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AHC HEALTH BENEFITS PLAN 401k Plan overview

Plan NameAHC HEALTH BENEFITS PLAN
Plan identification number 502

AHC HEALTH BENEFITS 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
  • Other welfare benefit cover

401k Sponsoring company profile

AMERICAN HEALTH COMPANIES LLC has sponsored the creation of one or more 401k plans.

Company Name:AMERICAN HEALTH COMPANIES LLC
Employer identification number (EIN):621191112
NAIC Classification:623000
NAIC Description: Nursing and Residential Care Facilities

Additional information about AMERICAN HEALTH COMPANIES LLC

Jurisdiction of Incorporation: Tennessee Secretary of State Division of Business Services
Incorporation Date:
Company Identification Number: 000138613

More information about AMERICAN HEALTH COMPANIES LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan AHC HEALTH BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022022-01-01JONATHAN COOPER2023-05-17
5022021-01-01JONATHAN COOPER2022-06-29
5022020-01-01
5022019-01-01
5022018-01-01
5022017-01-01
5022017-01-01ANDREW SIMS JONATHAN COOPER2018-10-15
5022016-01-01
5022015-01-01
5022014-01-01GALE ALEXANDER
5022014-01-01
5022013-01-01
5022012-01-01

Plan Statistics for AHC HEALTH BENEFITS PLAN

401k plan membership statisitcs for AHC HEALTH BENEFITS PLAN

Measure Date Value
2022: AHC HEALTH BENEFITS PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-012,493
Total number of active participants reported on line 7a of the Form 55002022-01-012,493
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-012,493
Number of employers contributing to the scheme2022-01-010
2021: AHC HEALTH BENEFITS PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-012,586
Total number of active participants reported on line 7a of the Form 55002021-01-012,493
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-012,493
Number of employers contributing to the scheme2021-01-010
2020: AHC HEALTH BENEFITS PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-012,593
Total number of active participants reported on line 7a of the Form 55002020-01-012,493
Number of retired or separated participants receiving benefits2020-01-0118
Number of other retired or separated participants entitled to future benefits2020-01-0175
Total of all active and inactive participants2020-01-012,586
2019: AHC HEALTH BENEFITS PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-012,275
Total number of active participants reported on line 7a of the Form 55002019-01-011,979
Number of retired or separated participants receiving benefits2019-01-0112
Number of other retired or separated participants entitled to future benefits2019-01-0198
Total of all active and inactive participants2019-01-012,089
2018: AHC HEALTH BENEFITS PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-012,355
Total number of active participants reported on line 7a of the Form 55002018-01-012,368
Number of retired or separated participants receiving benefits2018-01-0112
Number of other retired or separated participants entitled to future benefits2018-01-0125
Total of all active and inactive participants2018-01-012,405
2017: AHC HEALTH BENEFITS PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-011,888
Total number of active participants reported on line 7a of the Form 55002017-01-011,957
Number of retired or separated participants receiving benefits2017-01-010
Total of all active and inactive participants2017-01-011,957
Number of other retired or separated participants entitled to future benefits2017-01-01306
2016: AHC HEALTH BENEFITS PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-011,905
Total number of active participants reported on line 7a of the Form 55002016-01-011,882
Number of retired or separated participants receiving benefits2016-01-016
Total of all active and inactive participants2016-01-011,888
2015: AHC HEALTH BENEFITS PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-012,188
Total number of active participants reported on line 7a of the Form 55002015-01-011,905
Number of retired or separated participants receiving benefits2015-01-015
Total of all active and inactive participants2015-01-011,910
2014: AHC HEALTH BENEFITS PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-012,055
Total number of active participants reported on line 7a of the Form 55002014-01-012,185
Number of retired or separated participants receiving benefits2014-01-013
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-012,188
Total participants2014-01-012,188
2013: AHC HEALTH BENEFITS PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-012,067
Total number of active participants reported on line 7a of the Form 55002013-01-012,035
Number of retired or separated participants receiving benefits2013-01-0120
Total of all active and inactive participants2013-01-012,055
Total participants2013-01-012,055
2012: AHC HEALTH BENEFITS PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-012,083
Total number of active participants reported on line 7a of the Form 55002012-01-012,040
Number of retired or separated participants receiving benefits2012-01-0127
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-012,067
Total participants2012-01-012,067

