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PURERED LIFE AND AD&D 401k Plan overview

Plan NamePURERED LIFE AND AD&D
Plan identification number 503

PURERED LIFE AND AD&D Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Other welfare benefit cover

401k Sponsoring company profile

GA COMMUNICATIONS, INC. has sponsored the creation of one or more 401k plans.

Company Name:GA COMMUNICATIONS, INC.
Employer identification number (EIN):582301650
NAIC Classification:541400

Additional information about GA COMMUNICATIONS, INC.

Jurisdiction of Incorporation: Georgia Department of States Corporations Division
Incorporation Date: 1995-04-10
Company Identification Number: 939152
Legal Registered Office Address: 2196 W PARK CT

STONE MOUNTAIN
United States of America (USA)
30087-3528

More information about GA COMMUNICATIONS, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PURERED LIFE AND AD&D

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5032018-11-01
5032017-11-01
5032017-11-01
5032016-11-01DAVID ARNEY
5032016-11-01
5032015-11-01DAVID ARNEY
5032014-10-01DAVID ARNEY
5032013-10-01DAVID ARNEY
5032012-10-01DAVID ARNEY
5032011-10-01DAVID ARNEY
5032010-10-01DAVID ARNEY
5032009-10-01DAVID ARNEY
5032008-11-01DAVID ARNEY
5032007-11-01DAVID ARNEY
5032006-06-01DAVID ARNEY
5032005-06-01DAVID ARNEY
5032004-06-01DAVID ARNEY
5032003-06-01DAVID ARNEY
5032002-06-01DAVID ARNEY

