sponsorYes
2011: PARKDALE AMERICA LLC WELFARE PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – General assets of the sponsorYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – General assets of the sponsorYes
2009: PARKDALE AMERICA LLC WELFARE PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – General assets of the sponsorYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberOK969557
Policy instance 5
Insurance contract or identification numberOK969557
Number of Individuals Covered970
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of fees paid to insurance companyUSD $188
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $10,962
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees167
Additional information about fees paid to insurance brokerSALES & SERVICE
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberVDT962430
Policy instance 4
Insurance contract or identification numberVDT962430
Number of Individuals Covered952
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of fees paid to insurance companyUSD $2,305
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $85,746
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees2046
Additional information about fees paid to insurance brokerSALES & SERVICE
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberLK965486
Policy instance 3
Insurance contract or identification numberLK965486
Number of Individuals Covered456
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of fees paid to insurance companyUSD $2,591
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $173,142
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees2284
Additional information about fees paid to insurance brokerSALES & SERVICE
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX968072
Policy instance 2
Insurance contract or identification numberFLX968072
Number of Individuals Covered970
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of fees paid to insurance companyUSD $4,718
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $297,923
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees4172
Additional information about fees paid to insurance brokerSALES & SERVICE
Insurance broker organization code?3
GRANULAR INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93521 )
Policy contract number445
Policy instance 1
Insurance contract or identification number445
Number of Individuals Covered819
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $32,511
Welfare Benefit Premiums Paid to CarrierUSD $464,440
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $32,511
Insurance broker organization code?3
ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )
Policy contract number10566-01
Policy instance 1
Insurance contract or identification number10566-01
Number of Individuals Covered912
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of fees paid to insurance companyUSD $29,464
Welfare Benefit Premiums Paid to CarrierUSD $321,258
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees26802
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMP
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX968072
Policy instance 2
Insurance contract or identification numberFLX968072
Number of Individuals Covered442
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $4,736
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $249,335
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,736
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberLK965486
Policy instance 3
Insurance contract or identification numberLK965486
Number of Individuals Covered442
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $2,260
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $140,079
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,260
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberVDT962430
Policy instance 4
Insurance contract or identification numberVDT962430
Number of Individuals Covered429
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $492
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $79,079
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $492
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberOK969557
Policy instance 5
Insurance contract or identification numberOK969557
Number of Individuals Covered442
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $167
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $9,503
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $167
Insurance broker organization code?3
ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )
Policy contract number10566-00
Policy instance 1
Insurance contract or identification number10566-00
Number of Individuals Covered626
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $15,809
Welfare Benefit Premiums Paid to CarrierUSD $316,175
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,809
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX968072
Policy instance 2
Insurance contract or identification numberFLX968072
Number of Individuals Covered983
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $1,563
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $304,672
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,563
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberLK965486
Policy instance 3
Insurance contract or identification numberLK965486
Number of Individuals Covered470
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $830
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $152,428
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $830
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberVDT962430
Policy instance 4
Insurance contract or identification numberVDT962430
Number of Individuals Covered480
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $698
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $93,080
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $698
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberOK969557
Policy instance 5
Insurance contract or identification numberOK969557
Number of Individuals Covered983
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $58
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $10,248
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $58
Insurance broker organization code?3
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number00629017
Policy instance 6
Insurance contract or identification number00629017
Number of Individuals Covered218
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $50,200
Welfare Benefit Premiums Paid to CarrierUSD $393,060
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $50,200
BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 )
Policy contract number008098
Policy instance 1
Insurance contract or identification number008098
Number of Individuals Covered1004
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Welfare Benefit Premiums Paid to CarrierUSD $352,652
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberVDT962430
Policy instance 4
Insurance contract or identification numberVDT962430
Number of Individuals Covered572
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of fees paid to insurance companyUSD $2,877
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $148,866
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees2877
Additional information about fees paid to insurance brokerSALES & SERVICE
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberOK969557
Policy instance 5
Insurance contract or identification numberOK969557
Number of Individuals Covered1141
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of fees paid to insurance companyUSD $220
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $11,903
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees220
Additional information about fees paid to insurance brokerSALES & SERVICE
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberLK965486
Policy instance 3
Insurance contract or identification numberLK965486
Number of Individuals Covered566
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of fees paid to insurance companyUSD $3,669
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $153,806
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees3669
Additional information about fees paid to insurance brokerSALES & SERVICE
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX968072
Policy instance 2
Insurance contract or identification numberFLX968072
Number of Individuals Covered1141
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of fees paid to insurance companyUSD $6,631
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $340,237
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees6631
Additional information about fees paid to insurance brokerSALES & SERVICE
Insurance broker organization code?3
BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 )
Policy contract number008098
Policy instance 1
Insurance contract or identification number008098
Number of Individuals Covered1594
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Welfare Benefit Premiums Paid to CarrierUSD $333,394
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberVDT962430
Policy instance 4
Insurance contract or identification numberVDT962430
Number of Individuals Covered625
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $6,176
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $124,065
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,176
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberOK969557
Policy instance 5
Insurance contract or identification numberOK969557
Number of Individuals Covered1056
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $413
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $8,273
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $413
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX968072
Policy instance 2