Financial Data on AHC HEALTH BENEFITS PLAN

Measure Date Value
2019 : AHC HEALTH BENEFITS PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$12,068
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$12,068
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$130,735
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$130,735
Total income from all sources (including contributions)2019-12-31$15,348,616
Total income from all sources (including contributions)2019-12-31$15,348,616
Total loss/gain on sale of assets2019-12-31$0
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$15,120,047
Total of all expenses incurred2019-12-31$15,120,047
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$14,036,992
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$14,036,992
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$15,348,616
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$15,348,616
Value of total assets at end of year2019-12-31$3,880,053
Value of total assets at end of year2019-12-31$3,880,053
Value of total assets at beginning of year2019-12-31$3,770,151
Value of total assets at beginning of year2019-12-31$3,770,151
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$1,083,055
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$1,083,055
Total interest from all sources2019-12-31$0
Total interest from all sources2019-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$500,000
If this is an individual account plan, was there a blackout period2019-12-31No
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$5,608,109
Contributions received from participants2019-12-31$5,608,109
Value of other receiveables (less allowance for doubtful accounts) at end of year2019-12-31$403,302
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-12-31$614,599
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-12-31$614,599
Liabilities. Value of operating payables at end of year2019-12-31$12,068
Liabilities. Value of operating payables at end of year2019-12-31$12,068
Liabilities. Value of operating payables at beginning of year2019-12-31$130,735
Liabilities. Value of operating payables at beginning of year2019-12-31$130,735
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$228,569
Value of net income/loss2019-12-31$228,569
Value of net assets at end of year (total assets less liabilities)2019-12-31$3,867,985
Value of net assets at end of year (total assets less liabilities)2019-12-31$3,867,985
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$3,639,416
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-12-31$3,476,751
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-12-31$3,476,751
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-12-31$3,155,552
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-12-31$3,155,552
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-12-31$3,155,552
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-12-31$3,155,552
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-12-31$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$420,967
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$420,967
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$9,740,507
Contributions received in cash from employer2019-12-31$9,740,507
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$13,616,025
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$13,616,025
Contract administrator fees2019-12-31$1,083,055
Contract administrator fees2019-12-31$1,083,055
Did the plan have assets held for investment2019-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31No
Opinion of an independent qualified public accountant for this plan2019-12-31Unqualified
Opinion of an independent qualified public accountant for this plan2019-12-31Unqualified
Accountancy firm name2019-12-31LBMC, PC
Accountancy firm EIN2019-12-31621199757
2018 : AHC HEALTH BENEFITS PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets2018-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$130,735
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total income from all sources (including contributions)2018-12-31$16,371,165
Total loss/gain on sale of assets2018-12-31$0
Total of all expenses incurred2018-12-31$16,024,981
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$14,611,300
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$16,363,857
Value of total assets at end of year2018-12-31$3,770,151
Value of total assets at beginning of year2018-12-31$3,293,232
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$1,413,681
Total interest from all sources2018-12-31$7,308
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$500,000
If this is an individual account plan, was there a blackout period2018-12-31No
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$5,809,054
Value of other receiveables (less allowance for doubtful accounts) at end of year2018-12-31$614,599
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2018-12-31$567,762
Liabilities. Value of operating payables at end of year2018-12-31$130,735
Liabilities. Value of operating payables at beginning of year2018-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$346,184
Value of net assets at end of year (total assets less liabilities)2018-12-31$3,639,416
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$3,293,232
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2018-12-31$3,155,552