Plan Statistics for PURERED LIFE AND AD&D

401k plan membership statisitcs for PURERED LIFE AND AD&D

Measure Date Value
2018: PURERED LIFE AND AD&D 2018 401k membership
Total participants, beginning-of-year2018-11-01446
Total number of active participants reported on line 7a of the Form 55002018-11-010
Number of retired or separated participants receiving benefits2018-11-010
Number of other retired or separated participants entitled to future benefits2018-11-010
Total of all active and inactive participants2018-11-010
2017: PURERED LIFE AND AD&D 2017 401k membership
Total participants, beginning-of-year2017-11-01469
Total number of active participants reported on line 7a of the Form 55002017-11-01440
Number of retired or separated participants receiving benefits2017-11-010
Number of other retired or separated participants entitled to future benefits2017-11-010
Total of all active and inactive participants2017-11-01440
2016: PURERED LIFE AND AD&D 2016 401k membership
Total participants, beginning-of-year2016-11-01346
Total number of active participants reported on line 7a of the Form 55002016-11-01465
Number of retired or separated participants receiving benefits2016-11-010
Number of other retired or separated participants entitled to future benefits2016-11-010
Total of all active and inactive participants2016-11-01465
2015: PURERED LIFE AND AD&D 2015 401k membership
Total participants, beginning-of-year2015-11-01343
Total number of active participants reported on line 7a of the Form 55002015-11-01346
Number of retired or separated participants receiving benefits2015-11-010
Number of other retired or separated participants entitled to future benefits2015-11-010
Total of all active and inactive participants2015-11-01346
2014: PURERED LIFE AND AD&D 2014 401k membership
Total participants, beginning-of-year2014-10-01376
Total number of active participants reported on line 7a of the Form 55002014-10-01350
Number of retired or separated participants receiving benefits2014-10-010
Number of other retired or separated participants entitled to future benefits2014-10-010
Total of all active and inactive participants2014-10-01350
2013: PURERED LIFE AND AD&D 2013 401k membership
Total participants, beginning-of-year2013-10-01382
Total number of active participants reported on line 7a of the Form 55002013-10-01374
Number of retired or separated participants receiving benefits2013-10-010
Number of other retired or separated participants entitled to future benefits2013-10-010
Total of all active and inactive participants2013-10-01374
2012: PURERED LIFE AND AD&D 2012 401k membership
Total participants, beginning-of-year2012-10-01431
Total number of active participants reported on line 7a of the Form 55002012-10-01390
Number of retired or separated participants receiving benefits2012-10-010
Number of other retired or separated participants entitled to future benefits2012-10-010
Total of all active and inactive participants2012-10-01390
2011: PURERED LIFE AND AD&D 2011 401k membership
Total participants, beginning-of-year2011-10-01415
Total number of active participants reported on line 7a of the Form 55002011-10-01420
Number of retired or separated participants receiving benefits2011-10-010
Number of other retired or separated participants entitled to future benefits2011-10-010
Total of all active and inactive participants2011-10-01420
2010: PURERED LIFE AND AD&D 2010 401k membership
Total participants, beginning-of-year2010-10-01403
Total number of active participants reported on line 7a of the Form 55002010-10-01421
Number of retired or separated participants receiving benefits2010-10-010
Number of other retired or separated participants entitled to future benefits2010-10-010
Total of all active and inactive participants2010-10-01421
2009: PURERED LIFE AND AD&D 2009 401k membership
Total participants, beginning-of-year2009-10-01413
Total number of active participants reported on line 7a of the Form 55002009-10-01404
Number of retired or separated participants receiving benefits2009-10-010
Number of other retired or separated participants entitled to future benefits2009-10-010
Total of all active and inactive participants2009-10-01404
2008: PURERED LIFE AND AD&D 2008 401k membership
Total participants, beginning-of-year2008-11-01341
Total number of active participants reported on line 7a of the Form 55002008-11-01397
Number of retired or separated participants receiving benefits2008-11-010
Number of other retired or separated participants entitled to future benefits2008-11-010
Total of all active and inactive participants2008-11-01397
2007: PURERED LIFE AND AD&D 2007 401k membership
Total participants, beginning-of-year2007-11-01278
Total number of active participants reported on line 7a of the Form 55002007-11-01341
Number of retired or separated participants receiving benefits2007-11-010
Number of other retired or separated participants entitled to future benefits2007-11-010
Total of all active and inactive participants2007-11-01341
2006: PURERED LIFE AND AD&D 2006 401k membership
Total participants, beginning-of-year2006-06-01232
Total number of active participants reported on line 7a of the Form 55002006-06-01253
Number of retired or separated participants receiving benefits2006-06-010
Number of other retired or separated participants entitled to future benefits2006-06-010
Total of all active and inactive participants2006-06-01253
2005: PURERED LIFE AND AD&D 2005 401k membership
Total participants, beginning-of-year2005-06-01217
Total number of active participants reported on line 7a of the Form 55002005-06-01230
Number of retired or separated participants receiving benefits2005-06-010
Number of other retired or separated participants entitled to future benefits2005-06-010
Total of all active and inactive participants2005-06-01230
2004: PURERED LIFE AND AD&D 2004 401k membership
Total participants, beginning-of-year2004-06-01207
Total number of active participants reported on line 7a of the Form 55002004-06-01217
Number of retired or separated participants receiving benefits2004-06-010
Number of other retired or separated participants entitled to future benefits2004-06-010
Total of all active and inactive participants2004-06-01217
2003: PURERED LIFE AND AD&D 2003 401k membership
Total participants, beginning-of-year2003-06-01189
Total number of active participants reported on line 7a of the Form 55002003-06-01197
Number of retired or separated participants receiving benefits2003-06-010
Number of other retired or separated participants entitled to future benefits2003-06-010
Total of all active and inactive participants2003-06-01197
2002: PURERED LIFE AND AD&D 2002 401k membership
Total participants, beginning-of-year2002-06-01190
Total number of active participants reported on line 7a of the Form 55002002-06-01188
Number of retired or separated participants receiving benefits2002-06-010
Number of other retired or separated participants entitled to future benefits2002-06-010
Total of all active and inactive participants2002-06-01188