Insurance contract or identification numberFLX968072
Number of Individuals Covered1056
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $13,534
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $261,767
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,534
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberLK965486
Policy instance 3
Insurance contract or identification numberLK965486
Number of Individuals Covered604
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $7,984
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $144,593
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,984
Insurance broker organization code?3
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract numberNX00200
Policy instance 5
Insurance contract or identification numberNX00200
Number of Individuals Covered712
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $10,528
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $153,367
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,875
Insurance broker organization code?3
Insurance broker nameLOCKTON COMPANIES LLC
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract numberNX00100
Policy instance 4
Insurance contract or identification numberNX00100
Number of Individuals Covered659
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $20,294
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $338,240
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,783
Insurance broker organization code?3
Insurance broker nameLOCKTON COMPANIES LLC
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract numberNX00100-50002
Policy instance 3
Insurance contract or identification numberNX00100-50002
Number of Individuals Covered1023
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $18,855
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $271,107
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,226
Insurance broker organization code?3
Insurance broker nameLOCKTON COMPANIES LLC
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract numberNX00100-50001
Policy instance 2
Insurance contract or identification numberNX00100-50001
Number of Individuals Covered1093
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $5,496
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $78,528
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,282
Insurance broker organization code?3
Insurance broker nameLOCKTON COMPANIES LLC
BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 )
Policy contract number008098
Policy instance 1
Insurance contract or identification number008098
Number of Individuals Covered1657
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Welfare Benefit Premiums Paid to CarrierUSD $513,676
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 )
Policy contract number008098
Policy instance 1
Insurance contract or identification number008098
Number of Individuals Covered1333
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Welfare Benefit Premiums Paid to CarrierUSD $527,788
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract numberBV0466-0101
Policy instance 2
Insurance contract or identification numberBV0466-0101
Number of Individuals Covered1352
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $30,536
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $435,882
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $30,536
Insurance broker organization code?3
Insurance broker nameMEMBER RESOURCES INC
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number01-013978-00
Policy instance 3
Insurance contract or identification number01-013978-00
Number of Individuals Covered906
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $42,351
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $591,289
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $42,351
Insurance broker organization code?3
Insurance broker nameMEMBER RESOURCES INC
BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 )
Policy contract number008098
Policy instance 1
Insurance contract or identification number008098
Number of Individuals Covered1614
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Welfare Benefit Premiums Paid to CarrierUSD $289,604
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARLEYSVILLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64327 )
Policy contract numberG002896
Policy instance 2
Insurance contract or identification numberG002896
Number of Individuals Covered916
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $23,711
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $338,728
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $23,711
Insurance broker organization code?3
Insurance broker nameMEMBER RESOURCES INC
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number01-013978-01
Policy instance 3
Insurance contract or identification number01-013978-01
Number of Individuals Covered634
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $28,981
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $403,925
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $28,981
Insurance broker organization code?3
Insurance broker nameMEMBER RESOURCES INC
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number01-013978-01
Policy instance 3
Insurance contract or identification number01-013978-01
Number of Individuals Covered616
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $27,900
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $388,912
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $27,900
Insurance broker organization code?3
Insurance broker nameMEMBER RESOURCES INC
BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 )
Policy contract number008098
Policy instance 1
Insurance contract or identification number008098
Number of Individuals Covered880
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Welfare Benefit Premiums Paid to CarrierUSD $249,795
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARLEYSVILLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64327 )
Policy contract numberG002896
Policy instance 2
Insurance contract or identification numberG002896
Number of Individuals Covered903
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $23,867
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $342,006
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $23,867
Insurance broker organization code?3
Insurance broker nameMEMBER RESOURCES INC
HARLEYSVILLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64327 )
Policy contract numberG002896
Policy instance 2
Insurance contract or identification numberG002896
Number of Individuals Covered1028
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $24,433
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $349,040
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $24,433
Insurance broker organization code?3
Insurance broker nameMEMBER RESOURCES INC
BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 )
Policy contract number008098
Policy instance 3
Insurance contract or identification number008098
Number of Individuals Covered886
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Welfare Benefit Premiums Paid to CarrierUSD $235,151
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number01-013978-01
Policy instance 1
Insurance contract or identification number01-013978-01
Number of Individuals Covered591
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $30,392
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $422,844
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $30,392
Insurance broker organization code?3
Insurance broker nameMEMBER RESOURCES INC
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number01-013978-01
Policy instance 1
Insurance contract or identification number01-013978-01
Number of Individuals Covered724
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $32,966
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $459,587
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 )
Policy contract number008098
Policy instance 3
Insurance contract or identification number008098
Number of Individuals Covered1013
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Welfare Benefit Premiums Paid to CarrierUSD $229,051
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARLEYSVILLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64327 )
Policy contract numberG002896
Policy instance 2
Insurance contract or identification numberG002896
Number of Individuals Covered1217
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $25,775
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $358,091
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARLEYSVILLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64327 )
Policy contract numberG002896
Policy instance 2
Insurance contract or identification numberG002896
Number of Individuals Covered1341
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $28,521
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $403,771
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $28,521
Insurance broker nameMEMBER RESOURCES INC
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number01-013978-01
Policy instance 1
Insurance contract or identification number01-013978-01
Number of Individuals Covered791
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $38,037
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $528,923
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $38,037
Insurance broker nameMEMBER RESOURCES INC
BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 )
Policy contract number008098
Policy instance 3
Insurance contract or identification number008098
Number of Individuals Covered1175
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Welfare Benefit Premiums Paid to CarrierUSD $199,499
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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