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2018-12-31$2,725,470
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2018-12-31$2,725,470
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2018-12-31$7,308
Expenses. Payments to insurance carriers foe the provision of benefits2018-12-31$507,369
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31No
Was there a failure to transmit to the plan any participant contributions2018-12-31No
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Contributions received in cash from employer2018-12-31$10,554,803
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$14,103,931
Contract administrator fees2018-12-31$1,413,681
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32018-12-31No
Did the plan have assets held for investment2018-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31No
Opinion of an independent qualified public accountant for this plan2018-12-31Unqualified
Accountancy firm name2018-12-31LBMC, PC
Accountancy firm EIN2018-12-31621199757
2017 : AHC HEALTH BENEFITS PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$62,040
Total income from all sources (including contributions)2017-12-31$16,936,625
Total loss/gain on sale of assets2017-12-31$0
Total of all expenses incurred2017-12-31$16,507,095
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$15,167,619
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$16,930,549
Value of total assets at end of year2017-12-31$3,293,232
Value of total assets at beginning of year2017-12-31$2,925,742
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$1,339,476
Total interest from all sources2017-12-31$6,076
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$5,000,000
If this is an individual account plan, was there a blackout period2017-12-31No
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$5,863,991
Value of other receiveables (less allowance for doubtful accounts) at end of year2017-12-31$567,762
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2017-12-31$385,256
Liabilities. Value of operating payables at end of year2017-12-31$0
Liabilities. Value of operating payables at beginning of year2017-12-31$62,040
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$429,530
Value of net assets at end of year (total assets less liabilities)2017-12-31$3,293,232
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$2,863,702
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2017-12-31$2,725,470
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2017-12-31$2,540,486
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2017-12-31$2,540,486
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2017-12-31$6,076
Expenses. Payments to insurance carriers foe the provision of benefits2017-12-31$1,149,402
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31No
Was there a failure to transmit to the plan any participant contributions2017-12-31No
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Contributions received in cash from employer2017-12-31$11,066,558
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$14,018,217
Contract administrator fees2017-12-31$1,339,476
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32017-12-31No
Did the plan have assets held for investment2017-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31No
Opinion of an independent qualified public accountant for this plan2017-12-31Unqualified
Accountancy firm name2017-12-31LBMC, PC
Accountancy firm EIN2017-12-31621199757
2016 : AHC HEALTH BENEFITS PLAN 2016 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$62,040
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$129,932
Total income from all sources (including contributions)2016-12-31$15,177,052
Total of all expenses incurred2016-12-31$15,097,035
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$13,795,133
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$15,168,327
Value of total assets at end of year2016-12-31$2,925,742
Value of total assets at beginning of year2016-12-31$2,913,617
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$1,301,902
Total interest from all sources2016-12-31$8,725
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 bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$5,000,000
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
Contributions received from participants2016-12-31$5,233,031
Value of other receiveables (less allowance for doubtful accounts) at end of year2016-12-31$385,256
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2016-12-31$410,323
Liabilities. Value of operating payables at end of year2016-12-31$62,040
Liabilities. Value of operating payables at beginning of year2016-12-31$129,932
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
Value of net income/loss2016-12-31$80,017
Value of net assets at end of year (total assets less liabilities)2016-12-31$2,863,702
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$2,783,685
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
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2016-12-31$2,540,486
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2016-12-31$2,503,294
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2016-12-31$2,503,294
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2016-12-31$8,725
Expenses. Payments to insurance carriers foe the provision of benefits2016-12-31$1,435,040