Form 5500 Responses for PURERED LIFE AND AD&D

2018: PURERED LIFE AND AD&D 2018 form 5500 responses
2018-11-01Type of plan entitySingle employer plan
2018-11-01Submission has been amendedNo
2018-11-01This submission is the final filingYes
2018-11-01This return/report is a short plan year return/report (less than 12 months)Yes
2018-11-01Plan is a collectively bargained planNo
2018-11-01Plan funding arrangement – InsuranceYes
2018-11-01Plan benefit arrangement – InsuranceYes
2017: PURERED LIFE AND AD&D 2017 form 5500 responses
2017-11-01Type of plan entitySingle employer plan
2017-11-01Submission has been amendedNo
2017-11-01This submission is the final filingNo
2017-11-01This return/report is a short plan year return/report (less than 12 months)No
2017-11-01Plan is a collectively bargained planNo
2017-11-01Plan funding arrangement – InsuranceYes
2017-11-01Plan benefit arrangement – InsuranceYes
2016: PURERED LIFE AND AD&D 2016 form 5500 responses
2016-11-01Type of plan entitySingle employer plan
2016-11-01Submission has been amendedNo
2016-11-01This submission is the final filingNo
2016-11-01This return/report is a short plan year return/report (less than 12 months)No
2016-11-01Plan is a collectively bargained planNo
2016-11-01Plan funding arrangement – InsuranceYes
2016-11-01Plan benefit arrangement – InsuranceYes
2015: PURERED LIFE AND AD&D 2015 form 5500 responses
2015-11-01Type of plan entitySingle employer plan
2015-11-01Submission has been amendedNo
2015-11-01This submission is the final filingNo
2015-11-01This return/report is a short plan year return/report (less than 12 months)No
2015-11-01Plan is a collectively bargained planNo
2015-11-01Plan funding arrangement – InsuranceYes
2015-11-01Plan benefit arrangement – InsuranceYes
2014: PURERED LIFE AND AD&D 2014 form 5500 responses
2014-10-01Type of plan entitySingle employer plan
2014-10-01Submission has been amendedNo
2014-10-01This submission is the final filingNo
2014-10-01This return/report is a short plan year return/report (less than 12 months)No
2014-10-01Plan is a collectively bargained planNo
2014-10-01Plan funding arrangement – InsuranceYes
2014-10-01Plan benefit arrangement – InsuranceYes
2013: PURERED LIFE AND AD&D 2013 form 5500 responses
2013-10-01Type of plan entitySingle employer plan
2013-10-01Submission has been amendedNo
2013-10-01This submission is the final filingNo
2013-10-01This return/report is a short plan year return/report (less than 12 months)No
2013-10-01Plan is a collectively bargained planNo
2013-10-01Plan funding arrangement – InsuranceYes
2013-10-01Plan benefit arrangement – InsuranceYes
2012: PURERED LIFE AND AD&D 2012 form 5500 responses
2012-10-01Type of plan entitySingle employer plan
2012-10-01Submission has been amendedNo
2012-10-01This submission is the final filingNo
2012-10-01This return/report is a short plan year return/report (less than 12 months)No
2012-10-01Plan is a collectively bargained planNo
2012-10-01Plan funding arrangement – InsuranceYes
2012-10-01Plan benefit arrangement – InsuranceYes
2011: PURERED LIFE AND AD&D 2011 form 5500 responses
2011-10-01Type of plan entitySingle employer plan
2011-10-01Submission has been amendedNo
2011-10-01This submission is the final filingNo
2011-10-01This return/report is a short plan year return/report (less than 12 months)No
2011-10-01Plan is a collectively bargained planNo
2011-10-01Plan funding arrangement – InsuranceYes
2011-10-01Plan benefit arrangement – InsuranceYes
2010: PURERED LIFE AND AD&D 2010 form 5500 responses
2010-10-01Type of plan entitySingle employer plan
2010-10-01Submission has been amendedNo
2010-10-01This submission is the final filingNo
2010-10-01This return/report is a short plan year return/report (less than 12 months)No
2010-10-01Plan is a collectively bargained planNo
2010-10-01Plan funding arrangement – InsuranceYes
2010-10-01Plan benefit arrangement – InsuranceYes
2009: PURERED LIFE AND AD&D 2009 form 5500 responses
2009-10-01Type of plan entitySingle employer plan
2009-10-01Submission has been amendedNo
2009-10-01This submission is the final filingNo
2009-10-01This return/report is a short plan year return/report (less than 12 months)No
2009-10-01Plan is a collectively bargained planNo
2009-10-01Plan funding arrangement – InsuranceYes
2009-10-01Plan benefit arrangement – InsuranceYes
2008: PURERED LIFE AND AD&D 2008 form 5500 responses
2008-11-01Type of plan entitySingle employer plan
2008-11-01Submission has been amendedNo
2008-11-01This submission is the final filingNo
2008-11-01This return/report is a short plan year return/report (less than 12 months)No
2008-11-01Plan is a collectively bargained planNo
2008-11-01Plan funding arrangement – InsuranceYes
2008-11-01Plan benefit arrangement – InsuranceYes
2007: PURERED LIFE AND AD&D 2007 form 5500 responses
2007-11-01Type of plan entitySingle employer plan
2007-11-01Submission has been amendedNo
2007-11-01This submission is the final filingNo
2007-11-01This return/report is a short plan year return/report (less than 12 months)No
2007-11-01Plan is a collectively bargained planNo
2007-11-01Plan funding arrangement – InsuranceYes
2007-11-01Plan benefit arrangement – InsuranceYes
2006: PURERED LIFE AND AD&D 2006 form 5500 responses
2006-06-01Type of plan entitySingle employer plan
2006-06-01Submission has been amendedNo
2006-06-01This submission is the final filingNo
2006-06-01This return/report is a short plan year return/report (less than 12 months)No
2006-06-01Plan is a collectively bargained planNo
2006-06-01Plan funding arrangement – InsuranceYes
2006-06-01Plan benefit arrangement – InsuranceYes
2005: PURERED LIFE AND AD&D 2005 form 5500 responses
2005-06-01Type of plan entitySingle employer plan
2005-06-01Submission has been amendedNo
2005-06-01This submission is the final filingNo
2005-06-01This return/report is a short plan year return/report (less than 12 months)No
2005-06-01Plan is a collectively bargained planNo
2005-06-01Plan funding arrangement – InsuranceYes
2005-06-01Plan benefit arrangement – InsuranceYes
2004: PURERED LIFE AND AD&D 2004 form 5500 responses
2004-06-01Type of plan entitySingle employer plan
2004-06-01Submission has been amendedNo
2004-06-01This submission is the final filingNo
2004-06-01This return/report is a short plan year return/report (less than 12 months)No
2004-06-01Plan is a collectively bargained planNo
2004-06-01Plan funding arrangement – InsuranceYes
2004-06-01Plan benefit arrangement – InsuranceYes
2003: PURERED LIFE AND AD&D 2003 form 5500 responses
2003-06-01Type of plan entitySingle employer plan
2003-06-01Submission has been amendedNo
2003-06-01This submission is the final filingNo
2003-06-01This return/report is a short plan year return/report (less than 12 months)No
2003-06-01Plan is a collectively bargained planNo
2003-06-01Plan funding arrangement – InsuranceYes
2003-06-01Plan benefit arrangement – InsuranceYes
2002: PURERED LIFE AND AD&D 2002 form 5500 responses
2002-06-01Type of plan entitySingle employer plan
2002-06-01First time form 5500 has been submittedYes
2002-06-01Submission has been amendedNo
2002-06-01This submission is the final filingNo
2002-06-01This return/report is a short plan year return/report (less than 12 months)No
2002-06-01Plan is a collectively bargained planNo
2002-06-01Plan funding arrangement – InsuranceYes
2002-06-01Plan 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 numberFLX968154
Policy instance 1
Insurance contract or identification numberFLX968154
Number of Individuals Covered540
Insurance policy start date2018-11-01
Insurance policy end date2019-05-31
Total amount of commissions paid to insurance brokerUSD $6,048
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $40,318
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,048
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX968154
Policy instance 1
Insurance contract or identification numberFLX968154
Number of Individuals Covered438
Insurance policy start date2017-11-01
Insurance policy end date2018-10-31
Total amount of commissions paid to insurance brokerUSD $9,211
Total amount of fees paid to insurance companyUSD $778
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $61,410
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG 0284D
Policy instance 1
Insurance contract or identification numberGLUG 0284D
Number of Individuals Covered374
Insurance policy start date2013-10-01
Insurance policy end date2014-09-30
Total amount of commissions paid to insurance brokerUSD $2,753