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
Contributions received in cash from employer2016-12-31$9,935,296
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$12,360,093
Contract administrator fees2016-12-31$1,301,902
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
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31No
Opinion of an independent qualified public accountant for this plan2016-12-31Unqualified
Accountancy firm name2016-12-31LBMC, PC
Accountancy firm EIN2016-12-31621199757
2015 : AHC HEALTH BENEFITS PLAN 2015 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$129,932
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$217,161
Total income from all sources (including contributions)2015-12-31$16,436,117
Total of all expenses incurred2015-12-31$14,936,270
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$13,520,134
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$16,430,260
Value of total assets at end of year2015-12-31$2,913,617
Value of total assets at beginning of year2015-12-31$1,500,999
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$1,416,136
Total interest from all sources2015-12-31$5,857
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Was this plan covered by a fidelity bond2015-12-31No
If this is an individual account plan, was there a blackout period2015-12-31No
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$5,588,889
Value of other receiveables (less allowance for doubtful accounts) at end of year2015-12-31$410,323
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2015-12-31$72,793
Administrative expenses (other) incurred2015-12-31$129,932
Liabilities. Value of operating payables at end of year2015-12-31$129,932
Liabilities. Value of operating payables at beginning of year2015-12-31$217,161
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$1,499,847
Value of net assets at end of year (total assets less liabilities)2015-12-31$2,783,685
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$1,283,838
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2015-12-31$2,503,294
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2015-12-31$1,428,206
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2015-12-31$1,428,206
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2015-12-31$5,857
Expenses. Payments to insurance carriers foe the provision of benefits2015-12-31$1,368,189
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Contributions received in cash from employer2015-12-31$10,841,371
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$12,151,945
Contract administrator fees2015-12-31$1,286,204
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32015-12-31No
Did the plan have assets held for investment2015-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31No
Opinion of an independent qualified public accountant for this plan2015-12-31Unqualified
Accountancy firm name2015-12-31FRASIER, DEAN & HOWARD, PLLC
Accountancy firm EIN2015-12-31621073578
2014 : AHC HEALTH BENEFITS PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets2014-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$0
Total income from all sources (including contributions)2014-12-31$0
Total loss/gain on sale of assets2014-12-31$0
Total of all expenses incurred2014-12-31$0
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$0
Value of total assets at end of year2014-12-31$0
Value of total assets at beginning of year2014-12-31$0
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$0
Total interest from all sources2014-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2014-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Was this plan covered by a fidelity bond2014-12-31No
If this is an individual account plan, was there a blackout period2014-12-31No
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$5,146,516
Participant contributions at end of year2014-12-31$0
Participant contributions at beginning of year2014-12-31$320,495
Value of other receiveables (less allowance for doubtful accounts) at end of year2014-12-31$72,793
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2014-12-31$274,483
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2014-12-31$217,161
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2014-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net income/loss2014-12-31$0
Value of net assets at end of year (total assets less liabilities)2014-12-31$0
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2014-12-31$1,428,206
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2014-12-31$1,196,962
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2014-12-31$1,196,962
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2014-12-31$3,165
Expenses. Payments to insurance carriers foe the provision of benefits2014-12-31$2,354,560
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31No
Was there a failure to transmit to the plan any participant contributions2014-12-31No
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Contributions received in cash from employer2014-12-31$12,844,465
Employer contributions (assets) at end of year2014-12-31$0
Employer contributions (assets) at beginning of year2014-12-31$1,024,700
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$16,062,698
Contract administrator fees2014-12-31$1,109,690
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32014-12-31No
Did the plan have assets held for investment2014-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31Yes
Opinion of an independent qualified public accountant for this plan2014-12-31Disclaimer
Accountancy firm name2014-12-31BDO USA, LLP
Accountancy firm EIN2014-12-31135381590
2013 : AHC HEALTH BENEFITS PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets2013-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$0
Total income from all sources (including contributions)2013-12-31$0
Total loss/gain on sale of assets2013-12-31$0
Total of all expenses incurred2013-12-31$0
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$0
Value of total assets at end of year2013-12-31$0
Value of total assets at beginning of year2013-12-31$0
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$0
Total interest from all sources2013-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2013-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Was this plan covered by a fidelity bond2013-12-31No
If this is an individual account plan, was there a blackout period2013-12-31No
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Contributions received from participants2013-12-31$4,137,704
Participant contributions at end of year2013-12-31$320,495
Value of other receiveables (less allowance for doubtful accounts) at end of year2013-12-31$274,483
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2013-12-31$201,757
Total non interest bearing cash at end of year2013-12-31$0
Total non interest bearing cash at beginning of year2013-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Value of net income/loss2013-12-31$0
Value of net assets at end of year (total assets less liabilities)2013-12-31$0
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2013-12-31$1,196,962
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2013-12-31$2,365,199
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2013-12-31$2,365,199
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2013-12-31$4,837
Expenses. Payments to insurance carriers foe the provision of benefits2013-12-31$1,890,406
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31No
Was there a failure to transmit to the plan any participant contributions2013-12-31No
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Contributions received in cash from employer2013-12-31$12,689,691
Employer contributions (assets) at end of year2013-12-31$1,024,700
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$13,837,646
Contract administrator fees2013-12-31$854,496
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32013-12-31No
Did the plan have assets held for investment2013-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31Yes
Opinion of an independent qualified public accountant for this plan2013-12-31Disclaimer
Accountancy firm name2013-12-31BDO USA, LLP
Accountancy firm EIN2013-12-31135381590
2012 : AHC HEALTH BENEFITS PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets2012-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$0
Total income from all sources (including contributions)2012-12-31$0
Total loss/gain on sale of assets2012-12-31$0
Total of all expenses incurred2012-12-31$0
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$0
Value of total assets at end of year2012-12-31$0
Value of total assets at beginning of year2012-12-31$0
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$0
Total interest from all sources2012-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2012-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Was this plan covered by a fidelity bond2012-12-31No
If this is an individual account plan, was there a blackout period2012-12-31No
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Contributions received from participants2012-12-31$3,914,351
Value of other receiveables (less allowance for doubtful accounts) at end of year2012-12-31$201,757
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2012-12-31$71,214
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Value of net income/loss2012-12-31$0
Value of net assets at end of year (total assets less liabilities)2012-12-31$0
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
Were any leases to which the plan was party in default or uncollectible2012-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2012-12-31$2,365,199
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2012-12-31$2,118,339
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2012-12-31$2,118,339
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2012-12-31$8,145
Expenses. Payments to insurance carriers foe the provision of benefits2012-12-31$2,124,033
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31No
Was there a failure to transmit to the plan any participant contributions2012-12-31No
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Contributions received in cash from employer2012-12-31$12,679,805
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$13,263,623
Contract administrator fees2012-12-31$837,242
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32012-12-31No
Did the plan have assets held for investment2012-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-12-31Yes
Opinion of an independent qualified public accountant for this plan2012-12-31Disclaimer
Accountancy firm name2012-12-31BDO USA, LLP
Accountancy firm EIN2012-12-31135381590