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $18,354
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,753
Insurance broker organization code?3
Insurance broker nameLANDMARK INSURANCE LLC
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG 0284D
Policy instance 1
Insurance contract or identification numberGLUG 0284D
Number of Individuals Covered390
Insurance policy start date2012-10-01
Insurance policy end date2013-09-30
Total amount of commissions paid to insurance brokerUSD $2,973
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $19,817
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,743
Insurance broker organization code?3
Insurance broker nameLANDMARK INSURANCE LLC
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG 0284D
Policy instance 1
Insurance contract or identification numberGLUG 0284D
Number of Individuals Covered420
Insurance policy start date2011-10-01
Insurance policy end date2012-09-30
Total amount of commissions paid to insurance brokerUSD $2,932
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $19,549
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,932
Insurance broker organization code?3
Insurance broker nameLONNIE R VOGLER
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG 0284D
Policy instance 1
Insurance contract or identification numberGLUG 0284D
Number of Individuals Covered421
Insurance policy start date2010-10-01
Insurance policy end date2011-09-30
Total amount of commissions paid to insurance brokerUSD $2,895
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $19,303
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,895
Insurance broker organization code?3
Insurance broker nameLONNIE R VOGLER
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG 0284D
Policy instance 1
Insurance contract or identification numberGLUG 0284D
Number of Individuals Covered404
Insurance policy start date2009-10-01
Insurance policy end date2010-09-30
Total amount of commissions paid to insurance brokerUSD $2,963
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $19,755
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,963
Insurance broker organization code?3
Insurance broker nameLONNIE R VOGLER
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG 0284D
Policy instance 1
Insurance contract or identification numberGLUG 0284D
Number of Individuals Covered397
Insurance policy start date2008-11-01
Insurance policy end date2009-10-31
Total amount of commissions paid to insurance brokerUSD $2,508
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $16,722
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,508
Insurance broker organization code?3
Insurance broker nameLONNIE R VOLGER
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG 0284D
Policy instance 1
Insurance contract or identification numberGLUG 0284D
Number of Individuals Covered341
Insurance policy start date2007-11-01
Insurance policy end date2008-10-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberP86870-1
Policy instance 1
Insurance contract or identification numberP86870-1
Number of Individuals Covered253
Insurance policy start date2006-06-01
Insurance policy end date2007-05-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberP86870-1
Policy instance 1
Insurance contract or identification numberP86870-1
Number of Individuals Covered230
Insurance policy start date2005-06-01
Insurance policy end date2006-05-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberP86870-1
Policy instance 1
Insurance contract or identification numberP86870-1
Number of Individuals Covered217
Insurance policy start date2004-06-01
Insurance policy end date2005-05-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberP86870-1
Policy instance 1
Insurance contract or identification numberP86870-1
Number of Individuals Covered197
Insurance policy start date2003-06-01
Insurance policy end date2004-05-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberP86870-1
Policy instance 1
Insurance contract or identification numberP86870-1
Number of Individuals Covered188
Insurance policy start date2002-06-01
Insurance policy end date2003-05-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes

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