Form 5500 Responses for AHC HEALTH BENEFITS PLAN

2022: AHC HEALTH BENEFITS PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: AHC HEALTH BENEFITS PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: AHC HEALTH BENEFITS PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes
2019: AHC HEALTH BENEFITS PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: AHC HEALTH BENEFITS PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: AHC HEALTH BENEFITS PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan funding arrangement – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2017-01-01Plan benefit arrangement – General assets of the sponsorYes
2016: AHC HEALTH BENEFITS PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: AHC HEALTH BENEFITS PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: AHC HEALTH BENEFITS PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: AHC HEALTH BENEFITS PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: AHC HEALTH BENEFITS PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number905308
Policy instance 1
Insurance contract or identification number905308
Number of Individuals Covered1785
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $26,019
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedSTOP LOSS
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 $421,026
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees26019
Additional information about fees paid to insurance brokerOVERRIDE
Insurance broker organization code?3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number417005412008
Policy instance 1
Insurance contract or identification number417005412008
Number of Individuals Covered1988
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
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 BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedSTOP LOSS
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 $511,333
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract number417004412008
Policy instance 1
Insurance contract or identification number417004412008
Number of Individuals Covered1961
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,150,307
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract number417004412008
Policy instance 1
Insurance contract or identification number417004412008
Number of Individuals Covered1886
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $1,374,444
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE3906328
Policy instance 20
Insurance contract or identification numberE3906328
Number of Individuals Covered19
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $402
Total amount of fees paid to insurance companyUSD $6
Are there contracts with allocated funds for individual policies?No
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 $1,812
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE3906286
Policy instance 19
Insurance contract or identification numberE3906286
Number of Individuals Covered4
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $52
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
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 $248
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE3906377
Policy instance 18
Insurance contract or identification numberE3906377
Number of Individuals Covered26
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $418
Total amount of fees paid to insurance companyUSD $13
Are there contracts with allocated funds for individual policies?No
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 $1,646
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE3906062
Policy instance 17
Insurance contract or identification numberE3906062
Number of Individuals Covered28
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $773
Total amount of fees paid to insurance companyUSD $27
Are there contracts with allocated funds for individual policies?No
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 $3,278
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE3906153
Policy instance 16
Insurance contract or identification numberE3906153
Number of Individuals Covered55
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $1,574
Total amount of fees paid to insurance companyUSD $49
Are there contracts with allocated funds for individual policies?No
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 $10,506
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE3906088
Policy instance 15
Insurance contract or identification numberE3906088
Number of Individuals Covered38
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $538
Total amount of fees paid to insurance companyUSD $41
Are there contracts with allocated funds for individual policies?No
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 $2,369
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE3906294
Policy instance 21
Insurance contract or identification numberE3906294
Number of Individuals Covered25
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $512
Total amount of fees paid to insurance companyUSD $25
Are there contracts with allocated funds for individual policies?No
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 $3,448
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE3906005
Policy instance 22
Insurance contract or identification numberE3906005
Number of Individuals Covered41
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $636
Total amount of fees paid to insurance companyUSD $41
Are there contracts with allocated funds for individual policies?No
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 $2,182
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE3906187
Policy instance 23
Insurance contract or identification numberE3906187
Number of Individuals Covered23
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $581
Total amount of fees paid to insurance companyUSD $22
Are there contracts with allocated funds for individual policies?No
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 $2,406
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE3906344
Policy instance 24
Insurance contract or identification numberE3906344
Number of Individuals Covered14
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $418
Total amount of fees paid to insurance companyUSD $16
Are there contracts with allocated funds for individual policies?No
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 $2,156
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE3906302
Policy instance 25
Insurance contract or identification numberE3906302
Number of Individuals Covered10
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $203
Total amount of fees paid to insurance companyUSD $2
Are there contracts with allocated funds for individual policies?No
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 $1,409
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE3906351
Policy instance 26
Insurance contract or identification numberE3906351
Number of Individuals Covered24
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $377
Total amount of fees paid to insurance companyUSD $12
Are there contracts with allocated funds for individual policies?No
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 $2,487
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE3906310
Policy instance 28
Insurance contract or identification numberE3906310
Number of Individuals Covered23
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare 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 $2,753
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE3906419
Policy instance 27
Insurance contract or identification numberE3906419
Number of Individuals Covered93
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare 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 $6,875
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE3906393
Policy instance 14
Insurance contract or identification numberE3906393
Number of Individuals Covered43
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $1,472
Total amount of fees paid to insurance companyUSD $122
Are there contracts with allocated funds for individual policies?No
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 $5,405
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE3906310
Policy instance 13
Insurance contract or identification numberE3906310
Number of Individuals Covered23
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $599
Total amount of fees paid to insurance companyUSD $10
Are there contracts with allocated funds for individual policies?No
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 $2,753
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE3857778
Policy instance 12
Insurance contract or identification numberE3857778
Number of Individuals Covered70
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $2,591
Total amount of fees paid to insurance companyUSD $68
Are there contracts with allocated funds for individual policies?No
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 $12,403
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number048794200
Policy instance 1
Insurance contract or identification number048794200
Number of Individuals Covered136
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Are there contracts with allocated funds for individual policies?No
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 $11,155
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3337399
Policy instance 2
Insurance contract or identification number3337399
Number of Individuals Covered3458
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $421,432
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 $2,359,782
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE3906195
Policy instance 4
Insurance contract or identification numberE3906195
Number of Individuals Covered37
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $1,914
Total amount of fees paid to insurance companyUSD $101
Are there contracts with allocated funds for individual policies?No
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 $13,452
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE3906203
Policy instance 3
Insurance contract or identification numberE3906203
Number of Individuals Covered33
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $3,109
Total amount of fees paid to insurance companyUSD $94
Are there contracts with allocated funds for individual policies?No
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 $10,919
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE3906237
Policy instance 5
Insurance contract or identification numberE3906237
Number of Individuals Covered22
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $495
Total amount of fees paid to insurance companyUSD $12
Are there contracts with allocated funds for individual policies?No
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 $1,827
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE3906229
Policy instance 6
Insurance contract or identification numberE3906229
Number of Individuals Covered29
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $447
Total amount of fees paid to insurance companyUSD $22
Are there contracts with allocated funds for individual policies?No
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 $1,741
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE3906146
Policy instance 7
Insurance contract or identification numberE3906146
Number of Individuals Covered52
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $1,395
Total amount of fees paid to insurance companyUSD $24
Are there contracts with allocated funds for individual policies?No
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 $8,495
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE3906104
Policy instance 8
Insurance contract or identification numberE3906104
Number of Individuals Covered24
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $406
Total amount of fees paid to insurance companyUSD $8
Are there contracts with allocated funds for individual policies?No
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 $2,382
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE3930104
Policy instance 9
Insurance contract or identification numberE3930104
Number of Individuals Covered24
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $2,761
Total amount of fees paid to insurance companyUSD $46
Are there contracts with allocated funds for individual policies?No
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 $2,382
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE3906021
Policy instance 10
Insurance contract or identification numberE3906021
Number of Individuals Covered57
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $972
Total amount of fees paid to insurance companyUSD $17
Are there contracts with allocated funds for individual policies?No
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 $5,109
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE3906419
Policy instance 11
Insurance contract or identification numberE3906419
Number of Individuals Covered93
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $1,511
Total amount of fees paid to insurance companyUSD $77
Are there contracts with allocated funds for individual policies?No
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 $6,875
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract number247003240004
Policy instance 1
Insurance contract or identification number247003240004
Number of Individuals Covered2055
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $226,852
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 $1,889,558
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number247007240004
Policy instance 2
Insurance contract or identification number247007240004
Number of Individuals Covered0
Insurance policy start date2013-02-01
Insurance policy end date2013-12-31
Are there contracts with allocated funds for individual policies?No
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 $289,528
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number217103
Policy instance 3
Insurance contract or identification number217103
Number of Individuals Covered271
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $8,319
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
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 $69,083
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number217102
Policy instance 4
Insurance contract or identification number217102
Number of Individuals Covered10277
Insurance policy start date2013-02-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $46,644
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
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 providedEMPLOYEE BASIC AD&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 $266,356
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number217103
Policy instance 3
Insurance contract or identification number217103
Number of Individuals Covered274
Insurance policy start date2012-02-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $12,281
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
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 $116,498
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number217102
Policy instance 2
Insurance contract or identification number217102
Number of Individuals Covered2046
Insurance policy start date2012-02-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $51,206
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
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 $292,545
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract number247003240004
Policy instance 1
Insurance contract or identification number247003240004
Number of Individuals Covered2057
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $254,884
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 $2,123,358
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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